Anyone who loved physiology, pharmacology, labs, ekgs, etc that went into radiology anyway?

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.

Maybedoc1

Full Member
5+ Year Member
Joined
Dec 28, 2017
Messages
328
Reaction score
379
Soon to be MS4 applying to residency in September. I’ve had a rough time figuring out my specialty but at this point I’ve narrowed it down to IM + subspecialty or radiology I think.

I’ve posted before but I really like the knowledge base of IM, but I kinda hate the day to day of it.

Without writing a personal statement I started gaining interest in radiology during my clinical year (second year for my school). It started with looking at the imaging of some of my patients and then evolved to me reading every imaging report I could and being blown away by the complexity of what the radiologist was saying and how it guided treatment. I still remember a very well known and accomplished trauma surgeon asking an overnight resident whether this patient needed to go to the OR based on what he thought.

I’m finally on a radiology elective now and even though everyone keeps saying “rads is super boring to watch, but great when you’re doing it” I’m still finding myself pretty engaged and fascinated most of the time. In the last two weeks I’ve seen so much cool **** (so many tumor boards, esthesioneuroblastoma, MRA lymphangiography, VHL hemangioastomas in the spinal cord, congenital cardiac imaging, and so much more). I’ve been blown away by the attendings knowledge base not just with anatomy and rare pathology, but with their knowledge of management of diseases too. Things like surgical approaches for elbow fractures, different approaches for imperforate anus. How angioinvasive fungal sinusitis presents and how this subtle finding can clue you in versus this other subtle finding. Super rare diseases I’ve never heard of before, temporal bone anatomy and how x ENT procedure will work or won’t depending on this or that, etc.

Radiology is becoming more and more intriguing to me by the day, but it still feels like a big leap of faith since we don’t really learn much about radiology in med school. Sure we get shown the most obvious pneumothorax in existence on exams, but that’s not what being a radiologist is about. Meanwhile we learn a lot about the nuance of IM in med school. The 18 different causes of hyponatremia. How an elevated creatinine could be ATN, AIN, postrenal, a vasculitis, etc. How an elevated bilirubin could be alk hepatitis, criggler-najar, hepatitis B, autoimmune hepatitis, shock liver, etc. EKGs, murmur characteristics, preload, afterload, pulmonology, immunology, infectious disease, pharmacology, etc.

At this point I don’t care about patient interactions as I could take it or leave it. I just worry about missing labs, physiology, pharmacology, ekgs, etc if I do radiology. If you told me that I would find low sodium interesting prior to med school I would have laughed at you, but I would have never known about this if I wasn’t taught it. Im sure there’s a bunch of radiology things that are super nuanced and interesting too that I haven’t been exposed and could replace physiology and pharmacology for me, but I probably won’t know unless I take a risk and do it.

Was anyone else in a similar position?

Members don't see this ad.
 
I was in your shoes. I chose radiology. No regrets. I can still interpret basic labs and EKGs except for more complex ones which I can relearn if I need to.
 
  • Like
Reactions: 1 users
Similar situation. Rads resident now. No regrets. Both fields (anesthesiology) have their positives and negatives. Rads allows you to avoid a non-compete disrupting your family's life by doing tele for a year or whatever and allows you to live wherever Internet is good enough should location become paramount. These two things are highly risk mitigating factors to your family stability in the current PE hellscape that is medicine.
 
  • Like
Reactions: 1 users
Members don't see this ad :)
First year out of training currently and am really enjoying practice. Absolutely love physiology and pharmacology. In some ways that knowledge aids in my practice, with hepatobililiary imaging a particular example.
 
I’m in nucs administering and interpreting EKGs as part of cardiac nuclear stress tests, infusing theranostics patients, where we have to know a decent amount of medonc and radonc. I’m also in IR where pharmacology and patient interaction exists to whatever degree you want, and I get regular OR exposure, and requires a good amount of gen surg, medical GI, and ICU knowledge (and some minimal msk and gyn). These are both heavy clinical fields, but image interpretation remains a huge part of what I do.

One of the reasons rads is the coolest field ever is because it lets you, very easily, customize what you want to do. Interested in cardiology, but want to do procedures AND get involved with neurology? Cardiac imaging mini fellowship and a 2-year NIR/neurorads fellowship. You’ll be administering coronary CTA exams which requires knowledge of EKG interpretation and arrhythmias, reading cardiac HCM MRIs and MS / brain tumor followup MRIs, participating in neuro onc tumor board, taking stroke call in the evening busting MCA clots, and alternating clinic days seeing carotid stenosis and cerebral AVM referrals and followups. No other specialty gives you this kind of flexibility.

And most importantly, the current job market affords you enormous flexibility where you can relatively easily turn ship at the drop of a dime. Want to do all your scan-reading at home? No problem. Don’t want to do IR anymore and drop back to general tele imaging with no call? Easy. We’re the second most in demand specialty behind family medicine, and while we’re not the BEST paid, our flexibility is well worth the difference and is second to none, by a considerable margin.
 
Last edited:
  • Like
Reactions: 1 user
Soon to be MS4 applying to residency in September. I’ve had a rough time figuring out my specialty but at this point I’ve narrowed it down to IM + subspecialty or radiology I think.

I’ve posted before but I really like the knowledge base of IM, but I kinda hate the day to day of it.

Without writing a personal statement I started gaining interest in radiology during my clinical year (second year for my school). It started with looking at the imaging of some of my patients and then evolved to me reading every imaging report I could and being blown away by the complexity of what the radiologist was saying and how it guided treatment. I still remember a very well known and accomplished trauma surgeon asking an overnight resident whether this patient needed to go to the OR based on what he thought.

I’m finally on a radiology elective now and even though everyone keeps saying “rads is super boring to watch, but great when you’re doing it” I’m still finding myself pretty engaged and fascinated most of the time. In the last two weeks I’ve seen so much cool **** (so many tumor boards, esthesioneuroblastoma, MRA lymphangiography, VHL hemangioastomas in the spinal cord, congenital cardiac imaging, and so much more). I’ve been blown away by the attendings knowledge base not just with anatomy and rare pathology, but with their knowledge of management of diseases too. Things like surgical approaches for elbow fractures, different approaches for imperforate anus. How angioinvasive fungal sinusitis presents and how this subtle finding can clue you in versus this other subtle finding. Super rare diseases I’ve never heard of before, temporal bone anatomy and how x ENT procedure will work or won’t depending on this or that, etc.

Radiology is becoming more and more intriguing to me by the day, but it still feels like a big leap of faith since we don’t really learn much about radiology in med school. Sure we get shown the most obvious pneumothorax in existence on exams, but that’s not what being a radiologist is about. Meanwhile we learn a lot about the nuance of IM in med school. The 18 different causes of hyponatremia. How an elevated creatinine could be ATN, AIN, postrenal, a vasculitis, etc. How an elevated bilirubin could be alk hepatitis, criggler-najar, hepatitis B, autoimmune hepatitis, shock liver, etc. EKGs, murmur characteristics, preload, afterload, pulmonology, immunology, infectious disease, pharmacology, etc.

At this point I don’t care about patient interactions as I could take it or leave it. I just worry about missing labs, physiology, pharmacology, ekgs, etc if I do radiology. If you told me that I would find low sodium interesting prior to med school I would have laughed at you, but I would have never known about this if I wasn’t taught it. Im sure there’s a bunch of radiology things that are super nuanced and interesting too that I haven’t been exposed and could replace physiology and pharmacology for me, but I probably won’t know unless I take a risk and do it.

Was anyone else in a similar position?

In rads you will give up the numbers and lines of labs and EKGs to take on interpretation of higher dimensional data (3D images). You will give up pharmacology in order to learn a wider breadth of diagnoses that spans nearly all other specialties.
 
  • Like
Reactions: 1 users
Loved physiology as a med student. Anatomy? Not so much.

Never wanted to be a flea. Really tried to like anesthesiology, but just couldn't.

Nearly two decades later, I definitely made the right choice with radiology.

Sometimes you just have to do what you like...not what you're supposed to like.
 
  • Like
Reactions: 1 users
Loved physiology as a med student. Anatomy? Not so much.

Never wanted to be a flea. Really tried to like anesthesiology, but just couldn't.

Nearly two decades later, I definitely made the right choice with radiology.

Sometimes you just have to do what you like...not what you're supposed to like.
If you didn't like anatomy then what drew you into radiology?
 
If you didn't like anatomy then what drew you into radiology?
You didn't ask me but I didn't like anatomy that much in med school. It's not related at all to clinical applications of anatomy as it relates to radiology.
 
  • Like
Reactions: 1 users
I loved studying for Step 1. Loved just sitting down and learning a bunch of stuff all day, mostly pathology/physiology/pharmacology. Always thought anatomy was difficult and Rads wasn’t even on my radar since I was deluding myself that I needed to be a conventional clinician/surgeon. But ended up hating clinical rotations as an MS3 and fortunately found Rads. In retrospect after really enjoying my surgery internship I think I just hated the psychological “injury” of feeling useless as a med student yet under contestant evaluation. Really thrived when left to be an actual, functional member of the team who could get **** done, take a 10 minute break every once in a while on my own terms, and then leave when the work was done and not give a crap about anything except caring for the patient.

I love Rads, but that’s partly due to the lifestyle which allows me to take care of the vastly increased personal responsibilities that I didn’t have as a med student or intern (kids, wife, mortgage, aging parents etc).

Most people including myself would be happy in a number of fields. Could see myself being content in Path, Anesthesia, FM, Non-invasive Cards, or gen surg (mostly because of my positive internship experience and knowing you can carve out a nice life after residency).

Everyone overthinks this choice but are fine with the right mindset. If you are drawn to Rads and can see yourself enjoying the day to day at the workstation with the occasional procedure then choose Rads! If you really like clinical medicine then it’s probably not for you. Everything becomes mundane eventually so just try to envision the actual day to day life.
 
  • Like
  • Love
Reactions: 4 users
If you didn't like anatomy then what drew you into radiology?

My reasons have evolved over the years, and I would like to tell some grandiose story about how I fell in love with the field immediately. The truth is that as a medical student it boiled down to some pretty low rungs on Maslow's Hierarchy. I enjoyed the relative minute-by-minute control one can have over his/her life. For the most part, I can eat when I want; I can use the bathroom when I want; stand up; sit down. Hell, back as an MS3 scrubbed into a surgery, the idea of being able to scratch my own ass seemed like a luxury. As compared to elsewhere in a clinic or hospital, the reading room is tranquil, quiet, and controlled.

Now firmly mid career, I appreciate the versatility and flexibility of radiology. I've worked for the federal government, in academia, and in private practice. I've had jobs that were 100% in person and a couple that allowed some work from home. I've had jobs where I hardly did any procedures, to ones where that's all I did all day long regularly. I've practiced true general radiology as well as (almost) exclusively in my subspecialty. Soon, I'll be trying yet another version of radiology: 100% tele work from my basement while running my own LLC.

I've also come to appreciate the relative lack of BS of radiology to a greater degree. I enjoy the fact that, the phone calls and distractions notwithstanding, a large percentage of my time is spent actually interpreting exams. I like that, even after so many years, I still see things that I've never seen before and/or don't have a complete explanation of. And I really like the shift work nature of radiology, meaning that when I'm not working, then I have no obligation to stay tied to a phone or (and I'm dating myself here) a pager.
 
  • Like
  • Love
Reactions: 2 users
I was really interested in physiology in early med school because I enjoyed the mechanistic and logical thought process. I was ambivalent about anatomy, which always just felt like memorizing a long shopping list. Therefore thought I would do IM.

When I got to clinical rotations, I realized the reality of the situation was reversed. Abstract lab value abnormalities in IM were the ones with a shopping list of DDx's (think hyponatremia, hypercalcemia, etc.). Certain medical subspecialties (i.e. cards) still had a very strong link between physiology, disease, and practice. But it was clear that modern medical subspecialty practice would be dominated by various clinical studies/trials (and knowing how to evaluate/apply them), over thought processes about the physiology and disease.

On the other hand, I found that on imaging you could see a lesion, the anatomic & physiologic downstream changes, and make a general conclusion about the Dx and treatment approach. Studies in imaging heavy fields mostly acts to support the practice, rather than define it.

I became drawn towards radiology and certain surgical specialties in my clinical years of medical school. Eventually I concluded that I enjoyed the diagnostic aspect of medicine more than the treatment/procedural aspect, and so decided on radiology.
 
  • Like
Reactions: 2 users
Rads as a med student is a terrible way to determine if you will like it as an attending. I liked it because it was so boring and laid back as a med student but my cohorts didn't. I didn't like anatomy in med school or in rad training but love rads now. Just don't do msk or neuro fellowship and you'll be fine. That said, most people like what they know. I loved studying for step 1, loved learning about medicine but it was because that was all I was doing and I got pretty good at it. Rads was the same thing. Didn't like it at first because I knew less than my peers when first starting rad residency compared to knowing more than my peers the year before in med school/prelim year. After a bit of time it became less bad and now it's great. The best. People learn to love what they perceive themselves to be good at so spend time to be good at radiology and more than likely you will eventually love it more than you loved any other part of medicine. And before any one asks why I went into radiology if I didn't initially like it or anatomy. $$$ and vacation. Cherry on top that I never could have known before is that it's easy to practice. Again, couldn't be happier.
 
  • Like
Reactions: 1 user
Rads as a med student is a terrible way to determine if you will like it as an attending. I liked it because it was so boring and laid back as a med student but my cohorts didn't. I didn't like anatomy in med school or in rad training but love rads now. Just don't do msk or neuro fellowship and you'll be fine. That said, most people like what they know. I loved studying for step 1, loved learning about medicine but it was because that was all I was doing and I got pretty good at it. Rads was the same thing. Didn't like it at first because I knew less than my peers when first starting rad residency compared to knowing more than my peers the year before in med school/prelim year. After a bit of time it became less bad and now it's great. The best. People learn to love what they perceive themselves to be good at so spend time to be good at radiology and more than likely you will eventually love it more than you loved any other part of medicine. And before any one asks why I went into radiology if I didn't initially like it or anatomy. $$$ and vacation. Cherry on top that I never could have known before is that it's easy to practice. Again, couldn't be happier.

Why not neuro or MSK?
 
Rads as a med student is a terrible way to determine if you will like it as an attending. I liked it because it was so boring and laid back as a med student but my cohorts didn't. I didn't like anatomy in med school or in rad training but love rads now. Just don't do msk or neuro fellowship and you'll be fine. That said, most people like what they know. I loved studying for step 1, loved learning about medicine but it was because that was all I was doing and I got pretty good at it. Rads was the same thing. Didn't like it at first because I knew less than my peers when first starting rad residency compared to knowing more than my peers the year before in med school/prelim year. After a bit of time it became less bad and now it's great. The best. People learn to love what they perceive themselves to be good at so spend time to be good at radiology and more than likely you will eventually love it more than you loved any other part of medicine. And before any one asks why I went into radiology if I didn't initially like it or anatomy. $$$ and vacation. Cherry on top that I never could have known before is that it's easy to practice. Again, couldn't be happier.
What’s your subspecialty?
 
What’s your subspecialty?
Breast.

Yes, didn't ever consider neuro or msk because of the anatomy. Caveat being that once you learn the anatomy, it's generally pretty quick to 'relearn' on the fly as needed but I'm a big picture guy who doesn't like to get hung up on the minutiae so those fellowships wouldn't have been good for me anyways.

Cancer, no cancer. That's the job for me.
 
  • Like
Reactions: 1 user
Top