Ask a radiology attending anything

[Jalby]

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Can IR docs still do reads if their procedures dry up? It seems like at my hospital IR docs get all the difficult cases for patients that wouldnt tolerate open procedures or the other proceduralists wouldnt touch.

Sure. That is what they normally do. But a IR Rad who doesn't do anything is just a Rad.

 

[Jalby]

Ah shoot. Thanks for the heads up. Are there any other radiology fellowships that allow you to have patient contact?

Generally speaking, people don't go into Rad for the patient contact. If you go into Mammo you will get to tell a lot of women bad news. But that is about it.

 

[Jalby]

What's up Jalby! What are your top 3 bucket list places to see and travel to in the world before you die?

Wow. I have no idea. I plan on hitting like 50. Right now, I would want to go see the pyramids in Egypt, great barrier reef, and Tora Bora.

 

[Jalby]

What changes do you see in the future of radiology in general?

Do you find your day-to-day work as a physician intellectually stimulating? Do you have opportunities to be involved in research?

I really don't know what the future of radiology is. I can tell you that I don't think computers will ever be able to replace us and that it will never be shipped overseas. I also think that the ability for small practices to have contracts with hospitals is less likely. Outside of that, I don't know.

I don't find it stimulating at all. That's why I am on here and everywhere else. I basically read every ER case that comes in. There are only 150 or so diagnosis that I see and give. No thinking involved at all. I actually like it. Why waste my efforts thinking at work when I don't have to???

I will never ever ever do research again. I hate it.

 

[libertyyne]

Sure. That is what they normally do. But a IR Rad who doesn't do anything is just a Rad.

Considering an IR Rad can always fall back to DR and the PGY years are the same in integrated programs would you still discourage people from going into IR?

How was your residency like? What was your schedule like? Can one have a family life during residency?

Do you share profits in your group above what you get reimbursed per reading ?

Thanks for doing this I am very interested in DR /IR.

 

[iforget2]

Are you always 100% correct on your diagnoses and what would be the consequence if you were incorrect?

 

[hsmooth]

Wow. I have no idea. I plan on hitting like 50. Right now, I would want to go see the pyramids in Egypt, great barrier reef, and Tora Bora.

We just went to the Great Barrier Reef in November. Truly an amazing thing to see and snorkel. Sadly there was lots of parts that were bleached. Get there before it's too late!

 

[bashwell]

Hey @Jalby, I'm a dual American and Australian citizen who studied medicine in Australia, graduated, and am working Australia now (intern/resident). I'll be a US-IMG if I apply to the States for residency. I'm wondering about your research year because I've heard some IMGs may need to do a research year to get into radiology if they can't get in directly by applying. I assume they use the research year to network with the radiology PD or other radiology faculty (and maybe try to publish a poster or paper?) so they can have a better chance to get in -- is that correct? Cheers mate. 🙂

 

[Pablo94]

Hey @Jalby, I recently got accepted to MSUCOM (an osteopathic school) and have 5 MD interviews coming up. If I don't get into any of the MD schools, do you think it is possible for a DO to become a radiologist in a city like Denver or Seattle. Most of my family lives in these cities and I would love to work there. I do not really know what I want to specialize in yet, but radiology seems interesting.

 

[M_NYC]

Hi, can you tell me how you feel about the future of radiology as a specialization in this country?

Do you feel that radiology may be outsourced? Is there a push for outsourcing? Thank you.


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[Jalby]

I am going to be a freshman med student in the fall and I plan on shadowing in interventional radiology, it looks like a great field to fit my interests.

How do you think the lifestyle/hours/pay compare to diagnostic radiology? Radiology seems perfect for me but I do want to have patient interaction

I have no idea what will happen to IR vs normal Rad. Normally IR docs get a 10% bonus over regular rads, but that might change. But due to the fact a lot of the procedures are being lost, IR is getting to be a better life. In my 4 years at a community radiology residency program I never called in the IR doc at night.

 

[Jalby]

I mean in medical school. (I'm a med student already.)

Ohhh... I was about at 80 percentile for my first two years and maybe 75-80 percentile for my last two. I was one person off for making AOA.

 

[Jalby]

Hey @Jalby, I recently got accepted to MSUCOM (an osteopathic school) and have 5 MD interviews coming up. If I don't get into any of the MD schools, do you think it is possible for a DO to become a radiologist in a city like Denver or Seattle. Most of my family lives in these cities and I would love to work there. I do not really know what I want to specialize in yet, but radiology seems interesting.

You can get a teleradiology job and work anywhere. Thats why I love it. I live in my favorite city and that might not be possible if I wasn't doing this.

 

[Jalby]

Hi, can you tell me how you feel about the future of radiology as a specialization in this country?

Do you feel that radiology may be outsourced? Is there a push for outsourcing? Thank you.


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It can't really be outsourced. Medicare won't pay for a study unless you are physically in teh country. Other countries can only do prelim reads. So all outsourcing has to be in country.

 

[Jalby]

Are you always 100% correct on your diagnoses and what would be the consequence if you were incorrect?

I have a q/a error rate of about 0.5%. It rare that I have something that is significant. As of yet, there hasn't been a consequence. I tend to have a better rate than most of the docs, so I'm fine.

 

[Jalby]

Hey @Jalby, I'm a dual American and Australian citizen who studied medicine in Australia, graduated, and am working Australia now (intern/resident). I'll be a US-IMG if I apply to the States for residency. I'm wondering about your research year because I've heard some IMGs may need to do a research year to get into radiology if they can't get in directly by applying. I assume they use the research year to network with the radiology PD or other radiology faculty (and maybe try to publish a poster or paper?) so they can have a better chance to get in -- is that correct? Cheers mate. 🙂

I did a year of research in Orthopedics, so I'm not sure it is relevant. I'm really not sure how it would work for you applying as an IMG. You can probably get a residency spot at Saint Vincents in Bridgeport, CT, if you wanted it.

 

[Gordon Gekko]

You can get a teleradiology job and work anywhere. Thats why I love it. I live in my favorite city and that might not be possible if I wasn't doing this.

Is that for overnight shift? I was hoping to work in rural areas for a bump in pay, but if there's a similar bump for overnight shift near Philly, that would be ideal.


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[Pablo94]

What is teleradiology exactly?

 

[7331poas]

Are you concerned for the impact of AI in the careers of your current residents or prospective premeds on this forum late in their career?

 

[freak7]

Are you concerned for the impact of AI in the careers of your current residents or prospective premeds on this forum late in their career?

I believe that this was answered earlier in the thread and the answer was 'no'

 

[Jalby]

Is that for overnight shift? I was hoping to work in rural areas for a bump in pay, but if there's a similar bump for overnight shift near Philly, that would be ideal.

The bump you get is that you get to work much less hours than everybody else and the studies are easier. So if you get paid by the study, like I do, you can make a good amount if you know how to be efficient. Also I work about 1800 hours a year rather than the 2100 I would do if I was 8 to 5.

 

[Jalby]

What is teleradiology exactly?

I sit at home and read the studies from home and send back the reports.

 

[hydrographer]

I was under the impression that films read outside of the US are reimbursed so long as they're read by a US-trained radiologist. Are you saying it's not possible for a US-trained radiologist to live abroad and do tele-rads?

 

[artist27]

I just read this entire thread and I think I'm in love with @Jalby

 

[Full metal alchemist]

I have the free time. Soooo much free time.

What was one thing you wish you did differently as an undergrad?

 

[DrBowtie]

I was under the impression that films read outside of the US are reimbursed so long as they're read by a US-trained radiologist. Are you saying it's not possible for a US-trained radiologist to live abroad and do tele-rads?

Nope not for final reads. There may be some places still doing US prelims from outside the US but with reimbursement cuts and availability of domestic telerads for finals, this has decreessed.

 

[Jalby]

I was under the impression that films read outside of the US are reimbursed so long as they're read by a US-trained radiologist. Are you saying it's not possible for a US-trained radiologist to live abroad and do tele-rads?

You cannot read Medicare studies, which is about 1/3 of the studies and mixed in. It would be almost impossible to do that.

 

[Jalby]

I just read this entire thread and I think I'm in love with @Jalby

Awww.... Thanks. I've had better threads.

 

[Jalby]

What was one thing you wish you did differently as an undergrad?

I didn't give a crap my first two years and thought I could get by on talent alone. No studying whatsoever. I should have joined a frat so that I could have access to old tests. And I wish I took only the absolute easiest classes possible.

 

[BigBoss]

Can you give us any Step 1 tips that helped you do well?

 

[libertyyne]

How was residency ?
What should one look for in a rads residency?
How baller is your internet connection?
Could one potentially work 3600 hours a year or two to pay off loans once starting as an attending ? I take it income would be linear to the number of studies read in your case.

 

[Gordon Gekko]

When did you feel confident in your film reads? I remember viewing some cxrs while shadowing in the ER and being clueless. I saw a pts enlarged heart on one, but couldn't tell if the attending was messing with me when I told him I couldn't see a fracture he was pointing to on another. Thanks for your time and info.


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[deleted393595]

Apologies if this is a repeat question, but how's the rads job market?



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[Gordon Gekko]

Apologies if this is a repeat question, but how's the rads job market?



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He answered that in #4:

1. The training is. After that, nope
2. I tried to do Orthopedics, but accidently pissed off two of the residents because I knew more than they did and answered every question. Ortho PD told me I would get into a better place than my home program. I ended up not matching. I scrambled into Radiology.
3. Well right now nothing. I get to live in Los Angeles and make a good salary, but I'm lucky. I also realized I'm made for the current form of radiology where you get paid by the study.
4. I have no idea. Jobs are very hard to come by right now. That won't change until the ABR finally stops allowing FMG's to get board certified by doing four years of fellowship. That being said, they can't get jobs at all. I do teleradiology myself so I could work anywhere. I don't think you could find a normal job in NYC or LA easily.

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[chm9332]

First, thank you for doing this. You seem pretty awesome.
How do you kiss a boss's butt?
I don't exactly have the best social skills, and from the sound of it, it seems very important that you make your bosses 'like' you. Is it like doing the coffee runs for your director, helping with personal errands, etc, like pictured in Grey's Anatomy?

 

[deleted393595]

He answered that in #4:



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Thanks Gordon.

@Jalby , if Georgetown offered you to be the next Dean of Admissions, would you take the job?

 

[Jalby]

Can you give us any Step 1 tips that helped you do well?

I started studying for step one the day I arrived at medical school. I looked at the USMLE forums here and asked everybody what their favorite books were in each subject. I purchased those books, and as I was going through the classes I correlated what was taught with those books.

 

[Jalby]

How was residency ?
What should one look for in a rads residency?
How baller is your internet connection?
Could one potentially work 3600 hours a year or two to pay off loans once starting as an attending ? I take it income would be linear to the number of studies read in your case.

1. Uneventful. Radiology residency is easy.
2. Job placement of the people who graduate.
3. 300 mbps download speed. I pay $50 extra a month for it.
4. I did about 2200 hours last year in 200 work days. I don't think I could have done more and remained sane and I don't plan on doing that much again. Enjoy life.

 

[Jalby]

When did you feel confident in your film reads?

I am very confident I am not missing anything important. If I miss a nondisplaced rib fracture it doesn't matter at all. Nobody is going to give a **** about a 1 cm renal cyst.

 

[Jalby]

Apologies if this is a repeat question, but how's the rads job market?

Much better than it was 3 years ago. I'm not sure what changed. When I was finishing fellowship I was the only person who had a job by Jan. Everybody else got them in Feb and had to take what they can get. Now it is different.

 

[Jalby]

First, thank you for doing this. You seem pretty awesome.
How do you kiss a boss's butt?
I don't exactly have the best social skills, and from the sound of it, it seems very important that you make your bosses 'like' you. Is it like doing the coffee runs for your director, helping with personal errands, etc, like pictured in Grey's Anatomy?

You should never ever ever tell your boss no. This is especially important in residency and fellowship. Those bosses get you your next job. Right now, I am indespinsable for my company because I'm the fastest. So I am able to get away with some things others cannot.

And thanks. I try. I have a different sense of humor and it comes in handy in real life. I complained about someone in the office and she sent me an e-mail accusing me of being racist and telling me she was going to report me to HR. I showed it to my African American boss 6 months later and he found it hilarious. He said "Do you know what you can do to prevent this in the future?" I replied "Get myself a black girlfriend (which I have) and reproduce to produce Halfrican Americans so that I am insulated from ever being called racist again?" He said that was one of the funniest things he has heard all year.

 

[libertyyne]

1. Uneventful. Radiology residency is easy.
2. Job placement of the people who graduate.
3. 300 mbps download speed. I pay $50 extra a month for it.
4. I did about 2200 hours last year in 200 work days. I don't think I could have done more and remained sane and I don't plan on doing that much again. Enjoy life.

Is fellowship mandatory to find a job now?

 

[Jalby]

Thanks Gordon.

@Jalby , if Georgetown offered you to be the next Dean of Admissions, would you take the job?

Could I do it from home??? I have people who want me to run for a certain political office but I won't do it because it is a huge paycut. So literally there is almost no job I would be willing to take otherwise. And I think I am doing enough to affect their admin nowadays 🙂

 

[Jalby]

Is fellowship mandatory to find a job now?

Not at this exact moment, but I havn't heard anybody getting a job without one.

 

[libertyyne]

Not at this exact moment, but I havn't heard anybody getting a job without one.

That kinda blows.adds on an additional year.
Thanks for doing this!
Did you have opportunity to moonlight as a resident?
Would you recommend DR to a non traditional med student with a family?

 

[Jalby]

Did you have opportunity to moonlight as a resident?
Would you recommend DR to a non traditional med student with a family?

I made $50 an hour sitting with an MRI.
Absolutely. The lifestule is great.

 

[Gordon Gekko]

I am very confident I am not missing anything important. If I miss a nondisplaced rib fracture it doesn't matter at all. Nobody is going to give a **** about a 1 cm renal cyst.

How about when you became confident in reads? First rads rotation, pgy2, or 3? Have you seen or heard of a resident so bad in terms of reading films that they were dismissed? Thanks.


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[Hopeful1234567]

I started studying for step one the day I arrived at medical school. I looked at the USMLE forums here and asked everybody what their favorite books were in each subject. I purchased those books, and as I was going through the classes I correlated what was taught with those books.

I'm enrolling at a school this summer that schedules step one after 3rd year. By that point, I feel like I'll already have forgotten much of what I learned in pre-clinical years. Do you think in that case it's still worth it to go through USMLE books from day one?

 

[Jalby]

How about when you became confident in reads? First rads rotation, pgy2, or 3? Have you seen or heard of a resident so bad in terms of reading films that they were dismissed? Thanks.

Confident??? I was confident in every single one of my reads from day one. Accurate, on the other hand, not so much. I wouldn't say I felt like I was getting everything I should get until near the end of my first year as an attending. I always thought other people was better than me. It was only when I started working in real life and comparing my misses to other people that I would say I was really confident in my reads.

When I was a fellow there was a resident who couldn't do anything right. Couldn't see anything, couldn't learn how to do a procedure. I basically did all of my procedures and the residents with him. He eventually changed to a different type of residency.

 

[Jalby]

I'm enrolling at a school this summer that schedules step one after 3rd year. By that point, I feel like I'll already have forgotten much of what I learned in pre-clinical years. Do you think in that case it's still worth it to go through USMLE books from day one?

Absolutely. Even for the tests I took in the first year, it was a great source of information for those test. And also when you study from the review books it makes it that much easier to rereview it when you get to study for the test.