Attempting to make a decision on specialty

[kstreet]

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I am posting this in hopes of seeking advice from individuals that may have had to make a similar decision at a similar point in time and are now further along the path. As a 4th year medical student, we must solidify our specialty decision in preparation for the match and I've attempted to come up with pro's and con's with regard to radiology, especially because I also have an interest in a surgical field.

Two things I've noticed have drawn me to radiology, one being the residents/attendings and med students that have been a part of my rotations, and the other the ability to work in a field defined by imaging technology. I hope these are good enough reasons to pursue the field, and if not..do you feel there are better reasons to do so now that you have been a part of the field for a number of years?

A few things that have held me back and one is the daily workflow that I have come to see and read about. The pace of having to read 100-120 studies every day as an attending seems daunting, especially because that may leave little time else during the day to take a breather and reset. Is the workflow truly like this all the time? Does it ever feel like a grind a decade down the line?

The job market also seems to have slowly shifted within the past decade as well. Reading sites like here and AuntMinnie may not be conducive to getting a good picture, but you certainly do not see all other specialty pages making similar complaints about the job market/future of radiology. Are any of the residents/attendings that frequent this site worried at all about attempting to find a job? If one is a solid radiologist that makes consistently good and efficient reads, should that not be enough to find a good job anywhere in the country?

Any advice or suggestions would be appreciated.

 

[shark2000]

I am posting this in hopes of seeking advice from individuals that may have had to make a similar decision at a similar point in time and are now further along the path. As a 4th year medical student, we must solidify our specialty decision in preparation for the match and I've attempted to come up with pro's and con's with regard to radiology, especially because I also have an interest in a surgical field.

Two things I've noticed have drawn me to radiology, one being the residents/attendings and med students that have been a part of my rotations, and the other the ability to work in a field defined by imaging technology. I hope these are good enough reasons to pursue the field, and if not..do you feel there are better reasons to do so now that you have been a part of the field for a number of years?

A few things that have held me back and one is the daily workflow that I have come to see and read about. The pace of having to read 100-120 studies every day as an attending seems daunting, especially because that may leave little time else during the day to take a breather and reset. Is the workflow truly like this all the time? Does it ever feel like a grind a decade down the line?

The job market also seems to have slowly shifted within the past decade as well. Reading sites like here and AuntMinnie may not be conducive to getting a good picture, but you certainly do not see all other specialty pages making similar complaints about the job market/future of radiology. Are any of the residents/attendings that frequent this site worried at all about attempting to find a job? If one is a solid radiologist that makes consistently good and efficient reads, should that not be enough to find a good job anywhere in the country?

Any advice or suggestions would be appreciated.

1- There is a famous statement that "Do what you like". It is a gross stretch as before doing something as a senior resident or even attending, you do not know whether you like it or not. On the other hand, at least you can exclude the fields you hate. For the rest, always take into consideration the worst part of each specialty a and see whether you are OK with it or not.

2-Daily work flow is tough and it is getting tougher as the volume goes up. In summary if you don't like it or at least don't hate DR, you can not last for a long time in pp. On the other hand, you always have the option to choose slower systems like VA or pseudoacademic places. Also 100-120 studies is on lower side for private practice.

3- Job market is tight. Excluding primary care fields, radiology job market is in the middle range among specialists. It is not as grave or as bad as people describe here or in auntminnie. But take into account that only 6 years ago, radiology job market was better than even primary care fields.
Now, it should not be a big decision maker. Let's say job market in .... field is great now and for radiology is bad or mediocre. By the time that you finish training and work which is at least 7 years from now and includes 7-37 years from now which is the average of 15-20 years from now, there is not guarantee that ... field job market is better or even good at all.

4- You last statement is completely wrong. Medicine as a whole is a business. Quality has very very little to do with marketability. It is not only specific to radiology. The most successful surgeon in your town is the one that could get a lot of referrals by advertisement, communication with others and close relation with patients. If you do not have these, even if you are the best in your job, you will not be successful in pp.

At the end, I agree it is very tough to choose a field. Do not be picky. Just choose something that you do not hate and at least enjoy parts of it. You will be fine.

 

[Dr. USMLE]

A few things that have held me back and one is the daily workflow that I have come to see and read about. The pace of having to read 100-120 studies every day as an attending seems daunting, especially because that may leave little time else during the day to take a breather and reset. Is the workflow truly like this all the time? Does it ever feel like a grind a decade down the line?

The thing that people seem to miss is how gigantic the field of radiology truly is...there are so many options (more than any other field) for subspecialty training, practice type, setting, nature of work, case mix, DR/IR mix, full time/part time/locums, etc. etc. etc. If you're really into DR, you can go into msk or neuro. If you later decide you want pt contact, you can go into mammo. If you want procedural (and pt contact), you go IR. The field is wide open really. The only way I see someone being unhappy is if they have poor insight into their own personality or did not do much research before choosing their subspecialty. Otherwise, the field is big enough to accommodate anyone's unique interests. And the research is the best in all of medicine. Rads is the future of medicine...everything will eventually be minimally-invasive. How badass is a field that has modalities so innovative and fundamental that almost all of them won their inventors a nobel prize? That is not true for any other field in medicine! I also predict Paolo Zambini (sp?) will win a nobel in the next 5 years or so for his imaging work. Sam Gambhir's (at stanford) molecular imaging work is absolutely fascinating.

Regarding workflow specifically, there is a lot of process innovation at that level. Voice and vision recognition software is advancing faster than anyone expected. There are already programs developed by microsoft that allow integration of the PACS with the other patient record systems. The workflow by the time I graduate fellowship will be much better (seamless, integrated, instantiated directives, improved voice and vision recognition, etc.).

The job market also seems to have slowly shifted within the past decade as well. Reading sites like here and AuntMinnie may not be conducive to getting a good picture, but you certainly do not see all other specialty pages making similar complaints about the job market/future of radiology. Are any of the residents/attendings that frequent this site worried at all about attempting to find a job? If one is a solid radiologist that makes consistently good and efficient reads, should that not be enough to find a good job anywhere in the country?

The only reason you hear about this a lot is because rads was the hottest field in all of medicine circa 2005. It's only natural for people to complain when they were expecting perfection, especially if they had stats of 260+/junior AOA/pubs/etc. I'm guilty of this, too...in my really cushy TY right now I'm constantly looking for things to b*tch about because I momentarily lose perspective. Just trust me on this...I've studied it quite a bit...do not worry about the job market at all.

 

[colbgw02]

Depending on fellowships, there's a 6-8 year lag between when a rising 4th year medical student chooses radiology and when he or she enters the job market. Rest assured that the market will look different in 2019 than it does now, just as it is vastly different now than it was when the current fellows and senior residents applied. You'll end up chasing your own tail if you worry about the market too much, so do what makes you happy.

 

[shark2000]

I live in one of the desirable coastal cities. All of my classmates who finished their fellowships have found a job. Compared to 6 years ago, when we started here, it is considered bad job.
When I was first year 4-5 years ago, our fellows whom I am friend with many, used to find a well compensated job just a few miles from the nicest neighborhoods with no night calls. Now we find a job, but we have to forget about one of these factors. There are still jobs across the street, but pays less or we have to work much harder and after hours. Or we have to drive an hour or so to find a job that has other desirable factors.
So even now, our job market is considered average compared to many other specialties. Compared to primary care, it is really bad, as is the case for most other specialists. Compared to 6 years ago, job market is bad.
This rapid switch raised a lot of complaints. My fellow resident who started with me, expected her entire residency, an " 8-5 " job close to her house, as she wants to spend more time with her children; something that could be found 6 years ago. Now she has found a job, but it has a lot of after hours and night work. So she complains left and right about how horrible job market is.

 

[Medstudentquest]

I live in one of the desirable coastal cities. All of my classmates who finished their fellowships have found a job. Compared to 6 years ago, when we started here, it is considered bad job.
When I was first year 4-5 years ago, our fellows whom I am friend with many, used to find a well compensated job just a few miles from the nicest neighborhoods with no night calls. Now we find a job, but we have to forget about one of these factors. There are still jobs across the street, but pays less or we have to work much harder and after hours. Or we have to drive an hour or so to find a job that has other desirable factors.
So even now, our job market is considered average compared to many other specialties. Compared to primary care, it is really bad, as is the case for most other specialists. Compared to 6 years ago, job market is bad.
This rapid switch raised a lot of complaints. My fellow resident who started with me, expected her entire residency, an " 8-5 " job close to her house, as she wants to spend more time with her children; something that could be found 6 years ago. Now she has found a job, but it has a lot of after hours and night work. So she complains left and right about how horrible job market is.

I think the question is why is this happening and what's there to do to improve it. It says something concerning if people are having to do several fellowships, driving far, as well as expecting primary care compensation with working after hours in a field like rads. What's causing this shift? Why is the job market so bad? It makes sense that grads would be expecting a decent job with good compensation after 6 years of residency.

 

[naus]

I think the question is why is this happening and what's there to do to improve it. It says something concerning if people are having to do several fellowships, driving far, as well as expecting primary care compensation with working after hours in a field like rads. What's causing this shift? Why is the job market so bad? It makes sense that grads would be expecting a decent job with good compensation after 6 years of residency.

General surgeons after 5 years of intense 80 hr a week residency make about $250k a year in private practice with Q3 call, that would be considered a very bad income and lifestyle for radiologists. Fellowship trained breast surgeons make even less. So I wouldn't say the market for radiologists is "so bad." It's more like the expectations are not meeting reality.

 

[shark2000]

i think the question is why is this happening and what's there to do to improve it. It says something concerning if people are having to do several fellowships, driving far, as well as expecting primary care compensation with working after hours in a field like rads. what's causing this shift? Why is the job market so bad? It makes sense that grads would be expecting a decent job with good compensation after 6 years of residency.

Troll Alert.

DNFTT

 

[Medstudentquest]

Troll Alert.

DNFTT

There is no trolling. Not sure why you would say that? I think the OP is making a very valid point, and I agree with him/her that things are uncertain at this point.