Confused about which fellowships to pursue for my future career

[urhiddenncc]

Hello everyone! I’m a radiologist who has been accepted into an alternate pathway radiology fellowship program, which I’m absolutely thrilled about. I plan on doing four fellowships total, and two of those will definitely be Emergency Radiology and Body Imaging, since I see myself primarily practicing those subspecialties in the future. However, I’m somewhat stuck on my remaining two choices. My main confusion lies between Cardiothoracic Radiology and Body MRI—specifically, which pairing (Body Imaging + Cardiothoracic versus Body Imaging + Body MRI) would be most beneficial in both academic and private practice settings. I really enjoy the ILD-focused aspects of Cardiothoracic Radiology, but Body MRI and the chance of contributing to various tumor boards also seem compelling.
Another aspect of my dilemma is choosing between Neuroradiology and Pediatric Radiology to fulfill my ACGME requirement, I loved Neuroradiology during residency and feel pretty comfortable with basic neuro, but I don't really see myself practising as a neuroradiologist in the future and I have almost no experience in Pediatric Radiology (my residency program didn’t have a dedicated pediatric rotation). So I would be grateful if anyone trained in pediatric radiology could shed some insight into the Pediatric Radiology fellowship.

I’d truly appreciate any insights or advice on these fellowship combinations, especially from those who’ve gone through similar pathways or have experience in practicing multiple subspecialties. Thank you in advance!

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[maxxor]

Hello everyone! I’m a radiologist who has been accepted into an alternate pathway radiology fellowship program, which I’m absolutely thrilled about. I plan on doing four fellowships total, and two of those will definitely be Emergency Radiology and Body Imaging, since I see myself primarily practicing those subspecialties in the future. However, I’m somewhat stuck on my remaining two choices. My main confusion lies between Cardiothoracic Radiology and Body MRI—specifically, which pairing (Body Imaging + Cardiothoracic versus Body Imaging + Body MRI) would be most beneficial in both academic and private practice settings. I really enjoy the ILD-focused aspects of Cardiothoracic Radiology, but Body MRI and the chance of contributing to various tumor boards also seem compelling.
Another aspect of my dilemma is choosing between Neuroradiology and Pediatric Radiology to fulfill my ACGME requirement, I loved Neuroradiology during residency and feel pretty comfortable with basic neuro, but I don't really see myself practising as a neuroradiologist in the future and I have almost no experience in Pediatric Radiology (my residency program didn’t have a dedicated pediatric rotation). So I would be grateful if anyone trained in pediatric radiology could shed some insight into the Pediatric Radiology fellowship.

I’d truly appreciate any insights or advice on these fellowship combinations, especially from those who’ve gone through similar pathways or have experience in practicing multiple subspecialties. Thank you in advance!

If you plan on doing significant ER work, I'd argue neuro is the pretty important given the growing liability of H&N CTA.

 

[urhiddenncc]

If you plan on doing significant ER work, I'd argue neuro is the pretty important given the growing liability of H&N CTA.

Ohh ok got it! But wont the fellowship in ER make me competent in stroke work? Atleast i hope so🙄

 

[maxxor]

Ohh ok got it! But wont the fellowship in ER make me competent in stroke work? Atleast i hope so🙄

This depends a lot on the place you go. Some ER fellowships are actually mostly body work as a trainee with Neuro covering the ER stroke stat cases.

 

[urhiddenncc]

This depends a lot on the place you go. Some ER fellowships are actually mostly body work as a trainee with Neuro covering the ER stroke stat cases.

Ok, I understand that makes a lot of sense! Thank you so much🙂

 

[vm26]

Hello everyone! I’m a radiologist who has been accepted into an alternate pathway radiology fellowship program, which I’m absolutely thrilled about. I plan on doing four fellowships total, and two of those will definitely be Emergency Radiology and Body Imaging, since I see myself primarily practicing those subspecialties in the future. However, I’m somewhat stuck on my remaining two choices. My main confusion lies between Cardiothoracic Radiology and Body MRI—specifically, which pairing (Body Imaging + Cardiothoracic versus Body Imaging + Body MRI) would be most beneficial in both academic and private practice settings. I really enjoy the ILD-focused aspects of Cardiothoracic Radiology, but Body MRI and the chance of contributing to various tumor boards also seem compelling.
Another aspect of my dilemma is choosing between Neuroradiology and Pediatric Radiology to fulfill my ACGME requirement, I loved Neuroradiology during residency and feel pretty comfortable with basic neuro, but I don't really see myself practising as a neuroradiologist in the future and I have almost no experience in Pediatric Radiology (my residency program didn’t have a dedicated pediatric rotation). So I would be grateful if anyone trained in pediatric radiology could shed some insight into the Pediatric Radiology fellowship.

I’d truly appreciate any insights or advice on these fellowship combinations, especially from those who’ve gone through similar pathways or have experience in practicing multiple subspecialties. Thank you in advance!

I would drop any body imaging fellowship that did not include sufficient MR since CT/US body is basically general radiology.

If I were in your shoes, from a purely marketable standpoint* I would chose a year of neuro, a year of body (with plenty of MR), a year of MSK, 6 months of breast, and 6 months of light IR.

Peds only if you are looking for academics or very sub specialized job in mega-private practice.

Also stroke work is not super complex: bleed or no bleed, ASPECTS score, CT perfusion exam, and CTA which comes down to +/- LVO

*who knows what the field will look like 4 years from now

 

[urhiddenncc]

I would drop any body imaging fellowship that did not include sufficient MR since CT/US body is basically general radiology.

If I were in your shoes, from a purely marketable standpoint* I would chose a year of neuro, a year of body (with plenty of MR), a year of MSK, 6 months of breast, and 6 months of light IR.

Peds only if you are looking for academics or very sub specialized job in mega-private practice.

Also stroke work is not super complex: bleed or no bleed, ASPECTS score, CT perfusion exam, and CTA which comes down to +/- LVO

*who knows what the field will look like 4 years from now

Ok, body imaging does have at least half a year of MRI, I think, and I don't really want to do breast and MSK. Would a fellowship in body imaging and body MRI be better, or body imaging and cardiothoracic be better from a long-term practice perspective, as I don't really know how the American system works once we pass out. Also, I think I can't change midway what fellowships I can do, so I really appreciate your help! Neuro, I have settled on!

 

[vm26]

Ok, body imaging does have at least half a year of MRI, I think, and I don't really want to do breast and MSK. Would a fellowship in body imaging and body MRI be better, or body imaging and cardiothoracic be better from a long-term practice perspective, as I don't really know how the American system works once we pass out. Also, I think I can't change midway what fellowships I can do, so I really appreciate your help! Neuro, I have settled on!

When you say body imaging I am assuming that includes body MR. So thats one year. Neuro is another year. Cardiothoracic from my perspective (private practice of varying sizes) is not that marketable. Chest is more/less considered general radiology and any high paying cardiac studies are shared with or owned by cardiology. If you want more general radiology than just do ER. A year of IR would be be very marketable if you can deal with this type of work. NM would be good but I think 6 months is sufficient. Suppose this all depends on your long term plans. Do you want to do academics./pseuodo-academics, or private practice?

 

[urhiddenncc]

Ok, thank you so much. I have much more clarity now after your reply. So I am thinking I will do one year ER, one year neuro, one year body imaging (which has 5 month MRI and around 2 IR blocks) and one year of Body MRI (which has full 12 months MRI in all systems cardiac, vascular, abdomen and msk). I see myself doing either academics or, if PP, then a 1 week on 2 week off ER job. What is pseudo-academics btw? I love diagnostic radiology lifestyle too much to do IR, though I really enjoy the procedures and NM, Mammography are just not my cup of tea.

 

[vm26]

Ok, thank you so much. I have much more clarity now after your reply. So I am thinking I will do one year ER, one year neuro, one year body imaging (which has 5 month MRI and around 2 IR blocks) and one year of Body MRI (which has full 12 months MRI in all systems cardiac, vascular, abdomen and msk). I see myself doing either academics or, if PP, then a 1 week on 2 week off ER job. What is pseudo-academics btw? I love diagnostic radiology lifestyle too much to do IR, though I really enjoy the procedures and NM, Mammography are just not my cup of tea.

Happy to help.

Pseudo-academics is like when CCF (Cleveland Clinic) takes over smaller regional community type hospitals and kinda run them like a PP/academic hybrid. Solid compensation, slightly less wRVU demands per year than PP, and depending on case complexity, some subspecialty work.

Your year of "Body MR" seems like a mixed MR fellowship, which is fine but 5 months of body MR is already sufficient so seems a bit redundant. Also if I am interpreting accurately, vascular MR is essentially MRA which is essentially CTA without radiation and without all the other anatomy that happens to get included in the scan. To me this is general radiology unless you are at a large academic center dealing with unusual stuff.

The field and job market are extremely chaotic/volatile right now so hard to make predictions. However if you can nail down where you want to land, things will become clearer for you as to which path to take.

“If a man knows not which port he sails, no wind is favorable.”​

― Seneca