is radiology really a better lifestyle?

[Ganz]

Hi everyone,

I'm currently an MSII, considering Radiology. From what I gather, it appears that Radiology isn't as physically demanding as other specialties (i.e. Surgery). However from some of the other posts that I've read, it seems that Radiology is one of the most intellectually challenging specialties. For instance, as a radiology resident you get to leave the hospital earlier than a surgical resident, but the trade off is that you have to go home and read massive amounts of literature.

First off, is this assumption true? And second, as a practicing radiologist, would I miss out on just as many family functions sitting in my home office reading films, as compared to the surgeon who is always at the hospital?

Thanks

-Ganz

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[RADRULES]

You work a lot in radiology despite what people thing, and have to know your stuff if you want to be good. We take a lot more call these days and put in solid days at work. Yes, there is a lot of reading, but it is MUCH better than the crap you have to do in many clinical specialties.

Radiology reading is interesting and I enjoy it. Trust me, you will never have to read so much that you cannot do plenty of other things you enjoy.

If you are one of those people who can read things once or twice and remember it, you will be a star in radiology.

 

[RADRULES]

It is pretty easy to piss off all those clinicians. In reality it is pretty meaningless what they think of me or radiology. I suppose since I have to be nice to them at work and do all of their stupid exams I can stir up stuff around here.

Reading really is the key to being a good radiologist. I read about 1 hours a day even now. The key is to start early and keep it up over your residency, 4 years from now you will know a hell of a lot and pass your boards with ease. There will be a feeling of pure panic when you start, but remember you can't learn it all in one month or one year. Be cool, don't stress, do your reading and have a good time. We have an awesome job and there is no reason to be miserable.

As for my future.... I have a few PP job offers on the table right now, although I am still fairly commited to doing a Neuro fellowship. One dude out in the country is willing to pay me $450k next year to come out there. Tough to refuse, but I am thinking in the long term a fellowship would be the way to go.

 

[radiojimi]

What stops you from doing a fellowship after a few (or even several) years in private practice?

 

[What the pho]

Originally posted by radiojimi
What stops you from doing a fellowship after a few (or even several) years in private practice?

Yes masta, what stop you from making mad cheddar first then come back to fellowship to make mad cheddar later?
Grasshopper wanto know.

 

[RADRULES]

It would never happen. After several years in private practice you become very used to what you do everyday. You make a lot of money and have an established life and lifestyle.

Most partners (which takes a few years) out there make in the neighborhood of $500k to $800k. I doubt anyone would ever leave to go be a bitch again for $40,000.

I guess if you got really bored you would do it. But, general rads is not that boring to tell you the truth, you do a lot of different modalities and it is interesting work. Of course, you will work very hard for the bank you pull. But, expect 10+ weeks of vacation per year anyways.

Neuro is very cool. Lots of MRI which is a great place to be. I enjoy it and so am probably going to do a fellowship. This way I can read more head MRIs and less CXRs.

 

[What the pho]

Yeah that's what i was thinking your reasoning was, but working for a few years and investing some of that to supplement your income would make being somebodies bitch for 40K alot more barable.

 

[Voxel]

I think your numbers for partners are too high especially on either coast, cali or ne desirable locations. But I agree that it would be very hard to go back and do a fellowship after years in the field. Get the pain over with in one quick shot and then be prepared to learn and study for the rest of your life as new technology and applications emerge. Radiology is not a field for people who do not want to be on the cutting edge and expand their skill set.

 

[johnstoner]

radrulz,

Do you think the radiology salary today will be stable for the forseeable future? Money is not the only factor for my current interest in radiology but it sure is a big motivator...

How many hours/week do you have to work to pull in the 500-800K you mentioned?

I'm trying to decide on radiology, anesthesiology, or orthopedics... I'm looking for the right balance of intellectual challenge, financial compensation, and feeling like I'm actually making a difference in someone's (patient's) life.

 

[RADRULES]

My numbers are based on recent inquires and offers mainly in the south and midwest, specifically Texas. The numbers are certainly lower in NE and Cali. I didn't even look in Cali because they are notorious for underpaying.

As for hours, you work for your money in rads these days. That is why rads who can read fast are golden. Of course, fast and accurate is the best, and those guys can make a small fortune in rads. It is all about volume in the private world. Some people can't handle it and puss out into academia (NOTE: I am not saying all academics are puss, but rather that is where a lot of them end up if they can't hang in PP). The money is very good. Around here you can't find a rad for less than 250k a year starting, 1 to 2 years to partnership, 10-12 weeks vacation. I think this will remain like this for a while, as the demand for imaging studies continues to rise.

Keep in mind, I bitch about idiotic clinicians, but they order all these studies because they lack exams skills and knowledge, thus making us highly valuable.

The fastest and most accurate rads I have worked with were those with a tremendous knowledge of anatomy. If I could do one thing over I would spend more time learning my anatomy cold, and I am talking 3-D. Human anatomy will never change, and can give you the diagnosis if you know where to look.

 

[LovingItAll]

Originally posted by Dr. Cuts
What the hell does that have to do with anything !?

Seriously man I think the further you get in your training the more you'll realize what little impact modern medicine really has on helping people. And HEALING? Forget it man. It's all about treating the symptoms temorarily, only to have the patient return with the same but worse symptoms soon thereafter. Hey, I think I just summed up IM's mission statement with that. Yeah sure some of the surgical specialties save some lives (trauma) or better others (ortho) but do you really want to sacrifice your whole friggin life to them?

Rads baby. Rads.

Damn dude...kinda cynical, aren't you? I've been following your posts for a while, didn't you just *start* your medical training?

You make relieving symptoms sound inconsequential. I know you've been sick before, even if the worst you've had has been a head cold, and so I know you don't really believe that relieving symptoms is as pointless as you are making it sound.

As for sacrificing your life for patients - some people get satisfaction out of helping others. I sure do. If I go into rads, I may not witness the relief some of the patients will experience, but I will get tremendous satisfaction knowing that my work helped contribute to the diagnosis and management of they symptom, no matter how temporary the benefits of the therapy.

Some people *do* need to see it first hand to feel as though their "making a difference." For those people, radiology probably isn't for them...unless maybe they're wise enough to invest some of their 10-12 weeks of vacation to work with underserved populations.

Doctors without borders baby. Doctors without borders.

 

[Airborne]

I recently took a month elective in Rads - to have a look and to see what the field was all about.

Needless to say - it is a great specialty.

There are many times when their opinions matter on the wards - although I will admit that by the time their decisions come down the pathway, the clinical decision has already been made (albeit, this is most often for the less acute cases) - if a line needs to be placed (how many chest cases are about an ET tube?) it has already been adjusted, and need be readjusted, although the Radiologist is reimbursed for EVERY attempt at placement (even though it was attempted - or reattempted - hours ago).

In the trauma sense, they are a definite asset. Then can identify MANY subtle findings in many different modalities - although this comes with a caveat - they must be there to identify these. Sure teleradiology allows them to be at home (in a non-academic setting, I would hope) - but Rad's these days is becoming more and more in house.

In light of their competition from Rad's clearinghouses (ie national telerad's places) and even international domains (ie Nighthawk in Sydney) - I would think that more and more are willing to do what it takes to ensure their own propriety -

If one can hire a US trained Radiologist in Sydney to read images in real-time in the night hours (albeit in their daylight hours) - Why wouldn't the same radiologists agree to stay up late to read daytime images when their exchange rate is near 60c on the $ - ie a $300k salary here is worth $500k there, and the taxes are far less, as you are now out of country - combine that with the benefit of living in a beautiful place?!?!

While I am definitely not a fan of teleradiology - as there is nothing like the insight of going to a seasoned radiologist to REALLY see what is happening within the images of your patient - AND I do realize that there is a projected shortage of radiologists for YEARS to come - I do think that supply leads demand.... Moreover, I have been at several community hospitals (where there is a shortage of Rads) and have been met by outright hostility with the request to go over an image - truly this is NOt beneficial to the "consulting with fellow physician" repoire that the specialty claims to bring forth - In such cases I would have preferred to call a 1-800 number to speak to someone in Sydney to review the case.

Like FP's of today - where NPs, RPA-Cs and the like have either 1) reduced reimbursement and/or 2) mandated more patients per provider (I know, this is really a matter of debate - and one can argue the increasing remuneration of MDAs in the light of CNA vs MDAs - but is this due to the fact that no one would touch a MDA residency for 5-10 years? How about Rad's?) BUT I do think that if it push comes to shove - why couldn't a neurologist / neurosurgeon / ENT interpret a head & neck scan with a 3-6-12 month fellowship in reading this type of modality on top of their own residency? Indeed would one REALLY need to know pelvic ultrasound to do this? Or Chest CXR? Chest CT? Body MRI? Why not an OB/GYN interpreting pevic US - Indeed many OB's albeit MFM trained) do this already...

Sure I acquiese that the seasoned radiologist is definitely a "Jedi" as has been referred to - and I do think that their insight DOES have a very big impact in the management of SOME. However, in the real world of subspecialization - I wonder if reading priviledges will eventually fall upon the non-radiologists.

If so - It may be a rapidly falling world of compensation for the radiologists - as their income depends solely upon their referrals - and their control of the supply.

Although it can be argued that they have their own domain - One could argue that this was said of FPs, Pediatricians and IM docs of a decade ago.

Indeed - would you refer a head CT if you were a neurologist and it paid $300 to interpret (for 5-10 minutes of work) if you could do a 6 month fellowship to read? Currently many, if not most, PP neurologists do a 12 month electrophysiology fellowship for privledges to read these (ie EMGs, EEGs) exams - if the remuneration could be transferred (and indeed, if the demand continues to increase, I would guess it will) - this is not far off in the future.

Food for thought.

At the end of the day - I agree with what the Rads residents (and interns, too, Dr. Cuts!) say - one must ruly enjoy what they do - as the $$$ can fall off quickly... and in the end you are left reading the left overs.

Just ask the CT surgeons. - What happened to their $1M incomes of the 1980's? Oh yes - it went to someone else.

With kind regards,

Airborne

 

[RADRULES]

Those Australian radiologist are all US trained and ABR certified. There is no threat from other US boarded radiologist.

As for specialist reading films, this has been going on for many years and will continue to. This is not a threat to radiology either. If it were that easy to do radiology as a non-radiologist the specialty would have dissolved many years ago.

The truth is that radiology is constantly evolving, and it takes constant effort to stay ahead of a curve. Radiologist control the domain of the cutting edge, not clinicians, because we understang imaging better than anyone else in the hospital. Hell, we have to take a damn medical physics board exam. Trust me, clinicians may get to the point where they can read basic studies, but even so, I have seen many pulmonary folks struggle with CXRs. But, you are not going to see many clinical people reading the CTs and high end MRI.

I would happy to never read another CXR or mammo again, as long as I am reading the CTs, MRs, and PET scans. Radiology has a very biright future with lots of bright people entering the field, it is only going to get better.

 

[Thoinga Thoing]

Dr. Cuts: "....I'm so glad that Radiology exists, o/w after all these years of hard work and sacrifice, I would not have done a residency in any other field -- I would have quit medicine altogether. "


Interesting comment, Dr. Cuts, since you were having mental status changes last year (and pissing in your pants about even matching)--and went to the extent of ranking anesthesia programs as backup on top of the 140 Rads programs you applied to... Curiously enough, when defending yourself regarding said mental status changes, you feebly argued that Rads and Gas were very similar in scope (though they are completely opposite!!!), though the only similarity is lifestyle and complensation....Tsk, Tsk....

 

[Thoinga Thoing]

...good one! That's cuz I was too busy growing out my rockabilly mullet, tweaking my rat-tail mustache, and drag-racing down the suburban streets with my tricked-out 1979 Camaro IROC

Who posts on a Saturday night anyway?

 

[GMO2003]

Those Australian radiologist are all US trained and ABR certified. There is no threat from other US boarded radiologist.

As for specialist reading films, this has been going on for many years and will continue to. This is not a threat to radiology either. If it were that easy to do radiology as a non-radiologist the specialty would have dissolved many years ago.

The truth is that radiology is constantly evolving, and it takes constant effort to stay ahead of a curve. Radiologist control the domain of the cutting edge, not clinicians, because we understang imaging better than anyone else in the hospital. Hell, we have to take a damn medical physics board exam. Trust me, clinicians may get to the point where they can read basic studies, but even so, I have seen many pulmonary folks struggle with CXRs. But, you are not going to see many clinical people reading the CTs and high end MRI.

I would happy to never read another CXR or mammo again, as long as I am reading the CTs, MRs, and PET scans. Radiology has a very biright future with lots of bright people entering the field, it is only going to get better.

I've heard the so called stories of groups buying a timeshare overseas and having partners taking turns reading films via teleradiology...you know have a nice month long vacation at a exotic locale and read films during the day through a T line...what does the future of teleradiology look like?

 

[14022]

Radiology has a very biright future with lots of bright people entering the field, it is only going to get better.

I think this statement is just not true. Yes it is true that a lot of bright people are going into the field as shown by the ridiculously high average step 1 score among successful residency applicants. But in order for these bright people to accelerate the advances in the field, don't they have to go into research? It seems that a lot of people have admitted that money and lifestyle is a significant motivator for pursuing the field. It would be expected that these bright people would head for private practice and get as much work done in as little time as possible in order to enjoy their money and lifestyle. Somebody had implied that many (not all) people in academic radiology are the "pusses" who cannot handle the volume of studies required of a private practive radiologist. If this statement is true, this would suggest that many (not all) of those in academics are on the left side of the bell curve in terms of intelligence.

I would argue that because many are going into private practice, academics and research may not be an interest. This will ultimately hinder the development of advances in the field and possibly make the future of the field less bright than others may anticipate.

Also, there is a limit to the number of people who can be employed in private practice. I would imagine that eventually the private sector will become saturated. Based on simple economics, private groups will not need to pay their employees as much which will cause a drop in the average salary for radiologist.

Also, CT's are much more commonly ordered than the more expensive exams like MRI and PET. Will insurance companies continue to reimburse as well for a CT scan as it continues to emerge as the first-line imaging exam for several conditions? Conversations with GI doctors have indicated that insurance companies no longer reimburse as well for colonoscopies since it has become the screening exam for colon cancer.

Maybe I am way off base here but it seems that it would be difficult for this field to have such a bright future when several other high-paying specialties (eg, orthopedics) from years ago have taken huge hits on their earning potential.

 

[f_w]

- high step1 score = high motivation (not necessarily intelligence or ability).

- The folks going into academic radiology are on the left side of the 'greed' bellcurve, not the 'intelligence' bellcurve. (I probably fall on the right side of the 'greed' curve, the rest of the sentence I leave for others to decide.)

- once in a while, people actually do go back for a rads fellowship after a couple of years in practice. If they have a spouse able to maintain their lifestyle, some don't even take the stipend provided by the fellowship program. And without a spouse to pay the bills: If you are boarded and worked in PP for a couple of years, you can easily make a pediatricians income doing moonlight gigs on weekends and evenings. If your lifestyle expenses grew in proportion to your income, you are headed for financial trouble anyway. (The guys able to retire at 50 drive 10 year old Acuras and live in a nice but reasonable home in the burbs.)

- Reimbursements are dropping, what else is new ?

- (dr cuts will forever be remembered in the world of online radiology chatter for his incredibly mature comment (paraphrased): 'I won't care about this when I read studies in the mobile office on board of my Learjet going to my 3rd home in the caribbean.' I think by now he has realized that this was not such a smart thing to say and sort of apologized once, but why not rub it in another time ?)

 

[GMO2003]

- (dr cuts will forever be remembered in the world of online radiology chatter for his incredibly mature comment (paraphrased): 'I won't care about this when I read studies in the mobile office on board of my Learjet going to my 3rd home in the caribbean.' I think by now he has realized that this was not such a smart thing to say and sort of apologized once, but why not rub it in another time ?)

the guy can dream can't he...besides he seems like he's got the entrepeneurial bug and will use the capital attained from his radiology income and parlay that into much bigger and better things...he's got the right kind of mindset and sounds like a very cool cat to boot...I'd think I'd get along with him real good...

 

[samsoccer7]

the guy can dream can't he...besides he seems like he's got the entrepeneurial bug and will use the capital attained from his radiology income and parlay that into much bigger and better things...he's got the right kind of mindset and sounds like a very cool cat to boot...I'd think I'd get along with him real good...

I agree, Dr. Cuts was very helpful to me when I was trying to decide if radiology is my thing, as well as helping me with application information after I decided it is. A lot of people dream big. I would love to have a private jet and all that stuff, but I think we all realistically know that you have to get lucky in a few business ventures to live that dream. He's just at the far end of the optimism spectrum, nothing wrong with that. He may have apologized slightly, and that should be enough.

 

[MedGeek42]

There's nobody in medicine on the left side of the intelligence bellcurve. Some people are farther to the right than others, but I don't think we have too many genuinely stupid people here. The academic weeding process is just too rigorous.

That said, there are plenty of physicians who lack other, more important traits such as interpersonal skills, common sense, financial judgment...Intelligence is really vastly overrated.

 

[USFOptho]

Dr. Cuts is the man.