People don't have guts to apply to competitive fields these days

[sillystrings]

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I don't understand why people don't apply to the fields they are interested in just because of board score. Multiple classmates have gone with this approach: Apply to "easier" field and be more likely to get a prestigious match rather than apply to a "harder" field and have to settle in a mid-tier place. It seems like many people are focused on the name of the hospital rather than the actual job they want to do. With that said, where do you draw the line on taking a shot versus being naiive. In my opinion, if you are 225-235 you should follow your dreams, while the the 235-250+ crowd is good to go.

What are your thoughts and do you see this type of thinking at your schools?

 

[Serous Demilune]

I am the exact opposite. I thought med students are supposed to be risk averse. I'm always surprised people are willing to try their luck with derm or a surgical subspecialty. They could be throwing all their hard work away, even with good scores and letters.

 

[Psai]

Because you don't want to have spent four years of your life with a six digit loan and no easy way to repay it

 

[BobbyB]

I don't understand why people don't apply to the fields they are interested in just because of board score. Multiple classmates have gone with this approach: Apply to "easier" field and be more likely to get a prestigious match rather than apply to a "harder" field and have to settle in a mid-tier place. It seems like many people are focused on the name of the hospital rather than the actual job they want to do. With that said, where do you draw the line on taking a shot versus being naiive. In my opinion, if you are 225-235 you should follow your dreams, while the the 235-250+ crowd is good to go.

What are your thoughts and do you see this type of thinking at your schools?

i think people should be free to decide what they want to do. if you care about a prestigious match or location, then you should be allowed to match there.

why should they live their life based on your beliefs?

 

[DrOwnage]

It all depends. Medicine is a dynamic profession. All the people who did derm back in the 80's when no one else wanted to are currently smoking corn cob pipes by the fireplace with a fine glass of brandy. However, some of us are becoming increasingly skeptical of the way medicine will change with federal involvement. If I wasn't 320k in debt after graduation I would be fine with internal medicine because I think that's where my interests lie. Unfortunately, I have to choose a specialty that makes me financially secure and mentally sane that all my hard work has somehow paid off. So yes I would rather chance it. Just think of what people are going to have to deal with in 5-10 years competitive-wise. Even getting into medical school. Why not chance it now, the doors are slowly becoming narrower and narrower (step score average has gone up ~13 points in 5 years).

 

[Hemorrage]

Most medical students these days borrow 60-70k COA (maybe less if they're lucky) in loans a year. This ends up being anywhere from 150k-300k by the time graduation rolls around. Applying based on board score doesn't seem stupid at all, in fact, at that point in your life you're probably more concerned with location and prestige in order to lock down a well paying job and be near loved ones. Now if you're a spartan that can deny yourself most comforts in life, then sure, you probably won't mind being in the middle of no where doing what you love.. but most medical students are logical and pragmatic thinkers.

 

[DermViser]

I don't understand why people don't apply to the fields they are interested in just because of board score. Multiple classmates have gone with this approach: Apply to "easier" field and be more likely to get a prestigious match rather than apply to a "harder" field and have to settle in a mid-tier place. It seems like many people are focused on the name of the hospital rather than the actual job they want to do. With that said, where do you draw the line on taking a shot versus being naiive. In my opinion, if you are 225-235 you should follow your dreams, while the the 235-250+ crowd is good to go.

What are your thoughts and do you see this type of thinking at your schools?

You're right. Apply for a competitive specialty, put all your eggs in one basket, with no backups. Let me know how it turns out. Your statement (bolded) shows you know nothing.

 

[Fluffy Pomeranian]

You're right.Apply for a competitive specialty, put all your eggs in one basket, with no backups. Let me know how it turns out.

Plastic surgery in Beverley Hills or bust, ohhh yeah. #carpediem

 

[DermViser]

Plastic surgery in Beverley Hills or bust, ohhh yeah. #carpediem

 

[pre med 2014]

Follow your dreams #dermbevhills#plasticsNY

 

[Greenberg702]

You're right. Apply for a competitive specialty, put all your eggs in one basket, with no backups. Let me know how it turns out. Your statement (bolded) shows you know nothing.

If you're really really committed to going into a certain field, you should be able to at least scrape by with a 235+ as long as your clinical grades don't suck and you're willing to take a year off to do research and bolster your app.

 

[DermViser]

If you're really really committed to going into a certain field, you should be able to at least scrape by with a 235+ as long as your clinical grades don't suck and you're willing to take a year off to do research and bolster your app.

Even with the best commitment, getting a 235 is not a joke. A lot of things can affect your score on exam day even with the best preparation. Realize that the USMLE Step 1 average is now 228 (almost 230). This isn't 1999 when the average was only 215.

 

[Greenberg702]

Even with the best commitment, getting a 235 is not a joke. A lot of things can affect your score on exam day even with the best preparation. Realize that the USMLE Step 1 average is now 228 (almost 230). This isn't 1999 when the average was only 215.

Oh I'm sure. I thought you and the OP were talking about going for a single competitive specialty after already receiving those scores.

 

[Winged Scapula]

Even with the best commitment..This isn't 1999 when the average was only 215.

LOL...yeah we were stupider back then.

 

[DermViser]

Oh I'm sure. I thought you and the OP were talking about going for a single competitive specialty after already receiving those scores.

After receiving your scores, there are things that can mitigate it: class rank, clinical clerkship grades, USMLE Step 2 CK score, research, etc. It's all putting together puzzle pieces to come up with a picture.

 

[DermViser]

LOL...yeah we were stupider back then.

I was thinking more that the number of test preparation resources back then weren't as much as now. For example, if you ask anyone back then, the main resource they used for Pathology was BRS Path. That was the gold standard. Goljan's Rapid Review and his audios or now the illustrious Pathoma didn't even exist. USMLE World didn't exist for Step 1. NBME self-assessments didn't exist (which then the NBME realized they could fill their coffers by charging for students to see retired USMLE questions).

That being said there are some popular board review resources that have never changed since 1999 (i.e. Physiology/BRS by Linda Costanzo).

Also back then, medical schools were telling their students in the late 90s that if you entered specialty medicine you would be without a job and that primary care was coming of age (due to HMOs). Step 1 scores may not have been the almost "barrier to entry"-like function that they have now. It's nice to know in 15 years, medical schools either lying or giving bad advice is one thing that has never changed, no matter what the tuition.

 

[RJGOP]

LOL...yeah we were stupider back then.

Why is that actually? Is the test just easier, or are the students better taught? What is it?

 

[Greenberg702]

Why is that actually? Is the test just easier, or are the students better taught? What is it?

More savvy prep, increased importance of the test, and better prep materials (as discussed above). Same thing with the MCAT score inflation.

 

[evilbooyaa]

Honestly, depends on the field and how much of an importance step scores are given. I have no interest in derm or plastics, but even if I did, I wouldn't consider applying to them with anything below a 230.

Most people have multiple fields they would be happy in; they decide that they'll take their #2 specialty choice with a guarantee (or near guarantee) of matching instead of a hail mary on their #1 specialty choice.

What I also do not understand is those who would match in their #1 specialty in a mid-tier location, but go for their #2 specialty in a top 5 residency.

All that being said, people put emphasis on different things in life (and in medical school), and I'm not here to judge them on their decisions.

 

[DermViser]

What I also do not understand is those who would match in their #1 specialty in a mid-tier location, but go for their #2 specialty in a top 5 residency.

I don't understand how this is difficult to understand. If your #1 specialty is your top specialty but is very competitive, you're happy just to match. If you're going for #2 specialty which is known to not be as competitive (which you obviously exceed the "barrier-to-entry"), it's only natural that you want to be at a better, possibly more prestigious institution.

 

[DermViser]

It all depends. Medicine is a dynamic profession. All the people who did derm back in the 80's when no one else wanted to are currently smoking corn cob pipes by the fireplace with a fine glass of brandy. However, some of us are becoming increasingly skeptical of the way medicine will change with federal involvement. If I wasn't 320k in debt after graduation I would be fine with internal medicine because I think that's where my interests lie. Unfortunately, I have to choose a specialty that makes me financially secure and mentally sane that all my hard work has somehow paid off. So yes I would rather chance it. Just think of what people are going to have to deal with in 5-10 years competitive-wise. Even getting into medical school. Why not chance it now, the doors are slowly becoming narrower and narrower (step score average has gone up ~13 points in 5 years).

Realize also this was #1 - before the cap on residency positions was in place and #2 - before fee-for-service thru the RVU system was in place. Also that generation's physicians priorities were not at all centered on lifestyle as it is now.

 

[evilbooyaa]

I don't understand how this is difficult to understand. If your #1 specialty is your top specialty but is very competitive, you're happy just to match. If you're going for #2 specialty which is known to not be as competitive (which you obviously exceed the "barrier-to-entry"), it's only natural that you want to be at a better, possibly more prestigious institution.

I understood the definition of what I said. What I don't understand is that at least for me, personally, I would rather do my #1 specialty wherever I got in >>>>>>>>>>>>>>> my #2 specialty in a prestigious location.

Which is why I ended my post by saying I understand that people have different priorities in life. It's just that since those priorities are different than mine, I don't know what is going on in their heads for them to think like that.

 

[Greenberg702]

I understood the definition of what I said. What I don't understand is that at least for me, personally, I would rather do my #1 specialty wherever I got in >>>>>>>>>>>>>>> my #2 specialty in a prestigious location.

Which is why I ended my post by saying I understand that people have different priorities in life. It's just that since those priorities are different than mine, I don't know what is going on in their heads for them to think like that.

I actually see what you mean. If you know you're competitive enough to match integrated plastics somewhere (fantastic numbers/grades/letters/research), but not NYU, UCSF, UTSW why would you choose to apply general surgery in the hope of getting MGH et al? Plastics might be an extreme example because of the competitiveness but I get the gist.

 

[maxxor]

I understood the definition of what I said. What I don't understand is that at least for me, personally, I would rather do my #1 specialty wherever I got in >>>>>>>>>>>>>>> my #2 specialty in a prestigious location.

Which is why I ended my post by saying I understand that people have different priorities in life. It's just that since those priorities are different than mine, I don't know what is going on in their heads for them to think like that.

This is an overly simplistic view of the things.

Take my specialty. I'm a PGY-1 biding my time until Radiology residency starts.

Since the Radiology market has been bad for 7 years, there are way more people looking for jobs than there are good jobs to go around. The best way to try and get a job in the area of the country you want to practice is to either do residency in that city / region, OR go to the best program you can get into. Matching at a quality program is tough, which then makes it all the more challenging to match into the subsequently semi-required fellowship you need to get a good job. If someone with marginal boards (lets say 225, current average) scores would be happiest in rads and, say, pretty happy in Neurology (because they love the brain), then perhaps trying to match at a "better" neuro program makes more sense to them. Better neuro program could lead to better fellowship opportunities, which lead to better job opportunities.

Medical students are notoriously value prestige. Maybe you don't, but if someone is told by advisors that they have a high likelihood of matching into the Harvard/JHU/equivalent program for specialty 2 vs a state university hospital for specialty 1, it's not hard to see why they might go for the higher prestige.

 

[DermViser]

I actually see what you mean. If you know you're competitive enough to match integrated plastics somewhere (fantastic numbers/grades/letters/research), but not NYU, UCSF, UTSW why would you choose to apply general surgery in the hope of getting MGH et al? Plastics might be an extreme example because of the competitiveness but I get the gist.

Yes, but if you do General Surgery at a highly academic program like MGH, you have a higher chance of getting to do a fellowship in Plastics, vs. doing General Surgery at a community hospital program for example.

 

[Greenberg702]

This is an overly simplistic view of the things.

Take my specialty. I'm a PGY-1 biding my time until Radiology residency starts.

Since the Radiology market has been bad for 7 years, there are way more people looking for jobs than there are good jobs to go around. The best way to try and get a job in the area of the country you want to practice is to either do residency in that city / region, OR go to the best program you can get into. Matching at a quality program is tough, which then makes it all the more challenging to match into the subsequently semi-required fellowship you need to get a good job. If someone with marginal boards (lets say 225, current average) scores would be happiest in rads and, say, pretty happy in Neurology (because they love the brain), then perhaps trying to match at a "better" neuro program makes more sense to them. Better neuro program could lead to better fellowship opportunities, which lead to better job opportunities.

Medical students are notoriously value prestige. Maybe you don't, but if someone is told by advisors that they have a high likelihood of matching into the Harvard/JHU/equivalent program for specialty 2 vs a state university hospital for specialty 1, it's not hard to see why they might go for the higher prestige.

That's an interesting example. Despite how much the people over at AuntMinnie hate talking about prestige, there's no doubt that in the bad job market prestige in rads will become increasingly important (especially if you want to work anywhere in the country).

 

[Greenberg702]

Yes, but if you do General Surgery at a highly academic program like MGH, you have a higher chance of getting to do a fellowship in Plastics, vs. doing General Surgery at a community hospital program for example.

That's true but you might lose a couple of years going that route.

 

[DermViser]

That's true but you might lose a couple of years going that route.

The point is that if you have a high chance of not matching into Integrated Plastics, then your backup is in General Surgery. For Integrated Plastics, you take it where you can get it, vs. with General Surgery you can be pickier. If your goal is to still match into Plastics, then doing General Surgery at the best place you can is in your best interest.

 

[maxxor]

That's an interesting example. Despite how much the people over at AuntMinnie hate talking about prestige, there's no doubt that in the bad job market prestige in rads will become increasingly important (especially if you want to work anywhere in the country).

The secret about going to a prestigious program is not so much the training, it's the connections and pedigree. I'm going to a pretty good program and will most likely get a good shot at most fellowships. However, what I suspect will help is that there are groups comprised largely of alumni from my training program. That is, they only hire radiologists from my program. And they are all over the US, as we have a large class each year. This isn't some theoretical thing like med schools tooting their alumni horns. While I was audition rotating there, private practice alumni came to visit the reading rooms multiple times, handing out business cards to the R4s and Fellows in September.

These are for unadvertised positions. There's value in being local to where you want to practice, but if you aren't quite sure, maybe it's best to go to a super duper program and use that flexibility later.

 

[DermViser]

The secret about going to a prestigious program is not so much the training, it's the connections and pedigree. I'm going to a pretty good program and will most likely get a good shot at most fellowships. However, what I suspect will help is that there are groups comprised largely of alumni from my training program. That is, they only hire radiologists from my program. And they are all over the US, as we have a large class each year. This isn't some theoretical thing like med schools tooting their alumni horns. While I was audition rotating there, private practice alumni came to visit the reading rooms multiple times, handing out business cards to the R4s and Fellows in September.

These are for unadvertised positions. There's value in being local to where you want to practice, but if you aren't quite sure, maybe it's best to go to a super duper program and use that flexibility later.

I think part of the problem is that Radiology, as a specialty, has commoditized itself. Also, people weren't happy with the ridiculous salaries they were getting and wanted even more (TeleRadiology). On top of that, Radiology opened residencies at some ridiculous places that have no business having residencies and are built out of what are essentially private practices. Hence now with imaging cuts, etc. Radiology is stuck to where there are to many graduates coming out for the number of jobs, and fellowship (1 if not 2) has become the defacto requirement. Read what that insufferable Saurabh Jha writes.

 

[Greenberg702]

The secret about going to a prestigious program is not so much the training, it's the connections and pedigree. I'm going to a pretty good program and will most likely get a good shot at most fellowships. However, what I suspect will help is that there are groups comprised largely of alumni from my training program. That is, they only hire radiologists from my program. And they are all over the US, as we have a large class each year. This isn't some theoretical thing like med schools tooting their alumni horns. While I was audition rotating there, private practice alumni came to visit the reading rooms multiple times, handing out business cards to the R4s and Fellows in September.

These are for unadvertised positions. There's value in being local to where you want to practice, but if you aren't quite sure, maybe it's best to go to a super duper program and use that flexibility later.

👍 Ding, ding, ding we have a winner. I know the fellows at Penn who also did residency there got basically 2003 offers (450K starting with short partnership tracks in competitive locations all because of alumni).

 

[syma]

It is always about who you know and connections. For all fields. Why would medicine be any different?

 

[Greenberg702]

It is always about who you know and connections. For all fields. Why would medicine be any different?

People play down the value of prestige/connections in medicine a lot more than in other fields. There's definitely some truth to the fact that prestige may be less important than in business or law, but it's still an important factor (depending on the field, your personal goals, etc.)

 

[Winged Scapula]

Why is that actually? Is the test just easier, or are the students better taught? What is it?

As noted above, we didn't have near the resources. First Aid for Step 1 and the BRS books was about all that existed. There were no on-line question banks, lecture notes, and sharing of information and resources back then.

However, there also wasn't the emphasis on scores like there is now; it was unheard of to get a 250-260. 220 would have been a good score and good enough for the subspecialties.

Whether your generation are better test takers I'm not sure about but the combination of more resources and more emphasis on the examination today is probably the most likely explanation.

Or maybe you're just smarter. 😉

 

[alpinism]

Why is that actually? Is the test just easier, or are the students better taught? What is it?

This.

More savvy prep, increased importance of the test, and better prep materials (as discussed above). Same thing with the MCAT score inflation.

And the fact that most med students spend way more time studying for step 1 than they used to 10yrs ago. If you talk to most attendings they'll tell you they spent 1-2weeks at most studying for the exam. Nowadays 4-6 weeks is the norm for most med students and if you spend any time of the SDN step 1 forum most of those guys are studying for 4-6months and doing 5,000+ qbank questions to get that 250.

 

[SouthernSurgeon]

As noted above, we didn't have near the resources. First Aid for Step 1 and the BRS books was about all that existed. There were no on-line question banks, lecture notes, and sharing of information and resources back then.

However, there also wasn't the emphasis on scores like there is now; it was unheard of to get a 250-260. 220 would have been a good score and good enough for the subspecialties.

Whether your generation are better test takers I'm not sure about but the combination of more resources and more emphasis on the examination today is probably the most likely explanation.

Or maybe you're just smarter. 😉

Yup.

I remember when I was in high school I walked into my SAT and took it. No practice tests, no prep course.

I think most (good) high school guidance counselors would faint at that thought today.

When I took the MCAT I took a Kaplan course and was in the minority of my friends who did so.

Test prep has come a long way since I've been taking the "important" standardized tests.

 

[DermViser]

As noted above, we didn't have near the resources. First Aid for Step 1 and the BRS books was about all that existed. There were no on-line question banks, lecture notes, and sharing of information and resources back then.

However, there also wasn't the emphasis on scores like there is now; it was unheard of to get a 250-260. 220 would have been a good score and good enough for the subspecialties.

Whether your generation are better test takers I'm not sure about but the combination of more resources and more emphasis on the examination today is probably the most likely explanation.

Or maybe you're just smarter. 😉

I think also that so much in medical education has become "standardized". Whether it's to get into medical school (thru MCAT scores), medical school (clinical shelf exams and some schools do the preclinical shelf exams), USMLE Step exams, etc. to where you have someone who thinks the actual purpose of a clinical rotation is to do well on a shelf exam.

USMLE Step 1 Prep has literally become an entire industry in and of itself.

 

[DermViser]

People play down the value of prestige/connections in medicine a lot more than in other fields. There's definitely some truth to the fact that prestige may be less important than in business or law, but it's still an important factor (depending on the field, your personal goals, etc.)

Part of it is bc it's an anathema to believe that in medicine. As medicine is a helping profession, it leaves a bad taste in one's mouth to think that entering the profession requires one to be born a family in the top tax bracket. Medical school admissions is supposed to be more meritocratic (with some social engineering thrown in).

 

[maxxor]

I think part of the problem is that Radiology, as a specialty, has commoditized itself. Also, people weren't happy with the ridiculous salaries they were getting and wanted even more (TeleRadiology). On top of that, Radiology opened residencies at some ridiculous places that have no business having residencies and are built out of what are essentially private practices. Hence now with imaging cuts, etc. Radiology is stuck to where there are to many graduates coming out for the number of jobs, and fellowship (1 if not 2) has become the defacto requirement. Read what that insufferable Saurabh Jha writes.

Oh Saurabh is my favorite blowhard. Totally going to ruin the field if he had his way.

Telerad will hopefully burn itself out once hospitals get tired of having to call some dude 100 miles away to get clarification on a read.

I hope the controversy over the new CORE exam (15% of residents failed the minimum competency exam) provides some ammunition for closing the joke programs which basically exist to provide night and weekend coverage for private groups.

I also hope the RRC would raise the minimum standards for volume of training. They are way too low.

Finally, the ABR really needs to close the FMG 4 fellowship loophole. It's the only specialty in medicine where we don't require FMGs to redo their residency.

 

[DermViser]

Oh Saurabh is my favorite blowhard. Totally going to ruin the field if he had his way.

Telerad will hopefully burn itself out once hospitals get tired of having to call some dude 100 miles away to get clarification on a read.

I hope the controversy over the new CORE exam (15% of residents failed the minimum competency exam) provides some ammunition for closing the joke programs which basically exist to provide night and weekend coverage for private groups.

I also hope the RRC would raise the minimum standards for volume of training. They are way too low.

Finally, the ABR really needs to close the FMG 4 fellowship loophole. It's the only specialty in medicine where we don't require FMGs to redo their residency.

I swear everytime he uses his "Rajeev in Bangalore" example in defending MOC for physicians, when defending against incorporating free market in Medicine, etc. I want to scream. His example makes absolutely no sense on so many levels. Residency training is so much more than a requirement to check off.

The stupid part of the CORE exam is that it's taken a ridiculous number of months after DR residency is long over. That means you pretty much have to be in fellowship to maintain employment while waiting to take it. In Derm, once Derm residency is over, you take the test in July and you're done.

The FMG loophole is ridiculous considering there are enough AMGs who want to do Rads.

 

[Greenberg702]

I swear everytime he uses his "Rajeev in Bangalore" example in defending MOC for physicians, when defending against incorporating free market in Medicine, etc. I want to scream. His example makes absolutely no sense on so many levels. Residency training is so much more than a requirement to check off.

The stupid part of the CORE exam is that it's taken a ridiculous number of months after DR residency is long over. That means you pretty much have to be in fellowship to maintain employment while waiting to take it. In Derm, once Derm residency is over, you take the test in July and you're done.

The FMG loophole is ridiculous considering there are enough AMGs who want to do Rads.

I talked to a guy who works for the ABR the other day and essentially their justification for refusing to cut down on the number of spots and the FMG loophole is the possibility of future turf wars with other fields. They were adamant about the job market bouncing back and said that with the projected increase in volume, a cut in spots now could lead to a rads shortage down the road thus stimulating subspecialists to start reading their own films and/or the exportation rads. I'm not sure I 100% agree with this but basically that's what the ABR is thinking on the inside and their reasons for refusing to do anything about the number of spots.

 

[maxxor]

I talked to a guy who works for the ABR the other day and essentially their justification for refusing to cut down on the number of spots and the FMG loophole is the possibility of future turf wars with other fields. They were adamant about the job market bouncing back and said that with the projected increase in volume, a cut in spots now could lead to a rads shortage down the road thus stimulating subspecialists to start reading their own films and/or the exportation rads. I'm not sure I 100% agree with this but basically that's what the ABR is thinking on the inside and their reasons for refusing to do anything about the number of spots.

Twisted logic.

Why not increase state lobbying and push for strict state laws that require films to be interpreted by board certified radiologists? That would do more to fight off turf nonsense than creating more radiologists ever will.

 

[Greenberg702]

Twisted logic.

Why not increase state lobbying and push for strict state laws that require films to be interpreted by board certified radiologists? That would do more to fight off turf nonsense than creating more radiologists ever will.

^ This is much harder to achieve than simply doing nothing and we all know that bigwigs take the path of least resistance even when their specialty may suffer (except Ortho, those guys are politically savvy).

 

[DermViser]

I talked to a guy who works for the ABR the other day and essentially their justification for refusing to cut down on the number of spots and the FMG loophole is the possibility of future turf wars with other fields. They were adamant about the job market bouncing back and said that with the projected increase in volume, a cut in spots now could lead to a rads shortage down the road thus stimulating subspecialists to start reading their own films and/or the exportation rads. I'm not sure I 100% agree with this but basically that's what the ABR is thinking on the inside and their reasons for refusing to do anything about the number of spots.

How does increased number of Radiology graduates have anything to do with turf wars over certain procedures/imaging? If anything the number of imaging requests will go down due to Medicare refusing to reimburse it (i.e. why did you get that 4th CT scan in 3 years? Nope, not paying). Still doesn't explain why FMGs are not mandated to do a Diagnostic Radiology residency. AMGs still find Radiology to be popular.

Putting together different fellowships haphazardly doesn't = Diagnostic Radiology residency. Also, I think Radiology needs to stop making Nuclear Medicine a residency and only make it a fellowship after residency.

 

[Greenberg702]

How does increased number of Radiology graduates have anything to do with turf wars over certain procedures/imaging? If anything the number of imaging requests will go down due to Medicare refusing to reimburse it (i.e. why did you get that 4th CT scan in 3 years? Nope, not paying). Still doesn't explain why FMGs are not mandated to do a Diagnostic Radiology residency. AMGs still find Radiology to be popular.

Putting together different fellowships haphazardly doesn't = Diagnostic Radiology residency. Also, I think Radiology needs to stop making Nuclear Medicine a residency and only make it a fellowship after residency.

They're basically saying that a future shortage in radiologists will lead to an excess of films with nobody to read them. With this, hospitals/states will be looking for other ways to get them read. This is the exact same thing that happened with primary care. Shortage of PC docs ---> Nurse Practitioner turf war begins. I admit that I do not agree with their views and still support cutting slots + the FMG loophole.

 

[DermViser]

They're basically saying that a future shortage in radiologists will lead to an excess of films with nobody to read them. With this, hospitals/states will be looking for other ways to get them read. This is the exact same thing that happened with primary care. Shortage of PC docs ---> Nurse Practitioner turf war begins. I admit that I do not agree with their views and still support cutting slots + the FMG loophole.

Other practitioners already do read them (IM, Surgery, etc.) The only difference is who does the final read for the report. And no IM or Surgery doc will put their malpractice on the line to do a radiology report.

 

[Arkangeloid]

Just posting to say that at our ("midtier" US Allo) school, we had an abnormally large number of people who applied to Derm and Ortho (in particular) with no backups, and ended up SOAPing into a specialty they didn't have any interest in.

Following your heart is following your ego: it will lead you to ruin.

 

[Greenberg702]

Other practitioners already do read them (IM, Surgery, etc.) The only difference is who does the final read for the report. And no IM or Surgery doc will put their malpractice on the line to do a radiology report.

I agree with you on the whole but they seem convinced that some orthopods/cards guys who don't operate that much can make a big chunk of change by doing reads. He also complained about private practices being sweatshops with massive requirements for reads and said that cutting spots would only make this problem worse. There's also the question of radiologist assistants. Again, I don't agree with this. I'm just conveying what they seemed to passionately believe.

 

[DermViser]

Just posting to say that at our ("midtier" US Allo) school, we had an abnormally large number of people who applied to Derm and Ortho (in particular) with no backups, and ended up SOAPing into a specialty they didn't have any interest in.

Following your heart is following your ego: it will lead you to ruin.

I wonder how many of those students going for Derm and Ortho were advised by their Dean of Student Affairs, Faculty members/mentors from those specialties, after seeing their full application that they should 1) either not apply or 2) apply but at least should have a backup, and yet they still applied to that specialty anyway without any backup. In medical school, you HAVE to be flexible, you can't be completely rigid.

There's a reason the NRMP and AAMC came together to release the Charting Outcomes of the Match. It's bc 1) students wanted better advising than what they were getting and 2) students weren't listening to their advisors and this was a way to give them very objective data that they couldn't argue against.

Millenial medical students are known to be quite different than their predecessors so it's not really that surprising.

 

[SouthernSurgeon]

I agree with you on the whole but they seem convinced that some orthopods/cards guys who don't operate that much can make a big chunk of change by doing reads. He also complained about private practices being sweatshops with massive requirements for reads and said that cutting spots would only make this problem worse. There's also the question of radiologist assistants. Again, I don't agree with this. I'm just conveying what they seemed to passionately believe.

That's crazy.

I'm pretty comfortable looking at cross-sectional imaging that is relevant to my practice (tumors, evaluating for respectability; evaluating for bowel obstructions; appendicitis; diverticulitis; etc).

I would NEVER take on the legal obligations of being the formal reader on an image. There is way too much that is outside my training, and the skills I do have at evaluating imaging have largely been picked up informally on the job. I'm not going to catch the random pathology or lung nodule, and there is so much I don't know about imaging.

Despite our hubris about reading our own imaging, I can't imagine many surgeons willing to put their name on the dotted line...