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Practice as a general radiologist vs fellowship trained

Discussion in 'Radiology' started by noncestvrai, May 9, 2008.

  1. noncestvrai

    noncestvrai Member 5+ Year Member

    Feb 18, 2005
    What would be the pros and cons? Anybody has insight/views on the topic?

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  3. hans19

    hans19 I'm back... Moderator Emeritus 5+ Year Member

    Jun 9, 2004
    If you want to work at a one of the premier groups in a major metro area, it will be expected that you to have a fellowship from a respected institution. In large groups there are economies of scale where the IRs do IR, Neuros do neuro, etc... So you can practice more of a particular specialty. The down side of doing a fellowship is the opportunity cost of 1 year of fellowship. But you've got to pay to play.

    If you plan to work in a smaller town in a rural setting where everyone does a little of everything, but most cases are either normal or uncomplicated. Often you don't need a fellowship to land such a job.
    But doing a fellowship can still have its benefits. Doing a fellowship can give you an area of expertise, you can build a niche for yourself and be a valuable asset to a group. If the group ever has to cut someone are you integral to the group and hard to replace OR are you expendable and easily replacedr? This can also give you bargaining power in your group which you can use to get out of slinging barium or doing high liability mammo.
  4. colbgw02

    colbgw02 Delightfully Tacky 10+ Year Member

    I wonder how the impending changes to the boards will affect general radiology?

    Let's say you do your 3 areas of concentration (or whatever they're calling them) in A, B, and C, and your practice - which hired you as a generalist - says that you need to cover X, Y, and Z. The permutations of liability issues are dizzying.

    I'm just glad that I'm finishing my board certification before these changes go into effect.
  5. noncestvrai

    noncestvrai Member 5+ Year Member

    Feb 18, 2005
    What are these "areas of concentration"?

    Ok, but let's say you want to work in a non-academic setting, could be in the sticks or not, and will likely do a lot of everything, would you still recommend completing a fellowship as a "just in case"?

  6. colbgw02

    colbgw02 Delightfully Tacky 10+ Year Member

    The ABR has anounced that they intend to change their certification process. My understanding is the following:

    Radiology residents will complete 30 months of general radiology training, after which they will complete a combined general radiology and physics written examination.

    Subsequently, the resident will choose 3 radiology subspecialty areas in which to complete 6 month rotations. Upon finishing residency, radiologists not completing fellowships will practice for 15 months before becoming board certified by completing a computerized exam that concentrates on, but is not limited to, the three subspecialty areas in which the resident completed.

    The idea is that the last 6 months of residency will no longer be dedicated to preparing for oral boards. Apparently, the ABR considers this time too valuable to be spent studying.
  7. schan

    schan CoFounder Partner Organization 2+ Year Member

    Apr 30, 2008
    New York
    SDN Partner
    Great point and post describing the changes. This was one of the biggest points of contention and still continues to be. It is pretty much finalized now.

    One of the rationales for this is based on the fact that radiology residents not only need to learn more during the time spent for studying but also the generalized practice environment of "subspecialty" radiology. So it is the hope that residents/new staff will feel comfortable/confident in an area of subspecialization.

    Time will tell if this concept works out and if practice workflow is disrupted significantly, which many fear.

  8. f_w

    f_w 1K Member 5+ Year Member

    Jan 30, 2005
    Divide et impera.

    It is a short-sighted move to benefit a select group of academic attendings. In the long run, it will lead to further corrosion of the field of radiology and rather than strengthening the subspecialties it will make it easier for self-referring clinicians to pick away the financially interesting pieces of the pie.

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