Rad residency and call

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blaise77

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I was wondering if any rad residents could comment on their call situation. I know it varies greatly among programs and resident year but I was hoping to get a general feel. I have heard that call is really hard in Rads...does that mean its more frequent than other residencies. Are you really busy overnight or can you sleep while waiting for images to pop up. Is there any type of home call for residents? Any insight will help

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Question:
I have heard that call is really hard in Rads...does that mean its more frequent than other residencies.

Answer:
... it varies greatly among programs and resident year...
It can be anywhere between Q>7 or as busy as Q4 depending on the size of your resident class.

Question:
Are you really busy overnight...

Answer: Yes- and if you close your eyes while the study is being sent to PACS just remember to open them again in 5 minutes. Home call? Depends on your residency.

Look, radiology volume is exploding with a continued staffing shortage-- its becoming an extremely busy specialty. Although some people go into the field for academic interest and others may be lured by money, and some by both, I think everyone will agree-- YOU WILL work very hard. Radiology is not a residency for slouches.
 
I'll answer your question as I'm about to leave for a sweet little Sunday shift...

Radiology call ******* sucks. It's not a question of if you'll be busy, but how busy you'll be.

If you take a step back to consider it, it's really quite an amazing thing. You, as a resident, are responsible for pretty much every imaging study done for the entire hospital. Whether it's a lower extremity doppler or a brain MR, you've got to know what you're doing. The breadth of knowledge required is pretty stunning, to me at least. And at least until this year, you were expected to be comfortable with this knowledge after 6 months of training.

Call also highlights how incredibly unreasonable many clinicians can be. I mean, I kinda expect the ER docs to order head CTs on everybody with a headache, but the clinicians will order some shear craziness at the oddest hours. My favorite so far was the 1:30 am call to get an adenosine stress test.
 
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In most residencies, call is less often than clinical services (smaller programs may be more frequent). The range of q6-q15 depending on program and PGY level is a pretty good estimate with wide variation depending on the program. This is complicated by the fact that many places now do nightfloat, which makes it harder to judge the frequency. One thing that makes a big difference is the lack of rounding on weekend days. If you're not on call, you are completely free on the weekend in most radiology residencies.

As for the intensity, it is invariably intense when you're there. High volume of studies, pages, and consults are the norm in almost all rads residencies when on call. Usually, you're just trying to stay afloat and make it through the night. Sleep is rare. Luckily, you're usually done relatively early in the morning.
 
wow

I had no idea it was so rough

Is this something that's happened recently with the increase in imaging requests? Or has the residency always been this rigorous and I've just been ignorant?

Out of curiousity, how is call as an attending? Is it something that you can dictate? Or is it based on how large your group is and how the partners opt to delegate the call?
 
wow

I had no idea it was so rough

Is this something that's happened recently with the increase in imaging requests? Or has the residency always been this rigorous and I've just been ignorant?

Out of curiousity, how is call as an attending? Is it something that you can dictate? Or is it based on how large your group is and how the partners opt to delegate the call?

It's been getting worse. Part of it is the total number of studies being done has increased. Part of it is that studies that were once only done during business hours are now expected to be done at any and all hours. I have attendings that tell stories about the CT scanners shutting down at 5pm for the night. That's unheard of nowadays.

Call outside of residency is highly variable. Greater than 50% of radiology practices in the U.S. now use teleradiology to cover their nights, weekends, or both. Even without an outside firm providing preliminary reads, it's not uncommon for radiologists to take call from home using remote workstations.
 
It's been getting worse. Part of it is the total number of studies being done has increased. Part of it is that studies that were once only done during business hours are now expected to be done at any and all hours. I have attendings that tell stories about the CT scanners shutting down at 5pm for the night. That's unheard of nowadays.

Call outside of residency is highly variable. Greater than 50% of radiology practices in the U.S. now use teleradiology to cover their nights, weekends, or both. Even without an outside firm providing preliminary reads, it's not uncommon for radiologists to take call from home using remote workstations.

How much do these night services cost? If its a lot why dont the practices just rotate the call among themselves and get the money? Guess it may not be worth staying up all night though...lol
 
How much do these night services cost? If its a lot why dont the practices just rotate the call among themselves and get the money? Guess it may not be worth staying up all night though...lol
My rads resident told me a story of a private practice group who was having trouble getting people to agree to read films at night. So, what they did was purchase an apartment in Paris. Each radiologist would then spend 2 months in Paris reading during the day, which for the practice meant their films were being read at night. Problem solved...awesomely.
 
My rads resident told me a story of a private practice group who was having trouble getting people to agree to read films at night. So, what they did was purchase an apartment in Paris. Each radiologist would then spend 2 months in Paris reading during the day, which for the practice meant their films were being read at night. Problem solved...awesomely.

depends on how much you love paris i guess ;)
 
Paris is amazing, but I would do something like that in Spain, cheaper cost of living, and next to a beach...=)

noncestvrai
 
My rads resident told me a story of a private practice group who was having trouble getting people to agree to read films at night. So, what they did was purchase an apartment in Paris. Each radiologist would then spend 2 months in Paris reading during the day, which for the practice meant their films were being read at night. Problem solved...awesomely.
awesome :thumbup:
 
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It can be anywhere between Q>7 or as busy as Q4 depending on the size of your resident class.

A quick chance for a green 1st year to get a silly question answered - What do the numbers with the letter 'Q' mean when describing call during residency? I've been researching things lately, just to educate myself on what I may want to do. My guess was 'Q4' means 1 day of call every 4 days? Thanks
 
A quick chance for a green 1st year to get a silly question answered - What do the numbers with the letter 'Q' mean when describing call during residency? I've been researching things lately, just to educate myself on what I may want to do. My guess was 'Q4' means 1 day of call every 4 days? Thanks

I'm also a dumb M1 and would like to know the answer to this.
 
A quick chance for a green 1st year to get a silly question answered - What do the numbers with the letter 'Q' mean when describing call during residency? I've been researching things lately, just to educate myself on what I may want to do. My guess was 'Q4' means 1 day of call every 4 days? Thanks

I'm also a dumb M1 and would like to know the answer to this.

"Q" means "every."

So when you write prescriptions (which, granted, most radiologists don't do! :p), you write how frequently the patient should take the medication as "Q + period of time." "Qday" = every day, "Q4 hours" = every four hours, etc.

So if you are on "Q4" call, you are on call every 4 nights. For instance, if you are on a Q4 schedule, and you are on call on Monday night, you'll be on call again 4 nights later - on Friday night.

P.S. This isn't a dumb question, by the way. I don't think that most people really understand what "Q4" means until they hit third year.
 
"Q" means "every."

So when you write prescriptions (which, granted, most radiologists don't do! :p), you write how frequently the patient should take the medication as "Q + period of time." "Qday" = every day, "Q4 hours" = every four hours, etc.

So if you are on "Q4" call, you are on call every 4 nights. For instance, if you are on a Q4 schedule, and you are on call on Monday night, you'll be on call again 4 nights later - on Friday night.

P.S. This isn't a dumb question, by the way. I don't think that most people really understand what "Q4" means until they hit third year.

Cool, thanks a bunch for the knowledge! Learning is fun! :laugh:
 
Cool, thanks a bunch for the knowledge! Learning is fun! :laugh:

Don't worry. Your school/hospital's compliance office will make it abundantly clear when you get to your clinicals. There's a whole sheet of "forbidden" abbreviations on scripts and charts.

I'm pretty sure it's a federal requirement, but here we can't write QD for "every day." It has to be written as "daily."
 
I was wondering if any rad residents could comment on their call situation. I know it varies greatly among programs and resident year but I was hoping to get a general feel. I have heard that call is really hard in Rads...does that mean its more frequent than other residencies. Are you really busy overnight or can you sleep while waiting for images to pop up. Is there any type of home call for residents? Any insight will help

Someone I know made a great point about Radiology: you control the ambiance. That's usually true and very important. Yeah, it sucks reading studies all night, but just imaging being the the ER :eek:

There are plenty of reasons people, no matter how much they complain about their call, are in rads. I mean if it were that bad why, don't they just switch to ER or IM etc. :confused: :laugh:

BTW, night float is not so bad. Usually a week straight of 12 hours then check out (and then sleep). That's better than 24-30 hours, IMO. And it's a lot better than 24 hours followed by 6 hours of rounding.
 
It's been getting worse. Part of it is the total number of studies being done has increased. Part of it is that studies that were once only done during business hours are now expected to be done at any and all hours. I have attendings that tell stories about the CT scanners shutting down at 5pm for the night. That's unheard of nowadays.

Call outside of residency is highly variable. Greater than 50% of radiology practices in the U.S. now use teleradiology to cover their nights, weekends, or both. Even without an outside firm providing preliminary reads, it's not uncommon for radiologists to take call from home using remote workstations.

Have heard rumblings among practicing radiologists that the increased demand for imaging (partly due to an ever-increasing CYA mentality among clinicians--I always hated being told to go hassle rads about the results of [random study X]) will eventually result in diagnostic rads becoming a true "shift work" field, with round-the-clock coverage for all hospitals that can afford it. The upshot being that a group covering a given hospital will have to have people working ten-hour shifts a la EM physicians. So, instead of having a normal workday for everybody and night call coverage at a given frequency, you'd end up working the 7a-5p shift for a few months, then 3p-1a, then 11p-9a, or something similar. Maybe lighter on the graveyard shifts in an academic setting with residents, or vary somewhat if you're in a group with an outpatient breast center or something.

Any attendings care to comment on the likelihood of such a scenario? Might just be flights of fancy from some of the old guard.
 
Have heard rumblings among practicing radiologists that the increased demand for imaging (partly due to an ever-increasing CYA mentality among clinicians--I always hated being told to go hassle rads about the results of [random study X]) will eventually result in diagnostic rads becoming a true "shift work" field, with round-the-clock coverage for all hospitals that can afford it. The upshot being that a group covering a given hospital will have to have people working ten-hour shifts a la EM physicians. So, instead of having a normal workday for everybody and night call coverage at a given frequency, you'd end up working the 7a-5p shift for a few months, then 3p-1a, then 11p-9a, or something similar. Maybe lighter on the graveyard shifts in an academic setting with residents, or vary somewhat if you're in a group with an outpatient breast center or something.

Any attendings care to comment on the likelihood of such a scenario? Might just be flights of fancy from some of the old guard.
wouldn't that also mean that there will be plenty of work for rads to to do in the future and the job market will thrive for young rads?
 
wouldn't that also mean that there will be plenty of work for rads to to do in the future and the job market will thrive for young rads?

Without question. There's a reason radiology exists: it is difficult to accurately read any imaging study, let alone master many diverse imaging modalities. The field may change from the way it was practiced 10-15 years ago, but it's certainly not going anywhere.
 
Without question. There's a reason radiology exists: it is difficult to accurately read any imaging study, let alone master many diverse imaging modalities. The field may change from the way it was practiced 10-15 years ago, but it's certainly not going anywhere.
hey Dr. Dre,

I thought plastics residents spend like 100 hrs a week in the OR, how do you find time to educate green pre-meds and med students :p here on SDN?
 
hey Dr. Dre,

I thought plastics residents spend like 100 hrs a week in the OR, how do you find time to educate green pre-meds and med students :p here on SDN?

Been on vacation recently. Back to work soon. But the reality is that I don't sleep much, and I get bored when I'm not operating.
 
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