Radiology help from an ER Doc

[emergentmd]

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Guys,

Please help me with my dilemma. I am 36 years old, finished an ED residency 7 years ago and have been working in a community ED in Texas.

I can't remember any of my USMLE scores but it was middle of the road, and I was in the middle of my class. I am not even sure if my stats matter as I have been working for such a long time.

I am getting somewhat burned out and am looking into a radiology residency. I have saved enough money, this is not a big matter for me.

Here is my dilemma. I am a partner and make alittle over 400k a year, working 15-16 days a month, 8 hr shifts. I can go down to part time any time I want. I would like to make as much or more if I finish a radiology residency. I know I would enjoy radiology as I got my electrical engineering degree in college and I enjoyed the math and physics. I think I can work longer and be happier as a radiologist.

Please help me with these questions.

1. Is it reasonable to expect to make 500+K coming out of residency. I hear that some of the radiologists at my hospital makes $1mil plus
2. How many hours are the radiologist working per day, how many days a month, and how many days on call?
3. How hard would it be for me to get into a residency at my age, and experience
4. How should I approach matching? Should I call up the program directors and ask if there is an opening? Should I go through the matching process?
5. Can I skip the intern year as I have done it already in my ER residency


Any thoughts, or advice would be helpful to me.

Again, Thank you

 

[OHMAN0125]

Guys,

Please help me with my dilemma. I am 36 years old, finished an ED residency 7 years ago and have been working in a community ED in Texas.

I can't remember any of my USMLE scores but it was middle of the road, and I was in the middle of my class. I am not even sure if my stats matter as I have been working for such a long time.

I am getting somewhat burned out and am looking into a radiology residency. I have saved enough money, this is not a big matter for me.

Here is my dilemma. I am a partner and make alittle over 400k a year, working 15-16 days a month, 8 hr shifts. I can go down to part time any time I want. I would like to make as much or more if I finish a radiology residency. I know I would enjoy radiology as I got my electrical engineering degree in college and I enjoyed the math and physics. I think I can work longer and be happier as a radiologist.

Please help me with these questions.

1. Is it reasonable to expect to make 500+K coming out of residency. I hear that some of the radiologists at my hospital makes $1mil plus
2. How many hours are the radiologist working per day, how many days a month, and how many days on call?
3. How hard would it be for me to get into a residency at my age, and experience
4. How should I approach matching? Should I call up the program directors and ask if there is an opening? Should I go through the matching process?
5. Can I skip the intern year as I have done it already in my ER residency


Any thoughts, or advice would be helpful to me.

Again, Thank you

This has got to be some kind of joke. If u really are just working half a month with 8 hr days at 400k, I'd suggest u stick to what ur doing. Lol.

 

[yaah]

🙄

If you're only working 15-16 days a month, 8 hrs per day, then just get a second job and you can make double your salary. That way you won't eliminate 5+ years of high income from your career while you search for an even higher salary.

 

[emergentmd]

Guys,

I am not a troll, all the info I have posted are not exaggerated, and I am very interested in going back.

I could make more money if I worked more but the point is I am getting somewhat burned out and don't want to work more.

The hardest part for me is going back to residency for 4-5 yrs and lose about 2 mil of income. And if you track that in the market, then it becomes exaggerated with investments.

In all seriousness, please help me with any of my questions.

 

[DrDre311]

Guys,

I am not a troll, all the info I have posted are not exaggerated, and I am very interested in going back.

I could make more money if I worked more but the point is I am getting somewhat burned out and don't want to work more.

The hardest part for me is going back to residency for 4-5 yrs and lose about 2 mil of income. And if you track that in the market, then it becomes exaggerated with investments.

In all seriousness, please help me with any of my questions.

I'd try to track down some of those 1-mil plus/yr rads guys at your program and talk to them about it. It isn't impossible to go back and do a second residency--I've heard of practicing general surgeons becoming radiologists after getting burned out. I don't know about the match; if there's a residency program in your city, I'd try to give its PD a call and ask if he/she has ever dealt with a similar situation.

 

[colbgw02]

If money isn't an issue, why don't you just work fewer shifts to avoid burning out?

Seems to make more sense to work 1/3 of the month and make $250K/year rather than go back to residency, make ~$40K/year, work your butt off (relatively speaking), spend 4 years, then get an entry level radiology job for around $400K, work even harder, and then finally get that million dollar salary 10 years from now.

I'm just saying, I could put up with A LOT only working 30 hours per week.

 

[f_w]

1. Is it reasonable to expect to make 500+K coming out of residency.

In Texas: Yes

2. How many hours are the radiologist working per day, how many days a month, and how many days on call?

Talk to your local group. Typically, call is shared equally. Many groups these days have nighthawk coverage meaning the group members only read until a certain time after which a contracted teleradiology provider takes over.

3. How hard would it be for me to get into a residency at my age, and experience

It has been done before. One problem you will encounter is 'USMLE inflation'. When the USMLE was instituted, the median score was 200 and SD was something like 10. 220 got you into any residency you wanted. Today, the median is somewhere around 223 and most people getting into rads have scores in the 240 range (Lake Wobegon principle).

4. How should I approach matching?

Now !

Should I call up the program directors and ask if there is an opening? Should I go through the matching process?

Both. You are allowed but not required to participate in the match.

5. Can I skip the intern year as I have done it already in my ER residency

Yes. Any patient care GME counts.

You seem to have a grasp on the numbers. It sounds like your situation is above average for an ER doc. The opportunity cost for you to finish 4 years of radiology residency is 1.4mil in pre-tax income. I said that 500k can be done in nonmetropolitan TX (and many other rural locales) however with the reimbursement cuts in rads nobody can say whether that kind of income potential will be there 5 years from now when you get out. Even then, on a lifetime income basis it is not likely that you will ever make up for the hit you take by dropping out of an ER partnership to pursue rads.
But then again, I don't have to spend night after night looking after societies less fortunate as well as the drug-seekers that clog up our ERs.

You sound like someone who may benefit from taking a sabattical from your group. Spend 6 months doing something else, go and do some locums in other locations and then return to your job with a new appreciation of the good you can do there.

 

[Long Dong]

I remember a few years back there was this neurosurgeon attending in his 50s who ended up doing a rads res.

 

[emergentmd]

Guys,

Thanks for all of the help.

I think I may look into a few programs close to home. I don't think I want to uproot my family.

 

[schan]

I believe it is very admirable you are considering a switch for true interest in seeking out what you want to do. I believe that it is not a problem for an ED physician such as yourself to go to any residency as you would make an amazing radiology resident--which program wouldn't want you on board??

The issue is the $. I would say that the rumors you hear about some radiologists making >$1M -- it is true but it is by far not the median or mean. You must make partner in order to be making that much. Usually a private practice group. Being in Texas, there are a few that offer the potential, but it won't be for years. And it is possible to start >$500 but more realistically, in the mid/high 300s to mid 400s is the range in Texas as I hear from colleagues.

Steven

 

[mriandmsk]

i would think long and hard before taking that road. you will be giving up income you can never recover. income in radiology is based most upon the penetration of managed care. here in the northeast one million is exceptional. i have not heard of that level of income here. i do have friends in the mountain west and in the south who do make that as partners. those in the west work as hard as i do( 9 hours a day, call once per week 1 weekend every other month, not very excessive), those in the south put in big hours for that revenue. i cannot speak about incomes in texas.
burnout is not restricted to er's. Turf battles, coverage interests it all gets old. Reimbursement always seems to decrease, not increase. i still enjoy what i do,but there is no medical utopia. Talk to your local radiology friends.

 

[Jim Picotte]

Those salaries for Rads is mostly exaggerated. There are a few (very few) jobs out there where you can possibly make that much (particularly in South), but there is no free ride. You will work for it...I'm talking 12-14 hour days with call and little vacation to make close to that much money and those groups making that usually have some nice contracts and own several imaging centers. For the loss of income that you'll experience, there is no way I would do it. I don't think you'd make much more money and would only even consider it if you dread...absolutely dread going to work in the ER. Think very hard about this.

 

[hans19]

Those salaries for Rads is mostly exaggerated. There are a few (very few) jobs out there where you can possibly make that much (particularly in South), but there is no free ride. You will work for it...I'm talking 12-14 hour days with call and little vacation to make close to that much money and those groups making that usually have some nice contracts and own several imaging centers. For the loss of income that you'll experience, there is no way I would do it. I don't think you'd make much more money and would only even consider it if you dread...absolutely dread going to work in the ER. Think very hard about this.

Jim Picotte!!! Talk about a blast from the past!


Agree with above. The money is god but not million dollar (or even near million) great. Unless you want to work in the Mississippi river delta in a high-crime, impoverished area, worrying about getting sued from from some knucklehead hoping your next mistake will be his ticket to a better life, hours from the nearest major airport, and you can do this day in and day out 14 hours a day, with little vacation. Knock yourself out. More importantly will your significant other tolerate it?

 

[f_w]

This place is not the same since the apache indian disappeared into a puff of white smoke.

This would have been a prime thread for him to belittle the OPs current choice of specialty and to tell him how he could easily make gazibillions first year out of residency.

 

[Jim Picotte]

I know, you can tell I've been around a long time when my real name is used...back when the internet was a kind fluffy place and you could trust people. I find it fun to search my name and see 8 year old SDN posts that I wrote.

 

[FunkyR]

Just another perspective, I think most importantly you have to ultimately **enjoy** what you do. No point making $1M if you hate your job so much that everyday you kick the dog in the morning, commit road rage against the old lady driving to church and then swear your head off at the secretary for not making you a coffee.... all even before your day has begun. I dont like the after hours work of Interventional Radiology, but that's what interests me and hence I'm taking the good with the bad and going to pursue a career in IR. I could live a comfortable life as a generalist with not that much on call, but IR is my calling. I'm not in it for the money.

Sure you can do more training to become a Radiologist but need to weigh up how many years of practice you have left before you'd consider retirement. What if you end up hating Radiology? 36yo is not all that late to reconsider your career, but you'd want to make your decision soon.

Finance is of course important, but being any specialist you'll be living a comfortable lifestyle. In the bigger picture a few years of lost income to pursue what you enjoy isnt really that important - unless you have a Ferrari, 2 love children and a mistress to finance.... As ppl have said, the magic figures of huge salaries are probably the minority of the speciality, probably those who work their butts off in 60-70 hour weeks with additional on call or those who are partners in radiology firms who are tied up with admin work on top of their 60-70 hour week. If you are keen to work hard with those hours thats' great, there's a financial rewards attached with it.

My 2 cents

 

[Sleepygator]

Why ER to rays? Electrical engineering in college plus "I like math and physics" does not mean you will like rays. Don't forget about the grass being greener.

What about non-clinical options, such as getting an MBA while practicing ER and then getting out of clinical medicine altogether?

Listen to the other posts - they have good advice.

 

[adismo]

interesting thread. i wonder, have any radiologists ever left their chosen specialty to go into medicine, surgery, pathology, etc?

 

[PeepshowJohnny]

interesting thread. i wonder, have any radiologists ever left their chosen specialty to go into medicine, surgery, pathology, etc?

Ever? Sure. But I've got to imagine it's pretty rare.

 

[adismo]

Ever? Sure. But I've got to imagine it's pretty rare.

yes i'd "imagine" its rare too. thanks for the valuable feedback. anyone have real life examples?

 

[PeepshowJohnny]

yes i'd "imagine" its rare too. thanks for the valuable feedback. anyone have real life examples?

Well, I said imagine it's rare because no attending radiologist I've talked to can personally identify anyone who's switched out.

 

[emergentmd]

This thread popped up on my similar thread and I can't believe it has been 17 years. I am happy that radiology is doing well and I am sure I would have been happy if I decided to become a radiologist.

I decided to stick with EM due to opportunity costs and I still enjoyed EM.

I eventually went into the business of EM. I now work 3 dys/month and have 1 day of business meetings. I still enjoy EM work. I enjoy the business of medicine more. I make many times more now than I did 17 years ago.

Thank you all for your advice.

 

[Cognovi]

Am I reading right you do 4 days of work a month?

 

[emergentmd]

Yes. I am essentially retired and work to still stay busy/feel like I am still a doctor. Maybe eventually drop to 1 clinical and 1 business days a month once kids are all in college.

 

[SeekerOfTheTree]

Yes. I am essentially retired and work to still stay busy/feel like I am still a doctor. Maybe eventually drop to 1 clinical and 1 business days a month once kids are all in college.

Strong work, hope to get lucky like you one day. I asked about switching to Radiology on this forum before. Just don't think I can stomach being someone's b!t@h for 4 years again.

 

[emergentmd]

Strong work, hope to get lucky like you one day. I asked about switching to Radiology on this forum before. Just don't think I can stomach being someone's b!t@h for 4 years again.

Yeah, going back to residency when making 500K/yr would have been a tough pill to swallow. Not only loss of 2M but also 4 of your best years.

 

[SeekerOfTheTree]

Yeah, going back to residency when making 500K/yr would have been a tough pill to swallow. Not only loss of 2M but also 4 of your best years.

Why can't they make these career transitions easier. That's the only tough part about medicine; once you pick a specialty you are stuck.