ToothJockey

Young Bidness
Apr 21, 2019
345
280
Just out of curiosity, not in medicine, but why isn't radiology by far the most competitive specialty in medicine?
Making 850k as a partner with 27 weeks off seems like a dream job... derm, ortho, neurosurg etc. can't even size up to that

Is there a catch (other than night shift)?
 

Radology

2+ Year Member
Jun 3, 2017
166
232
Because a job paying 850k doesn’t exist outside of rural Alaska . To a med student, that sounds possible to work like a dog and do that indefinitely. But that schedule is not compatible with having a normal, happy life. You will get older, and you will burn out

and majority of jobs are still academic and corporate private practice which have less vacation and max out at 450

It’s a very call heavy field and you’ll sacrifice an evening a week and a weekend a month.

no patient contact, which is a plus for me, but a nonstarter for others

typically one of the least respected fields in medicine, so people with egos can’t do it

although I find it funny that AI is probably scaring off more students than anything, even though were more likely to profit off AI than be negatively impacted by it
 
Last edited:
About the Ads

Rad2013

7+ Year Member
Aug 21, 2012
81
50
Status
Resident [Any Field]
Just out of curiosity, not in medicine, but why isn't radiology by far the most competitive specialty in medicine?
Making 850k as a partner with 27 weeks off seems like a dream job... derm, ortho, neurosurg etc. can't even size up to that

Is there a catch (other than night shift)?
I can't speak to all groups. But, at my group, moonlighting opportunities to increase income are typically undesirable shifts. In my group, often the available shifts are extra nights (particularly weekend nights) and day shifts during peak vacation times (throughout Summer and around holidays). So to boost your income that high... you sacrifice additional weekends (remember, you already work 1/3rd of weekends) and time off during periods of time when people typically want time off... Summer and holidays. The other time moonlighting opportunities pop up are when someone is out unexpectedly (illness, bereavement, etc). In which case, you have to be able to pick the shifts up with little notice.

It creates a rather erratic schedule. But for a single person, or at least people without kids, it can work.


For the record. I live in a large city. The largest in my state and one of the largest in the region.
 
  • Like
Reactions: ToothJockey

ToothJockey

Young Bidness
Apr 21, 2019
345
280
I can't speak to all groups. But, at my group, moonlighting opportunities to increase income are typically undesirable shifts. In my group, often the available shifts are extra nights (particularly weekend nights) and day shifts during peak vacation times (throughout Summer and around holidays). So to boost your income that high... you sacrifice additional weekends (remember, you already work 1/3rd of weekends) and time off during periods of time when people typically want time off... Summer and holidays. The other time moonlighting opportunities pop up are when someone is out unexpectedly (illness, bereavement, etc). In which case, you have to be able to pick the shifts up with little notice.

It creates a rather erratic schedule. But for a single person, or at least people without kids, it can work.


For the record. I live in a large city. The largest in my state and one of the largest in the region.
Ah I see, for a single guy it really is a great gig. With family/kids it might be tougher to make it work, but good for you for finding a good opportunity and capitalizing on it. Can you estimate how many hours you work per year total (including moonlighting)?
 

Radology

2+ Year Member
Jun 3, 2017
166
232
You worked an average of 35 hours a week, with all of your shifts overnight including 1:3 weekends, on site for 450k

I take back what I said about corporate valuing overnight rads
 

libertyyne

2+ Year Member
Mar 5, 2015
9,786
17,475
Status
Medical Student
Will tightening of the job market make fellowship not necessary anymore or will this trend of essentially required fellowship continue?

What sort of hurdles are there for starting private practice or contracting with a hospital to provide reads ?

Are there practices where you eat what you read? Are these a bad deal usually?

How expensive is malpractice insurance comparitively ?
 
Jan 22, 2019
1,080
945
Status
Resident [Any Field]
Honestly the only thing that pisses me off to no end is how little control we have. ED docs order every ****ing thing under the sky because they cannot make any diagnosis without imaging and we have no say what they order.
It's everywhere; that is why they get criticized by most services in the hospital.
 

Radology

2+ Year Member
Jun 3, 2017
166
232
Fellowship already isn’t required; particularly if you want to do tele for below market rates. Many have offers out of residency nowadays, they just tend to be bad ones.

it’s virtually impossible to start a private practice nowadays. You either need massive capital to support the equipment/infrastructure or a group of 20+ friends with non competes all willing to jump in and displace an already established groups contract. Although, I think a lot of these Radpartners/envision practices are going to fold after buyouts are paid and they are unable to staff, so they would be ripe for a new PP forming from the ashes

plenty of practices offer bonuses for meeting productivity/rvu criteria. A true “pay per study” model is isolated to nighthawk and corporate and is Always a bad deal

malpractice depends on where you practice and multiple other variables (how often you’ve been sued, experience, etc). It’s typically in the low 5 figure range annually per rad
 
About the Ads

thatsrad

2+ Year Member
Sep 23, 2015
58
34
Status
Resident [Any Field]
General radiology without fellowship isn’t just for below market tele jobs and nighthawk, although that is one option. Many rads who don’t do fellowship have no problem getting jobs with small PP groups. A lot of corporate jobs are also open to the non-fellowship trained rad. Pseudo academic positions at one of the “clinics” are also available, usually covering one of the smaller hospitals. The caveat is that you have to be competent and willing to read most studies and do basic procedures. It’s a myth that fellowship is needed for most jobs. Only if you want to live in one of the saturated huge city markets or want true academics. Getting a fellowship will only open an additional small slice of jobs within your subspecialty and jobs with highly subspecialized large groups.
 

thatsrad

2+ Year Member
Sep 23, 2015
58
34
Status
Resident [Any Field]
As for eating what you read, you won’t find that often outside of certain corporate tele jobs, and if you do, you should run. Paying by RVU is the surest way to destroy an otherwise stable group.
 

thatsrad

2+ Year Member
Sep 23, 2015
58
34
Status
Resident [Any Field]
as far as salary right now a newly fellowship trained rad should receive anywhere from 300-350k starting but nothing below that unless its part time (speaking only about day positions). anything higher has to be taken with a grain of salt for example i had another job offer from my home medical school however they were asking me to cover more ED and essentially id be working alone which is a recipe for burnout right out of fellowship.
$300-350k is low for a starting position unless you are on a partnership track. For example, a 2 year partnershiptrack making $325, whereas the partners make $625, you essentially are buying in with $600 plus whatever less vacation/benefits you got compared to partner.

I’d say PP true equal owner partnership positions range from $500-800 depending on how much the group values lifestyle and the location/local market factors. *Caveat is NYC, where most jobs are total crap outside of academics.

The VA pays $300-350, as well as a lot of true academic positions. But outside of that, most of people from my graduating class and years prior who took employed positions were making mid-$400s before moonlighting. The IR people made $50-100 more.
 
  • Like
Reactions: slowthai

Radology

2+ Year Member
Jun 3, 2017
166
232
That buy in analogy makes no sense

by that logic, in academics Or corporate your buy in is 200k * every year you work there, without ever getting the full distribution for the work you generate
 
Last edited:
Sep 4, 2019
13
5
1. Yes

2. Pay is often redistributed throughout a group by some mechanism—if it were not for this, you would see imbalances in pay even between diagnostic subspecialties. Anyway, to answer your question while DR generates more in a group, IR pay is often higher because they take more call.
ive heard IR loses money for some PP groups... is this true?

also why does eat what you kill have a bad rap? isnt it fair to make more if u read more?

hopefully these big private practices fold and we get some more smaller ones
 

Radology

2+ Year Member
Jun 3, 2017
166
232
Yes. IR is often subsidized by DR in big groups.

You can always churn more patients through a scanner; you can only do so many procedures

eat what you kill leads to toxicity. The RVU assigned to each case is really arbitrary. Reading a lumbar spine mri with contrast takes about 10 minutes. Reading a whole body PET/CT with 10 priors can take 45 minutes. But the lumbar spine mri counts for the same RVU

So now the nucs reader feels he is getting the shaft because the neuro guy is getting paid 4x for the same amount of work.

so he starts to cherry pick the easy studies off other people’s lists, like negative dvt us. Then the US reader gets pissed that their easy money is being stolen by someone else.

so they start dumping their disaster cases to the next person on the shift.

etc, etc

this model also incentivizes reading with reckless Speed and sacrificing quality, and punishes practice building activities like giving tumor board, networking with physicians
 

thatsrad

2+ Year Member
Sep 23, 2015
58
34
Status
Resident [Any Field]
That buy in analogy makes no sense

by that logic, in academics Or corporate your buy in is 200k * every year you work there, without ever getting the full distribution for the work you generate
Except in the corporate or academic gig you’re getting paid at market rate for that job.

in the PP partnership track job, you’re doing the job of a partner in hopes of making partner, purposely getting paid below market rate for a partner for period of time as the “buy in.”

Contrast that to the employee option some PP groups give for potential new hires. I’ve seen groups offer both options, partner track or employee, and sometimes the rad chooses employee. They don’t have to do practice building, go to admin meetings, take call (usually), or have the financial risk of being a partner. For example, a group might offer 2-year partner track at $325/year OR employee at $400-450, depending on call taken.
 
  • Like
Reactions: slowthai

Radology

2+ Year Member
Jun 3, 2017
166
232
Except that is market rate. It just the market rate for being an employee of a private practice.

Corporate jobs purposely underpay you too when you start. There’s just a smaller reward for that at the end. The starting market rate at Radpartners is a little higher, but still less than what the RP “partners” make. Youre still buying in then too per your logic, just not as much. You’re Just trading a smaller “buy in” during the 2-3 partner track years in return for a 30% pay cut for the next 30 years of your career.

it’s very shortsighted to pick a job based on the partner track years salary. Presuming it works out, You will ultimately make far more money in a traditional private practice
 
Last edited:

thatsrad

2+ Year Member
Sep 23, 2015
58
34
Status
Resident [Any Field]
No, it’s not market rate. That was my point. Haven’t you come across some of these PP groups that are offering both options: either permanent employee or partner track?

Here’s an example of one I saw recently. PP group offering either option, new rad’s choice:

1. Partner track. 2 years, 1st year $300, 2nd year $325. 6 weeks vacation (partners got something like 12-14). Take all weeknight and weekend call that partners take. Have to do practice building.

2. Permanent employee. $450. 6 weeks vacation. No call. No practice building. No meetings.

Say what you want, but option 1 definitely has a substantial “buy in” to become partner. What that *exact* number is can be debated, but it’s real.

Option 2 is market rate. Some people don’t want the partner lifestyle and responsibility, plus the risk your group is sold out before becoming partner. But concessions like no call have to be thrown in to entice people to take lower pay than partner.
 

Radology

2+ Year Member
Jun 3, 2017
166
232
Option 1: 50% salary shave for 2 years, make 100% of an equal share of the earnings thereafter, go to 5 meetings a year and give a couple conferences.

Option 2: 30% salary shave forever, don’t goto 5 meetings a year or give conference.

The “buy in” in option 1 equals the “buy in” in option 2 after two years as a partner. Option 2 the “buy in” continues indefinitely. you would have to really hate giving conference and going to meetings to forgo 150k a year

“Market rate” is the kinda bs the corporations will spew at you to make you think you’re getting a good deal. The only market rate is 100% of the professional and technical fees your group bills for. And being an equity partner is the only way to achieve that. Everything else is a salary shave.
 
Last edited:
About the Ads
Sep 18, 2019
14
36
Status
Resident [Any Field]
Except in the corporate or academic gig you’re getting paid at market rate for that job.

in the PP partnership track job, you’re doing the job of a partner in hopes of making partner, purposely getting paid below market rate for a partner for period of time as the “buy in.”

Contrast that to the employee option some PP groups give for potential new hires. I’ve seen groups offer both options, partner track or employee, and sometimes the rad chooses employee. They don’t have to do practice building, go to admin meetings, take call (usually), or have the financial risk of being a partner. For example, a group might offer 2-year partner track at $325/year OR employee at $400-450, depending on call taken.
Corporate = permanent skim by the business admin, with loss of autonomy (meaning if all rads decided to become corporate employees, they would have significant control over your pay and schedule).

PP = temporary skim by partners for 2 years. PP sets the rate for corporate and other jobs, so you are doing both yourself and fellow rads a disservice if you sign on with corporate when there's a reasonable PP option available.
 

thatsrad

2+ Year Member
Sep 23, 2015
58
34
Status
Resident [Any Field]
I agree with you on that, and by no means am I promoting corporate gigs. I think they’re the worst of all possible options.

But you gotta consider no call in option 2 is worth at least $50k compared to option 1 and full partner, depending on # of shifts. And maybe more for some people, especially if the group covers their own nights.
 
Sep 18, 2019
14
36
Status
Resident [Any Field]
To clarify things for everyone, corporate pays only according to however much PP is willing to offer. Corporate will often make their entry positions more enticing than PP's entry portion of a partnership track job, but over the long term corporate will certainly leave you worse off because there is a permanent skim on your pay.

Moreover, if you go back to my first sentence, you will realize that if corporate displaced all PP groups, then there would be no pressure for them to pay at the level they currently do. In corporate controlled medicine the end result would maximize the MBA's pay while shrinking yours. And it's not just pay—you would see drops in vacation time and further increases in work hours. PP is only able to set the standard as long as it is the dominant way radiology is practiced.

Lastly for the medical students and junior residents, you've probably heard about ballooning admin costs in medicine and medical training are contributing to how all physicians are getting the raw end of the deal. Signing on for corporate is signing on to give these same types of people more power over you and your career. In a corporate job there's an admin who gets paid 6-7 figures to find ways to make you work harder and for less money.

I agree with you on that, and by no means am I promoting corporate gigs. I think they’re the worst of all possible options.

But you gotta consider no call in option 2 is worth at least $50k compared to option 1 and full partner, depending on # of shifts. And maybe more for some people, especially if the group covers their own nights.
It is definitely a buy-in but I don't think it's unreasonable that partners should reap some reward for their work. The partners are the ones who have built the practice (building good relationships with referrers, expanded imaging modalities, etc.).

From a monetary perspective going corporate is like having a life-long buy-in that never ends.
 

thatsrad

2+ Year Member
Sep 23, 2015
58
34
Status
Resident [Any Field]
Agreed. I would personally never take a corporate job or recommend anyone to do so.

I’m more advocating that if someone doesn’t want a partnership for lifestyle reasons (although there are lifestyle oriented groups), it’s not an unreasonable option to consider an employed gig with a good PP group.

Definitely a much better option than corporate. At least it’s radiologists skimming your pay, not private equity and MBA’s. And only because you yourself voluntary chose for your pay to be skimmed, because it is worth it in your situation for whatever reasons. But it’s not worth giving up our autonomy.

Agree that the biggest problem with corporatization is the loss of autonomy, loss of control over schedules, how much you work, being able to say no to something that isn’t right for the group or patients, etc.
 

thatsrad

2+ Year Member
Sep 23, 2015
58
34
Status
Resident [Any Field]
It is definitely a buy-in but I don't think it's unreasonable that partners should reap some reward for their work. The partners are the ones who have built the practice (building good relationships with referrers, expanded imaging modalities, etc.).
I don’t think a buy is at all unreasonable either, wasn’t suggesting that it was. Just something to be aware of.

In fact, it’s probably ideal to have a buy in period to make sure someone is right for the group before becoming full partner and so they have some skin in the game.

It’s better for everyone involved to simply offer less pay during the “buy in” time to partnership rather than requiring a lump sum of cash. Especially for tax implications.
 

CharlieBillings

5+ Year Member
Jan 11, 2015
501
604
Status
Medical Student
Do radiologists actually take the vacation time they are offered? 12 weeks a year is 3 solid months off. Are they actually gone for weeks at a time or even months at a time?

Or is the vacation time a way of earning bonus salary that converts into $ when you leave/retire/max-out (or do people work and take vacation pay at the same time for effectively double pay)?
 

Neopolymath

ASA Member
5+ Year Member
Mar 5, 2014
961
2,477
Status
Medical Student
Do radiologists actually take the vacation time they are offered? 12 weeks a year is 3 solid months off. Are they actually gone for weeks at a time or even months at a time?

Or is the vacation time a way of earning bonus salary that converts into $ when you leave/retire/max-out (or do people work and take vacation pay at the same time for effectively double pay)?
They definitely took all the vacation at the places I have worked.
 
About the Ads

Radology

2+ Year Member
Jun 3, 2017
166
232
Don’t forget, radiologists often work a weekend a month plus holidays

25 days of call a year basically counters five 5 day weeks of vacation.

And it’s not rounding for 2 hours and going home; it’s the most mentally exhausting shift in medicine. Every bit of vacation is absolutely necessary to stave off burnout
 
Jan 22, 2019
1,080
945
Status
Resident [Any Field]
Don’t forget, radiologists often work a weekend a month plus holidays

25 days of call a year basically counters five 5 day weeks of vacation.

And it’s not rounding for 2 hours and going home; it’s the most mentally exhausting shift in medicine. Every bit of vacation is absolutely necessary to stave off burnout
Most specialties don't have that kind of 'privilege' and one can argue they work hard as well. For instance, 6 wks vacation in IM is unheard of.
 

Radology

2+ Year Member
Jun 3, 2017
166
232
7 on 7 off is extremely common for internal medicine/hospitalists.
That’s 16 weeks of vacation adjusting for weekends

plenty of outpatient specialties from IM operate on 4 day work weeks (~10 week vacation equivalent), don’t take call, AND have 4-6 weeks vacation
 
Last edited:
  • Like
Reactions: Norick13
Aug 29, 2019
51
34
Status
Pre-Medical
I think radiology is flying under the radar. I don't know why people always say dermatology is the best, but personally, lifestyle wise, radiology seems to be the best. What other job can you have with 16 weeks of vacation and still make 400k? Obviuosly you have to be interested in the field, otherwise you'll be miserable.
 
  • Like
Reactions: gn4

Mh0311

2+ Year Member
Apr 27, 2016
32
17
Status
Medical Student (Accepted)
^ That's what I've been thinking, it seems like only 1 other person that I know of in my class want to do rads also. Glad I made the switch now rather than later.
 
  • Like
Reactions: 9blade

odyssey2

5+ Year Member
Jul 30, 2013
147
76
Status
Medical Student
I think radiology is flying under the radar. I don't know why people always say dermatology is the best, but personally, lifestyle wise, radiology seems to be the best. What other job can you have with 16 weeks of vacation and still make 400k? Obviuosly you have to be interested in the field, otherwise you'll be miserable.
I'd love for an actual radiologist to correct me, but apparently it's considered a downgrade from the ultra-lifestyle specialties like derm since it's more fast paced and high-acuity. Mistakes can be prosecuted at any time since it's recorded for everyone to see so malpractice isn't ever far from your mind. Overnight and evening call all is still a reality for attendings and can be brutal. You also have to be mentally "on" all day in a way that seems unmatched in medicine.
 
Jan 23, 2020
9
0
My job is less common and typically shunned on forums. But, I suppose it may be helpful for newcomers to know what options other than traditional daytime PP can look like. I do ER nights, 1 week on 2 weeks off.

1. Where do you work (hospital or private practice, and which state)
South. Corporate private practice. Partnership-track (not yet partner).

2. How quickly do you have to read scans? Are you pressured to read faster or is it relatively at your own pace?
Being ER, efficiency is important. But, my own pace is fast, so I've never felt pressure.

3. What are your hours, what is call like for you and do you work weekends.
Overnight, 10 hour shifts, 7 in a row followed by 14 off. So, I work 1/3rd of weekends.

4. How many weeks of vacation do you get per year?
No vacation in a formal sense. But, 34 weeks off per year.

5. What do you think, given that you are in the field, will be the future of radiology? Will demand increase? Will reimbursements drop?
Who knows? I think demand will increase and reimbursement will decrease. But how much and how fast remains TBD.

6. What is your salary?
Salary and bonus for 2019, around 450k. But, did quite a bit of moonlighting to boost to over 630k. 401k is an additional 56k.

7. Are you happy?
Yes.
What fellowship did you do?
 

Rad2013

7+ Year Member
Aug 21, 2012
81
50
Status
Resident [Any Field]
Chest/Body. But, I’d recommend Neuro if night radiology interests you. That is the most desirable fellowship for nights.
 

efle

not an elf
5+ Year Member
Apr 6, 2014
11,822
15,881
Status
Medical Student
Just to reiterate something similar to the above poster, because it's been stumping me...

Why isn't rads more competitive? Surely there are hundreds or thousands of competitive students, with all options on the table, who would rather deal with 1 weekend call per month than deal with all the inpatient BS or $kin pathologies.

Seeing the salary data on SDN and in MGMA, work and vacation hours, and "pure medicine" appeal, I really can't reconcile with the fact that a step score of 220 gives you a 95% match success rate.

Can anybody shed some light?
 

libertyyne

2+ Year Member
Mar 5, 2015
9,786
17,475
Status
Medical Student
Just to reiterate something similar to the above poster, because it's been stumping me...

Why isn't rads more competitive? Surely there are hundreds or thousands of competitive students, with all options on the table, who would rather deal with 1 weekend call per month than deal with all the inpatient BS or $kin pathologies.

Seeing the salary data on SDN and in MGMA, work and vacation hours, and "pure medicine" appeal, I really can't reconcile with the fact that a step score of 220 gives you a 95% match success rate.

Can anybody shed some light?
Im assuming its the recent job market before the uptick and AI fears.
 
About the Ads