Radiology Regret?

[natrimestan]

I am currently a PGY-1 finishing an IM prelim year about to start DR residency in a few months and I have been having major regrets about my choice of specialty. I matched at a low tier radiology program which may be also contributing to my regret. I had strongly considered anesthesiology up until the point of applying, and now I really wish I had gone that route and thought more about some of the priorities which mattered most to me. I was dissuaded by the CRNA encroachment and surgeon envy, but that truly seems overblown after a few anesthesia rotations late in 4th year. Meanwhile, AI, falling reimbursements, and high burn out rates in rads seem more imminent.

The 6 years of a rads residency + fellowship all to enter an extremely tight job market which will likely force me out of my desired location just feels like an awfully impractical deal. My interest in the science of radiology hasn't diminished, but I did find other fields, including pharm and physio enjoyable in med school. I am doubting if it was the best option to do 2-3 years extra years (over IM, EM, FM, gas) to enter a shaky job market. I am strongly considering switching specialties to be able to stay in my desired geographic location (major city/ suburbs), finish residency faster, and get a better paying job.

As switching residencies is a risky and significant decision, I wanted to see if there are any last-minute ways to justify the near-NSG training length in the setting of declining reimbursement, aside from my strong interest in the field? What is the reality of the current job market for new grads? Is it really a wise practical decision to enter radiology at this time?

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[SeisK]

1) AI is not a substantial threat in the foreseeable future.

2) EVERYONES reimbursements, including anesthesiologists, reimbursements are declining.

3) The job market was booming precovid. Like never been this hot booming. Other specialties are seeing essentially the same tightening right now in terms of job placement because of this pandemic.

 

[Neopolymath]

Covid is a terribly stupid reason to choose a specialty in the short term unless it unearths something about you that you didn't already know.

 

[natrimestan]

Covid is a terribly stupid reason to choose a specialty in the short term unless it unearths something about you that you didn't already know.

agreed. Covid isn't the reason I considered it. Experienced gas too late into 4th year and now I feel like I jumped into a risky market esp coming from a low tier program.

 

[Neopolymath]

agreed. Covid isn't the reason I considered it. Experienced gas too late into 4th year and now I feel like I jumped into a risky market esp coming from a low tier program.

What did you enjoy so much about anesthesia beyond pharm and phys?

 

[Cognovi]

Echoing the above: there's nothing uniquely imminent to radiology.

 

[natrimestan]

What did you enjoy so much about anesthesia beyond pharm and phys?

The option for patient interaction (crit care, pain) is more available than rads, more procedural, more learning by DOING (less mandatory reading daily) typically a lot of support amongst attendings and co-residents, larger residency class, and networking opportunities. To top it off, a continuously strong job market in big cities with the ability to practice in well funded large academic centers and better return on time invested (4 year residency vs 6 year for rads).

I think rads advocates are well-intentioned, but need to be more realistic about the outlook especially with so few older radiologists leaving and even more new residency spots opening up yearly.

 

[Neopolymath]

The option for patient interaction (crit care, pain) is more available than rads, more procedural, more learning by DOING (less mandatory reading daily) typically a lot of support amongst attendings and co-residents, larger residency class, and networking opportunities. To top it off, a continuously strong job market in big cities with the ability to practice in well funded large academic centers and better return on time invested (4 year residency vs 6 year for rads).

I think rads advocates are well-intentioned, but need to be more realistic about the outlook especially with so few older radiologists leaving and even more new residency spots opening up yearly.

I have to disagree with the bolded. I have many family and friends in anesthesia and they all say the PP job market sucks in bigger cities and it's mostly AMCs and not good jobs at all. Academics is obvious a totally different topic.

The rest of what you are saying makes sense to me.

 

[Tiger100]

To OP:
If you like Anesthesiology or IM more, definitely go for it. You are still young and have a lot of time ahead of you. You live once and you have to live a life that YOU LIKE. Nobody can say which is better for you.

Radiology job market always has had more variability compared to many other fields. The main reason is its nature of work.

If you choose radiology, accept the fact that you may not be able to get the job that you want for a few years. If that is a very important factor fro you, choose a different field. Even when the job market was very good, fellows had hard time to find quality jobs in big coastal cities. FOr Anesthesiology is easier to find a job.

 

[clutch21]

It’s common to develop intern blues and have a grass is greener mentality this time of year. Might as well give R1 a shot with an open mind, and see if you feel differently. I imagine you could apply to gas this upcoming cycle to hedge your bets. Also, don’t get too caught up in going to a “lower” tier program. Local ties are more important to job prospects than name, and fellowship matters quite a bit as well. There are many lower tier programs that provide better training than perceived top tier programs.

 

[natrimestan]

To OP:
If you like Anesthesiology or IM more, definitely go for it. You are still young and have a lot of time ahead of you. You live once and you have to live a life that YOU LIKE. Nobody can say which is better for you.

Radiology job market always has had more variability compared to many other fields. The main reason is its nature of work.

If you choose radiology, accept the fact that you may not be able to get the job that you want for a few years. If that is a very important factor fro you, choose a different field. Even when the job market was very good, fellows had hard time to find quality jobs in big coastal cities. FOr Anesthesiology is easier to find a job.

Thanks. It is good to know that there are some options. Does anyone know the process for switching out? Can I reapply to the match while I'm still bound to my radiology program?

 

[deleted746658]

i think those who say that AI is not an imminent threat are naive and defensive

nearly every day or so there is a study like this one - https://pubs.rsna.org/doi/10.1148/radiol.2020201491 (here, an example of AI>>AI+human>>human). this tech is coming and it will transform the field. i have no doubt.

anesthesia much safer option. and if you liked it all along, go for it!

 

[Kuratz]

Both Rads and anesthesia had great job markets prior to COVID. Both have to deal with private equity. Anesthesia has midlevel encroachment, Rads the spectre of AI encroachment. No field is perfect and trying to choose based on what you speculate the job market will look like in 2025 and beyond is very short-sighted.

At some point one just has to take a leap of faith. May as well choose something that you find interesting and can see yourself doing for an entire career.

 

[natrimestan]

i think those who say that AI is not an imminent threat are naive and defensive

nearly every day or so there is a study like this one - https://pubs.rsna.org/doi/10.1148/radiol.2020201491 (here, an example of AI>>AI+human>>human). this tech is coming and it will transform the field. i have no doubt.

anesthesia much safer option. and if you liked it all along, go for it!

This is exactly how I'm feeling right now. One major thing I can't understand though is: given these facts, why does radiology tend to be MUCH more competitive with higher board scores on average? Are smart medical students not taking into account the cost/ benefit situation of radiology as a career? This seems highly unlikely. Or is there something I am missing about radiology market?

 

[sievert_fever]

i think those who say that AI is not an imminent threat are naive and defensive

Precisely the opposite for me actually. I have a decent background in computer stuff, have years of experience in automation related to radiology, and have been working on AI research for a while. If anything I'm even more convinced that its numerous profound intrinsic limitations will preclude it from ever being competition in our lifetimes. There are certainly few narrow applications where it does well but these are few, far between, and often not actually of clinical utility.

 

[medradthrowaway]

This is exactly how I'm feeling right now. One major thing I can't understand though is: given these facts, why does radiology tend to be MUCH more competitive with higher board scores on average? Are smart medical students not taking into account the cost/ benefit situation of radiology as a career? This seems highly unlikely. Or is there something I am missing about radiology market?

In 2015, there were tons of unmatched spots. The job market was bouncing back until recently. Obviously, the applicant pool and stats will lag behind a bit. I think this cycle or next cycle might reflect a down trend in radiology apps. Also, the higher avg is due to high scorers at top programs and also the nature of the job tends to attract people that like taking exams and solving puzzles. Radioloy has a lot of spots and many match below avg as well.

 

[CallMeBigJeff]

This is exactly how I'm feeling right now. One major thing I can't understand though is: given these facts, why does radiology tend to be MUCH more competitive with higher board scores on average? Are smart medical students not taking into account the cost/ benefit situation of radiology as a career? This seems highly unlikely. Or is there something I am missing about radiology market?

As a rising M4 with the stats to do Derm it ultimately boiled down to "am I going to let fear guide this life-altering decision?" I, like many med students still going for Rads, figured it's better to try to do what I really want to do and not look back. I'd rather try and retrain if (and that's a big if) AI decimates the job market, than not try at all and live a life of regret.

 

[Tiger100]

i think those who say that AI is not an imminent threat are naive and defensive

nearly every day or so there is a study like this one - https://pubs.rsna.org/doi/10.1148/radiol.2020201491 (here, an example of AI>>AI+human>>human). this tech is coming and it will transform the field. i have no doubt.

anesthesia much safer option. and if you liked it all along, go for it!

As a person who has background in IT, I don't see any significant threat from AI.

For example, the study that you mentioned in a total BS.

 

[NDcienporciento100]

The option for patient interaction (crit care, pain) is more available than rads, more procedural, more learning by DOING (less mandatory reading daily) typically a lot of support amongst attendings and co-residents, larger residency class, and networking opportunities. To top it off, a continuously strong job market in big cities with the ability to practice in well funded large academic centers and better return on time invested (4 year residency vs 6 year for rads).

I think rads advocates are well-intentioned, but need to be more realistic about the outlook especially with so few older radiologists leaving and even more new residency spots opening up yearly.

I feel that you are seriously downplaying nurse anesthetist encroachment, Im a surgical intern I can count on one hand how many times a anesthesiologist did an entire case it was always the nurse Anesthetist and in some smaller rural hospitals that’s all they have, that’s right some small hospitals have no anesthesiologist‘s anymore It’s unfortunat.

 

[NDcienporciento100]

i think those who say that AI is not an imminent threat are naive and defensive

nearly every day or so there is a study like this one - https://pubs.rsna.org/doi/10.1148/radiol.2020201491 (here, an example of AI>>AI+human>>human). this tech is coming and it will transform the field. i have no doubt.

anesthesia much safer option. and if you liked it all along, go for it!

The thing is we have been hearing this story for over 20 years. Look, go on Google translator and type in a random thing you would like translated from English to Spanish and at best its going to be accurate high 60s to low 70% of the time for some of the less common languages it’s like 30-40% of the time. If they can’t even figure out Language translation I don’t see a complex MRI being read by anyone other then a radiologist in the near future.

 

[NDcienporciento100]

This is exactly how I'm feeling right now. One major thing I can't understand though is: given these facts, why does radiology tend to be MUCH more competitive with higher board scores on average? Are smart medical students not taking into account the cost/ benefit situation of radiology as a career? This seems highly unlikely. Or is there something I am missing about radiology market?

What your missing is in the 20 years that study’s like this have been comeing out none have actually been implemented.

 

[SeisK]

As a person who has background in IT, I don't see any significant threat from AI.

For example, the study that you mentioned in a total BS.

In the news: AI that has access to a wide variety of cases learns faster than radiologists who don’t! I’m extremely shocked.

So anyone know what the word is on using AI to extract features that are unique to a particular disease pattern that radiologists haven’t picked up on yet, so that radiologists can learn from AI? Not really meaningful to extrapolate this paper at all to other circumstances if the radiologists themselves haven’t been reliably taught to identify COVID from pneumonia.

 

[medradthrowaway]

AI isn't even here yet but the rads job maket already taking a big hit over something like COVID. It is concerning at the very least that rads seems to always get hit the most. OP definitely has valid concerns.

 

[zero0]

As someone who almost went into anesthesia I feel like you're getting a grass is greener mentality here too. Anesthesiologists just lost the VA

Both Rads and anesthesia had great job markets prior to COVID. Both have to deal with private equity. Anesthesia has midlevel encroachment, Rads the spectre of AI encroachment. No field is perfect and trying to choose based on what you speculate the job market will look like in 2025 and beyond is very short-sighted.

At some point one just has to take a leap of faith. May as well choose something that you find interesting and can see yourself doing for an entire career.

I'd give the advantage to radiology by far. No one is lobbying on behalf of AI.

We can't even get AI to read an EKG. Worst case scenario within our lifetimes is it makes reading a very narrow spectrum of modalities easier. This would actually increase number of reads. I may be too optimistic, but I think AI can do nothing but help in the near future.

 

[medradthrowaway]

As someone who almost went into anesthesia I feel like you're getting a grass is greener mentality here too. Anesthesiologists just lost the VA

I'd give the advantage to radiology by far. No one is lobbying on behalf of AI.

We can't even get AI to read an EKG. Worst case scenario within our lifetimes is it makes reading a very narrow spectrum of modalities easier. This would actually increase number of reads. I may be too optimistic, but I think AI can do nothing but help in the near future.

There's no money in AI reading EKGs. That's why the technology hasn't taken off. There's a lot of money to be had in perfecting AI for radiology. There are tons of lobbying for AI (hospital admins with MBAs in suits probably dreaming of this every night, venture capitalists, profit-driven medtech companies).

 

[90sportsfan]

This is exactly how I'm feeling right now. One major thing I can't understand though is: given these facts, why does radiology tend to be MUCH more competitive with higher board scores on average? Are smart medical students not taking into account the cost/ benefit situation of radiology as a career? This seems highly unlikely. Or is there something I am missing about radiology market?

As a rising M3 who is strongly considering Rads, I think a big part of the draw for many students with good grades/high scores is the more diagnostic/cerebral aspects of Rads and the lower levels of direct patient care on the front lines. Rads does offer a limited amount of procedures which is good for a variety of work (AI can't do procedures) and it's nice to have some minor procedures to get a little bit of patient interaction. In summary, I think many students with good scores are attracted to the more diagnostic/cerebral aspects of medicine, and may prefer less direct patient care.

Covid will hopefully only have a relatively short-term impact on medicine and our world as a whole, but I do wonder the psychological impact of the stresses and how few resources/support for our front-line colleagues who in many cases are literally risking their lives during this pandemic. I wonder if it will deter some people from more direct patient care specialties, if they also have interest in specialties like Rads (with less direct patient care)?

 

[Lnsean]

OP, do what you love and follow your gut instinct. No one here can tell you anything 5 years out.

 

[CallMeBigJeff]

AI isn't even here yet but the rads job maket already taking a big hit over something like COVID. It is concerning at the very least that rads seems to always get hit the most. OP definitely has valid concerns.

Every field is taking a big hit with COVID. Psych, Urology, etc. are all seeing a huge drop in cases/patient load. Go looking for jobs right now on sites like Meritt Hawkins, anything non-COVID essential is taking a hit.

 

[Tiger100]

In the news: AI that has access to a wide variety of cases learns faster than radiologists who don’t! I’m extremely shocked.

So anyone know what the word is on using AI to extract features that are unique to a particular disease pattern that radiologists haven’t picked up on yet, so that radiologists can learn from AI? Not really meaningful to extrapolate this paper at all to other circumstances if the radiologists themselves haven’t been reliably taught to identify COVID from pneumonia.

What is your exact point?

 

[Tiger100]

AI isn't even here yet but the rads job maket already taking a big hit over something like COVID. It is concerning at the very least that rads seems to always get hit the most. OP definitely has valid concerns.

What you are describing is confirmation bias.

As I mentioned earlier, due to nature of work the volatility in radiology job market is more than many other fields.

But this time, most fields have taken a big hit over COVID. Do you think plastic surgeons are working at their 100% capacity? I bet their volume is down by 90%.

 

[changeofheart2016]

When the volume finally picks up post covid, the rate of burn out in radiology will also pick up..

Being on call precovid is a grind. Literally nonstop from the moment your shift starts to when it ends, and not infrequently having to go over your shift just to clean the list.

Anesthesia does not have that problem. Haven't heard an anesthesia resident/attending burn out maybe EVER.

People underestimate the sheer amount of studies that come through everyday and the stress that has on the radiologist.

Additionally, mistakes in radiology are solidified in stone. You miss a small SAH, it's in the report forever. This also is why radiologists are dragged into lawsuits frequently. In anesthesia, IM, etc, small mistakes often go unnoticed/undocumented. Too much fluid during case, no big deal. ET tube too low, no big deal, retract a little after CXR. Can't get IV in, no problem, call IR for midline preop.

You miss a small focal bleed, but patient comes back later with seizures and new scan now shows the initial small bleed that you missed, is now a much larger bleed, game over.

I, for one, am all for OP switching.

 

[NDcienporciento100]

When the volume finally picks up post covid, the rate of burn out in radiology will also pick up..

Being on call precovid is a grind. Literally nonstop from the moment your shift starts to when it ends, and not infrequently having to go over your shift just to clean the list.

Anesthesia does not have that problem. Haven't heard an anesthesia resident/attending burn out maybe EVER.

People underestimate the sheer amount of studies that come through everyday and the stress that has on the radiologist.

Additionally, mistakes in radiology are solidified in stone. You miss a small SAH, it's in the report forever. This also is why radiologists are dragged into lawsuits frequently. In anesthesia, IM, etc, small mistakes often go unnoticed/undocumented. Too much fluid during case, no big deal. ET tube too low, no big deal, retract a little after CXR. Can't get IV in, no problem, call IR for midline preop.

You miss a small focal bleed, but patient comes back later with seizures and new scan now shows the initial small bleed that you missed, is now a much larger bleed, game over.

I, for one, am all for OP switching and I wish I had the forsight to switch.

Wait so are you still in rads?

 

[changeofheart2016]

Wait so are you still in rads?

yeah i'm still in rads

 

[NDcienporciento100]

yeah i'm still in rads

So do you hate it?

 

[changeofheart2016]

So do you hate it?

nah definitely don't hate it at all. but the volume of studies that come thru the shop everyday certainly has destroyed my soul....of course this sentiment is all precovid

 

[tigga2013]

I am currently a PGY-1 finishing an IM prelim year about to start DR residency in a few months and I have been having major regrets about my choice of specialty. I matched at a low tier radiology program which may be also contributing to my regret. I had strongly considered anesthesiology up until the point of applying, and now I really wish I had gone that route and thought more about some of the priorities which mattered most to me. I was dissuaded by the CRNA encroachment and surgeon envy, but that truly seems overblown after a few anesthesia rotations late in 4th year. Meanwhile, AI, falling reimbursements, and high burn out rates in rads seem more imminent.

The 6 years of a rads residency + fellowship all to enter an extremely tight job market which will likely force me out of my desired location just feels like an awfully impractical deal. My interest in the science of radiology hasn't diminished, but I did find other fields, including pharm and physio enjoyable in med school. I am doubting if it was the best option to do 2-3 years extra years (over IM, EM, FM, gas) to enter a shaky job market. I am strongly considering switching specialties to be able to stay in my desired geographic location (major city/ suburbs), finish residency faster, and get a better paying job.

As switching residencies is a risky and significant decision, I wanted to see if there are any last-minute ways to justify the near-NSG training length in the setting of declining reimbursement, aside from my strong interest in the field? What is the reality of the current job market for new grads? Is it really a wise practical decision to enter radiology at this time?

If the thought of training at a lower tier rads program plays a big role in your regret, then would you be happy about a low tier anesthesia program? Switching residencies is not easy - chances of you matching into a top tier, highly reputable anesthesia program is low if not slim.

Also if anything I think strictly from a jobs perspective rads may turn out to be the safer bet since many are saying it will take multiple years - 4, 5, maybe 6? Who knows- for the general job market to return the level it was pre-covid.

Just some food for thought.

 

[yeet]

You miss a small focal bleed, but patient comes back later with seizures and new scan now shows the initial small bleed that you missed, is now a much larger bleed, game over.

Can you explain "game over"? Is it just the radiologist that takes the fall for something like this? Does malpractice insurance cover this? What are the repercussions?

 

[The wise one]

My 2 cents.. You probably dodged a bullet. The CNRA take over is almost complete.

source: American Society of Anesthesiologists
Thread: Oppose CRNAs Replacing Anesthesiologist in VA - help Anesthesiologist colleagues

 

[Tiger100]

When the volume finally picks up post covid, the rate of burn out in radiology will also pick up..

Being on call precovid is a grind. Literally nonstop from the moment your shift starts to when it ends, and not infrequently having to go over your shift just to clean the list.

Anesthesia does not have that problem. Haven't heard an anesthesia resident/attending burn out maybe EVER.

People underestimate the sheer amount of studies that come through everyday and the stress that has on the radiologist.

Additionally, mistakes in radiology are solidified in stone. You miss a small SAH, it's in the report forever. This also is why radiologists are dragged into lawsuits frequently. In anesthesia, IM, etc, small mistakes often go unnoticed/undocumented. Too much fluid during case, no big deal. ET tube too low, no big deal, retract a little after CXR. Can't get IV in, no problem, call IR for midline preop.

You miss a small focal bleed, but patient comes back later with seizures and new scan now shows the initial small bleed that you missed, is now a much larger bleed, game over.

I, for one, am all for OP switching.

Burnout in radiology is a hype. Way way exaggerated.

See people's actions and don't pay too much attention to what they say.

I am mid career. I have been to several business meetings. The same radiologists who constantly complain about burn out are the first ones who strongly vote against hiring a new associate. And they are the first ones who pick up the extra shifts. These observations make me question the validity of their "burn out complaints".

Still there are lots of life-style jobs out there that pay pretty well. But people choose high volume jobs and still complain and don't want to change jobs.

 

[changeofheart2016]

Burnout in radiology is a hype. Way way exaggerated.

See people's actions and don't pay too much attention to what they say.

I am mid career. I have been to several business meetings. The same radiologists who constantly complain about burn out are the first ones who strongly vote against hiring a new associate. And they are the first ones who pick up the extra shifts. These observations make me question the validity of their "burn out complaints".

Still there are lots of life-style jobs out there that pay pretty well. But people choose high volume jobs and still complain and don't want to change jobs.

I guess as attendings maybe it's different. You have options to decrease hours and still make decent salary.

Strictly speaking as a resident, however, with no choice and required amount of never ending over night calls, burn out is real.

 

[90sportsfan]

My 2 cents.. You probably dodged a bullet. The CNRA take over is almost complete.

source: American Society of Anesthesiologists
Thread: Oppose CRNAs Replacing Anesthesiologist in VA - help Anesthesiologist colleagues

View attachment 304907

What.....this is crazy! I was unaware of this and I'm guessing many med students are not aware of this either. I know that many medical students (including aspiring anesthesiologists) are excited about potential opportunities to practice at the VA in the future. This is a big deal.

Explore the rewards of an anesthesiology career at VA during #ANES19 - VA News

Interested in a VA career? Talk with VA recruiters about a healthcare career in anesthesiology at Anesthesiology 2019 in Orlando.

www.blogs.va.gov

Although, I'm curious as to when this is going into effect. I just did a search on USAJobs and there are Physician Anesthesiologist job announcements as recent as 3 days ago. Is this something that is being proposed that will have to go through lots of red tape/opposition to get implemented? Or is it something that will in fact be phased into the VA?

 

[medradthrowaway]

What.....this is crazy! I was unaware of this and I'm guessing many med students are not aware of this either. I know that many medical students (including aspiring anesthesiologists) are excited about potential opportunities to practice at the VA in the future. This is a big deal.

Explore the rewards of an anesthesiology career at VA during #ANES19 - VA News

Interested in a VA career? Talk with VA recruiters about a healthcare career in anesthesiology at Anesthesiology 2019 in Orlando.

www.blogs.va.gov

Although, I'm curious as to when this is going into effect. I just did a search on USAJobs and there are Physician Anesthesiologist job announcements as recent as 3 days ago. Is this something that is being proposed that will have to go through lots of red tape/opposition to get implemented? Or is it something that will in fact be phased into the VA?

CRNAs already practice independently in a like 30 states or so. This is definitely crazy that the VA has allowed this though. Medicine is being attacked from all sides. Make sure you join your advocacy groups and try to at least be active in advocating for your profession.

 

[Matthew9Thirtyfive]

Haven't heard an anesthesia resident/attending burn out maybe EVER.

Have you ever been to the anesthesiology forum? Like ever?

 

[Steve_Zissou]

i think those who say that AI is not an imminent threat are naive and defensive

nearly every day or so there is a study like this one - https://pubs.rsna.org/doi/10.1148/radiol.2020201491 (here, an example of AI>>AI+human>>human). this tech is coming and it will transform the field. i have no doubt.

anesthesia much safer option. and if you liked it all along, go for it!

You still never answered my question. Earlier, in a different thread, you claimed that there are way better specialties that are more insulated from encroachment/loss of jobs than radiology. I asked you which ones and you didn’t answer. So which ones?

 

[SeisK]

What is your exact point?

My point was a question.

 

[AndM17]

Thanks. It is good to know that there are some options. Does anyone know the process for switching out? Can I reapply to the match while I'm still bound to my radiology program?

1. You can apply for a Match waiver to get you "out" of your advanced position in radiology. Please read the NRMP information carefully because there is a deadline (I believe it is December 1st of the year before you start your advanced position). You need to inform your upcoming radiology PD if your apply for a Match waiver. My understanding is that unlike other kinds of match waivers, those for specialty change are more or less routinely granted. Once you obtain a Match waiver, it is possible to reapply for the Match again. Note you cannot re-enter the Match and keep your advanced spot. You must get a waiver which opens your PGY-2 spot up so your radiology PD can find someone else to fill it.

2. It may be possible to find spots outside the match at the program. This most commonly involves "staying on" in the categorical equivalent of your intern year specialty (e.g. general surgery or internal medicine).

3. Consider talking to your PD and to mentors. They are great resources for specialty choice issues and for matching.

 

[sievert_fever]

Strictly speaking as a resident, however, with no choice and required amount of never ending over night calls, burn out is real.

Puh-lease. If you're burning out as a radiology resident you're doing it wrong. Even the most blue collar programs are very manageable. Most residents also have protected didactic time, lunch hours, and breaks for readout. Volume substantially increases as an attending (in most gigs). Also, most programs are 10-25 weeks of night float over a cumulative four years (208 weeks -> 10-20%); hardly never ending.

 

[qxrt]

Burn out can oftentimes have more to do with the type of work than simply hours at work. I can spend all day and night doing IR procedures and feel fine, but put me in a reading room for 8-9 hours straight just reading scans, and I definitely feel like I'm going to burn out after less than a straight week of that. I enjoy diagnostic radiology, but only in moderation and not as my primary duty, and I will admit that there were diagnostic days even in residency when I felt like I was on the verge of burning out. Had nothing to do with hours but rather the fact that I am the type who gets satisfaction from being on my feet and doing procedures/making clinical management decisions, not grinding away at the worklist over which I otherwise have very little control. I know plenty of people who don't mind the reading worklist workflow (most radiologists fall under this category), it's just not for me -- just personal preference.

Similarly, back in medical school, the clinical rotation that burned me out the most was actually psychiatry, which is funny enough the rotation that we had the lightest hours by far on.

The nature of the work can play a far bigger role in burnout than just the sheer number of hours.

 

[Tiger100]

Good points.

Having said that, I see a huge discrepancy between most radiologists' words and actions when it comes to burn out.

 

[Rad2013]

I think being an attending is way less burnout prone than being a resident.

I think as a resident, the day to day burnout you experience is highly dependent on the attending you’re working with each day.

I had “protected” didactic time, which meant we were guaranteed to be behind when we returned if the attending was lazy.

Having to decide how to dictate a study based on who your attending is can be tiring and tedious.

In the real world, you dictate your way (for the most part). You work at your pace. And once you’ve read the study, you’re done with it.

I may be lucky though. My group regularly monitors volume for each seat assignment and adjusts as needed so that no rotation is consistently overwhelming.