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Damn I’m reading more and more of these threads and it’s making me really nervous about starting Rads next year. Maybe I should have ranked anesthesia programs before the rads ones. How likely is it to transfer out as a PGY1 if your program is advanced?

Man that’s how you end up bitter like Cosine. As an M4 very excitedly applying Rads it took me some time to figure out that all of the hype is blabbered by non-radiologists. Notice how general their terminology is, “once AI can screen through the normals vs abnormal”. I’m sorry, what? Try to think just for one second how many algorithms that would entail, really think about it. Think about EVERY medical condition and it’s imaging findings you learned in med school. Now think about the plethora that you didn’t learn in med school. For Rads to be replaced or even “provide prelim reads like a resident” you are necessarily implying that it can identify (and correlate) any and all findings. Furthermore, that pancreatic cancer algorithm Google is developing needs to be able to interact well with the HCC algorithm IBM is producing, or else how are we gonna do this? Are the hundreds of companies independently working on their on AI going to merge? Is a hospital going to buy IBM’s lung AI and another company’s breast AI? I’m just a 4th year and these are some of the problems I can envision, imagine the ones an attending can.

My point is, jump in head first and don’t look back. Not choosing Rads out of some abstract fear that may or may not come to realization is a recipe for a life of REGRET. And I personally would rather retrain in 30 years than wake up one day and see that nothing happened, and that the NON-RADIOLOGISTS who have probably spent as much, if not LESS time in the reading room than you, were wrong.
 
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Kuratz

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You can live your life afraid to venture from the beaten path and God forbid it doesn’t go exactly as planned. Or you can grab life by the balls and take a challenge head on. Not choosing a field because of something theoretically happening is short-sighted and you could talk yourself out of anything.

@CallMeBigJeff has the mentality to succeed regardless of what happens.

@CidHighwind switch or don’t. But for Christ sake have a spine and lean into it
 
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Roadhouse

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Many radiologists do not, and should not, care about how other specialties perceive them. There is unreal hypocrisy with some referring doctors who like to talk **** about radiologists. Misses happen and are inevitable. We have all seen countless scans with significant surgical complications following operating room misadventures, line placements, etc. Radiologists try to stay objective about scan findings and not finger point with the iatrogenic f ups that we see (patients read reports).

Unfortunately, some referring physicians are egotistical clowns who see themselves as infallible and are surrounded by "yes men" (read: residents and fellows seeking approval by any means necessary). They enjoy pointing out radiologist misses to feel better about their own insecurities. Other surgeons and clinicians are more understanding and rational. Needless to say, they are treasured by our radiologists and we go to great lengths to make their lives easier.

Radiology requires a healthy dose of humility. Your misses will be seen by all. It's part of them game. Many malignant clinicians will chatter about the mistakes you make here and there. Especially the short sighted ones who convince themselves they should be hospitalists because it's only 3 years of training.

Very few people will pat you on the back for the great calls you make throughout your career (think corner shot incidental RCC that if missed patient will return in 2 years with widespread mets).

As far as AI, who knows...
 
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Peregrinus

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For what it's worth, at my hospital there's a whole midlevel service (with innumerable NPs) admitting, rounding/treating, and discharging general medicine patients independently (with minimal MD supervision). In contrast, the hospitalist service gets dumped with every million-cormorbidities-trainwreck, mind-numbing-socialwork-disaster that comes through the ED. Inpatient medicine costs the hospital money, but it's an essential service. Cost-conscious hospitals like mine will replace as many hospitalists as they can with midlevels with minimal supervision. They'll just need a handful of hospitalists to handle the trainwrecks. AI is not the imminent threat to medicine. Midlevels are.

That said, if anyone wants to switch to IM, please do. I would wholeheartedly encourage you to. Less competition for me in the future. Heme/Onc, GI, and Cards are the IM subspecialties worth pursuing, but getting into one of them will demand a lot of personal sacrifices (and oftentimes an extra research year... and sometimes a marriage).
 
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For what it's worth, at my hospital there's a whole midlevel service (with innumerable NPs) admitting, rounding/treating, and discharging general medicine patients independently (with minimal MD supervision). In contrast, the hospitalist service gets dumped with every million-cormorbidities-trainwreck, mind-numbing-socialwork-disaster that comes through the ED. Inpatient medicine costs the hospital money, but it's an essential service. Cost-conscious hospitals like mine will replace as many hospitalists as they can with midlevels with minimal supervision. They'll just need a handful of hospitalists to handle the trainwrecks. AI is not the imminent threat to medicine. Midlevels are.

That said, if anyone wants to switch to IM, please do. I would wholeheartedly encourage you to. Less competition for me in the future. Heme/Onc, GI, and Cards are the IM subspecialties worth pursuing, but getting into one of them will demand a lot of personal sacrifices (and oftentimes an extra research year... and sometimes a marriage).
lol.

((Extra-Research year and some times a marriage,))


that is way over-reach man, I speak to many matched residents and alumni in my academic IM program, none of them had to go through what you were saying.

I respect radiology and feel very amused by its advancement . I choose IM, because I value patient interaction and the longevity of care. I reckon that down the road Ive seen a bit more of frustrating events that made me feel jaded and disappointed. However, it did not mean that my speciality sucks. we still get to enjoy the flexibility of open job market, not susceptible to economic downturns and Capital ventures buy-in. the future of reimbursements is unknown with Value based Care model is the direction. it can spell good for primary care and bad for Rad/sub-speciality medicine. Mid-level encroachment is there. but, no one knows how it will effect the Primary care job market.

the bottomline, do what make you happy, and at the end of the day if you are going to make more than 250000. you will be happy no matter what. happiness is not solely based on what you have in your bank account.

also it is worth to add that, if some one get a thorough look into the curve of physicians salary growth rate compared to their RVU since 2011.
Rads work a lot more and they are barely back to where they used to make.
IM and its sub/Speciality are stuck with Paperwork and lost hours on EMR but still their compensation growth yearly are rising incrementally .

level of burn-out in Rads is rising concern. Rad is not a fun easy going high paying speciality as it once was prior to 2008.
but, it is a still a lucrative speciality and vastly evolving and expanding. AI, Reimbursement may change its future outlook , but it is still going to be an essential speciality. If you want to go with RAD, it is a still a successful gig as long as you are ok with working 55H/W looking at 100 scan min/day.
 

Peregrinus

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In 2020, there were 1400 fellowship applications for cardiology with 1,010 positions available. That's a self-selected pool of highly competitive applicants with glowing letters of recommendations, tons of research, exceptional clinical evaluations. Of my four exceptional friends who applied cards this year, two didn't match. The two that did match did a chief year or research year. I think you're underestimating the competitiveness of these fellowships.

That said, I agree with you that you should do what suits you personally. IM is a great field for the right person. Radiology itself is a self-selective field. It's perfect for me, but it's not for everyone.
 

zero0

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lol.

((Extra-Research year and some times a marriage,))


that is way over-reach man, I speak to many matched residents and alumni in my academic IM program, none of them had to go through what you were saying.

I respect radiology and feel very amused by its advancement . I choose IM, because I value patient interaction and the longevity of care. I reckon that down the road Ive seen a bit more of frustrating events that made me feel jaded and disappointed. However, it did not mean that my speciality sucks. we still get to enjoy the flexibility of open job market, not susceptible to economic downturns and Capital ventures buy-in. the future of reimbursements is unknown with Value based Care model is the direction. it can spell good for primary care and bad for Rad/sub-speciality medicine. Mid-level encroachment is there. but, no one knows how it will effect the Primary care job market.

the bottomline, do what make you happy, and at the end of the day if you are going to make more than 250000. you will be happy no matter what. happiness is not solely based on what you have in your bank account.

also it is worth to add that, if some one get a thorough look into the curve of physicians salary growth rate compared to their RVU since 2011.

Rads work a lot more and they are barely back to where they used to make.
IM and its sub/Speciality are stuck with Paperwork and lost hours on EMR but still their compensation growth yearly are rising incrementally .

level of burn-out in Rads is rising concern. Rad is not a fun easy going high paying speciality as it once was prior to 2008.
but, it is a still a lucrative speciality and vastly evolving and expanding. AI, Reimbursement may change its future outlook , but it is still going to be an essential speciality. If you want to go with RAD, it is a still a successful gig as long as you are ok with working 55H/W looking at 100 scan min/day.
I'm guessing you're referring to this:
https://physiciancompensation.org/PDFs/2015RSPWB/2015Survey.pdf

Looking at page 6 and onward there's no doubt radiology had one of the highest increases in RVUs, up nearly 1000 RVUs on average from 2011 to 2015 (page 13). All just to keep the same salary. Wonder how true this trend is going into 2020 though...
 

NDcienporciento100

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lol.

((Extra-Research year and some times a marriage,))


that is way over-reach man, I speak to many matched residents and alumni in my academic IM program, none of them had to go through what you were saying.

I respect radiology and feel very amused by its advancement . I choose IM, because I value patient interaction and the longevity of care. I reckon that down the road Ive seen a bit more of frustrating events that made me feel jaded and disappointed. However, it did not mean that my speciality sucks. we still get to enjoy the flexibility of open job market, not susceptible to economic downturns and Capital ventures buy-in. the future of reimbursements is unknown with Value based Care model is the direction. it can spell good for primary care and bad for Rad/sub-speciality medicine. Mid-level encroachment is there. but, no one knows how it will effect the Primary care job market.

the bottomline, do what make you happy, and at the end of the day if you are going to make more than 250000. you will be happy no matter what. happiness is not solely based on what you have in your bank account.

also it is worth to add that, if some one get a thorough look into the curve of physicians salary growth rate compared to their RVU since 2011.
Rads work a lot more and they are barely back to where they used to make.
IM and its sub/Speciality are stuck with Paperwork and lost hours on EMR but still their compensation growth yearly are rising incrementally .

level of burn-out in Rads is rising concern. Rad is not a fun easy going high paying speciality as it once was prior to 2008.
but, it is a still a lucrative speciality and vastly evolving and expanding. AI, Reimbursement may change its future outlook , but it is still going to be an essential speciality. If you want to go with RAD, it is a still a successful gig as long as you are ok with working 55H/W looking at 100 scan min/day.
Lol, most radiologist get 9 weeks vacation while making over 400k a year! Think about that next time your updating the discharge summary on the chronic pancreatitis patient that has been in the same bed for 3 months.
 
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appalachian_man

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"Don't go into radiology! It will ruin your career in medicine!" he says, frantically typing his comment between notes nobody will read at 7 p.m. on a 12 hr "short call" Saturday
 
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GadRads

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Lol, most radiologist get 9 weeks vacation while making over 400k a year! Think about that next time your updating the discharge summary on the chronic pancreatitis patient that has been in the same bed for 3 months.

That may be true, but radiologists earn every penny of their pay. I did a full IM year, though the hours were longer, I have found radiology more challenging. Per unit of time, we are doing more work than internists, which is not to say they have it easy.

"What is your least favorite thing about radiology?

That everyone is now working at such a fast pace and the cases are getting so complex that it’s simply not as much fun as it used to be. I’m really tired at the end of the day. Less time is available to talk, teach, and interact with the residents and fellows than there used to be."

 
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Lol, most radiologist get 9 weeks vacation while making over 400k a year! Think about that next time your updating the discharge summary on the chronic pancreatitis patient that has been in the same bed for 3 months.

Did you not see the chart he posted about radiologists having to work wayyyy more in order to generate the same salary from 10 yrs ago?
 
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NDcienporciento100

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Did you not see the chart he posted about radiologists having to work wayyyy more in order to generate the same salary from 10 yrs ago?
look, don’t know who you are what you do but trust me whatever little extra a radiologist is doing to make that kind of money is nothing compared to the social, discharge, polymedical comorbitie train recs that internal medicine has to deal with on a daily bases. To make 400k as a hospitalist you would have to be slave.
 
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NDcienporciento100

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That may be true, but radiologists earn every penny of their pay. I did a full IM year, though the hours were longer, I have found radiology more challenging. Per unit of time, we are doing more work than internists, which is not to say they have it easy.

"What is your least favorite thing about radiology?

That everyone is now working at such a fast pace and the cases are getting so complex that it’s simply not as much fun as it used to be. I’m really tired at the end of the day. Less time is available to talk, teach, and interact with the residents and fellows than there used to be."

I’m not saying radiology is not less intellectually challenging, it’s all the other things that makes internal medicine unbearable long notes 90% of which no one will read, patient that camp out impossible to dc. I agree with everything you said but let’s be honest we both know (unless you have forgotten) you have it better, while your scratching your head on what to say about what to say about a borderline incidental finding with a rising stack of reads to complete some internist is being yelled at by a patient who won’t let him go outside an smoke, or arguing with a social worker who does not understand why we can’t discharge patient x.
 
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NDcienporciento100

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That may be true, but radiologists earn every penny of their pay. I did a full IM year, though the hours were longer, I have found radiology more challenging. Per unit of time, we are doing more work than internists, which is not to say they have it easy.

"What is your least favorite thing about radiology?

That everyone is now working at such a fast pace and the cases are getting so complex that it’s simply not as much fun as it used to be. I’m really tired at the end of the day. Less time is available to talk, teach, and interact with the residents and fellows than there used to be."

By the way I’m on your side just in case you don’t know
 

zero0

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Did you not see the chart he posted about radiologists having to work wayyyy more in order to generate the same salary from 10 yrs ago?
That certainly was the case, but that was 5 years ago. I'm wondering how $/RVU has changed going into 2020. All salary surveys point to reimbursement going up, but I won't even go down that road on these forums after what happened with the Deficit Reduction Act.
 
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About the only thing that's making me a little hesitant about pursuing Rads is that everything I read online (studies/journal articles), indicates that outside of surgery and OBGYN, Rads is next specialty most likely to have to deal with lawsuits in their career. Most indicate that 75-90% of Radiologists will have to deal with a lawsuit during their career, compared to like 25% in Derm, Pediatrics, and Psych.

That seems really high. Is this accurate in "real life" and has it led to any regret about Rads as a career? I know that a malpractice case shouldn't be a surprise in a career as a physician, but it seems almost a guarantee in Rads, which is a little daunting to know going into a career.
 
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That certainly was the case, but that was 5 years ago. I'm wondering how $/RVU has changed going into 2020. All salary surveys point to reimbursement going up, but I won't even go down that road on these forums after what happened with the Deficit Reduction Act.
This post did not age well. CMS will cut reimbursement by 11% for rads and IR.
 
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About the only thing that's making me a little hesitant about pursuing Rads is that everything I read online (studies/journal articles), indicates that outside of surgery and OBGYN, Rads is next specialty most likely to have to deal with lawsuits in their career. Most indicate that 75-90% of Radiologists will have to deal with a lawsuit during their career, compared to like 25% in Derm, Pediatrics, and Psych.

That seems really high. Is this accurate in "real life" and has it led to any regret about Rads as a career? I know that a malpractice case shouldn't be a surprise in a career as a physician, but it seems almost a guarantee in Rads, which is a little daunting to know going into a career.
People can sue for anything these days. What you want to know is the success rate and what is the payout, which I forget the sourcez, but rads is nowhere even in the top 10.
 
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People can sue for anything these days. What you want to know is the success rate and what is the payout, which I forget the sourcez, but rads is nowhere even in the top 10.
Thanks for the information. That is encouraging. I think what really got me was a post on here from 2012 (I believe) where a neuroradiology fellow was saying that attendings were getting served every other week. I'm sure this was exaggeration, but it was coming from something beyond an article. I agree with you that anyone can sue, and it is encouraging to hear that there is low success rate. Thanks.
 

Bobcat18

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This post did not age well. CMS will cut reimbursement by 11% for rads and IR.
This is actually incorrect. It did pass but another bill was just passed which decreased the reimbursement cut from 11 to 4%. See below.

 
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Smallfishtinypond

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As a rad attending practicing in community hospital for about 10 years, I would like to suggest another perspective at the advance of technology vs human debate, in medicine in particular. No one here is certain how fast technology is advanced in displacing human in medicine in 30, 50 or 100 years. But there is one thing future physicians now can predict. You are not going to practice medicine in 50 years from now with tech whiz born in 2100. You are going to practice medicine with overwhelmingly with your current colleagues. Look around you, do you think Eileen who wants to go in to peds, or IM or Card, or Brad in surgical scrubs at the gym will utilize AI the same way that Sci-fi channel portrait ? No. These are the people you will work with at your entire career, be that 20 or 30 years. They are trained and much more comfortable with the technology of we can see now, not 50 years from now.

You all will do fine at your career choices as we all practice medicine together, with your current peers.
We often treat new technology with two opposite extreme : either " the sky is falling" or "just another Palm Pilot garbage".
 
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RapidEyeMovementLearning

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Interested in rads or gas like OP. I'm an introverted guy who hates repetitive work and has a low attention span. Is rads immediately out for me?
 
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Interested in rads or gas like OP. I'm an introverted guy who hates repetitive work and has a low attention span. Is rads immediately out for me?
I would wager that this is not a good quality for Rads. It is very detail-oriented and has pretty high malpractice risk, so 'low attention span' could get you in a lot of trouble. But I'm just a MS3, so I'll let the Residents/Fellows/Attendings chime in....
 
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Interested in rads or gas like OP. I'm an introverted guy who hates repetitive work and has a low attention span. Is rads immediately out for me?
I hate to break it to you my friend but medicine is repetitive. There's a reason people advise you to really see if you like a specialty's Bread and Butter as a means of choosing a specialty.
 
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Interested in rads or gas like OP. I'm an introverted guy who hates repetitive work and has a low attention span. Is rads immediately out for me?
Interested in rads or gas like OP. I'm an introverted guy who hates repetitive work and has a low attention span. Is rads immediately out for me?
You could be a good fit for IR. You would see less patients in clinic than most other specialists if you have a clinic and I would say a large amount of IRs don’t have clinic (though we should).

we do a lot of different procedures so the variety is there and you don’t really need the long attention span for the bread and butter cases.
 
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