Stay away from Nuclear Medicine - My experience

[partusa]

Long story short:
I did nucs residency in a University Hospital, also did a PET fellowship in the same place.
I have been out of fellowship for almost 2 years and I was not able to get even 1 interview for nucs.
I have been bouncing around general physicians jobs since the completion of my training. I did home assesments, house calls, medicare stuff with censeohealth but nothing really worked. There is no job stabiltity. I'm constantly looking for the next job. This reality really sucks! I spent years studying, residency, fellowship and I have nothing, no job stability, no future, zero expectations. I'm contemplating the posibility of applying to residency again.
Nobody in medicine really knows how bad is to be unemployed after all the years spent on your training.
This has to stop, residency programs for nucs should be closed, all of them, without exceptions. PD and hospitals use cheap labor and make money from medicare, just from having a couple of residents working for them. They will make you read and report all the studies, write papers, present conferences, presentations, work your ass off for NOTHING!
Residencies are still opened because the abuse the system, as simple as that.
SERIOUSLY, STAY AWAY FROM NUCS!
There are no jobs for pure nuclear medicine physicians, don't let PDs and radiology departments use you.
If you cannot get another specialty and the only option is nucs, do not do it, try to get into psych or wound care or something else.
Honestly my professional life sucks! Don't be stupid and stat away from Nucs.

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[deleted480308]

I totally get the warning future students. What I don't get is the total blame on the programs...did you not look into job situations prior to appying to residency? You would have been a 4th yr med student =>25yrs old....they didn't trick a child, they made an offer to an educated adult.

 

[partusa]

I totally get the warning future students. What I don't get is the total blame on the programs...did you not look into job situations prior to appying to residency? You would have been a 4th yr med student =>25yrs old....they didn't trick a child, they made an offer to an educated adult.

The only thing that I can tell you is that I'm an IMG that failed the step 1 once and because of that I was not able to get any other residency at that time. Believe me that if I would be an american grad I would be in the endoscopy suite now. If you are an IMG you know how hard it's for us to do what we like. If you are an american grad, then you have no freaking clue how tough this whole process is. Just from learning a new language, new method of studying and testing, starting from scratch, moving from your home and leaving everything behind, racism you name it. I did not even mention all the visa related crap.
Why do I blame the residency programs? Because you don't train people for a specific job even if there is no job market; unless you benefit from it (cheap labor/medicare money). BTW you are paying the hospital and those residents because the money comes from your taxes.

 

[coroner]

All I can say is wow. After stumbling on this sub-forum I am surprised how rough the market is for Nuclear Medicine. I thought we had it pretty bad in Pathology and you'll see the regular complaints about the job market over in the Path forums but it's nothing like this. Even we don't have residency PD's publicly announcing that it's a disservice for people pursuing this field as prospects are slim thereafter and as a result choose to close down their respective program like that guy from Baylor. But then again, that may be more do to corrupt leadership in Pathology who'd rather have warm bodies to fill a spot so they can continue to get GME funding, and have trainees do useless research even though putting out too many Pathology grads continues to flood our market.

I noticed you've been posting since around 2010 or longer about the Nuclear Med field. Even though you're an IMG who failed Step 1, I'm surprised you couldn't get into Family Med, Psych, or even Preventive/Occupational Med which would allow plenty of job opportunities. I had no idea it was that tough to even get into those residencies. I guess it's too late for you to go back now, but I'm sure there's other income streams that are potentially more lucrative than relying on hit-and-miss job opportunities in your field. Once you have a state medical license you can do a multitude of things e.g. botox clinics, laser hair removal centers, H&P's for people getting controlled substances (there's a limit per physician as to not raise flags from the DEA), even moonlighting doing basic primary care in walk-in clinics, etc. I haven't pursued these myself, but I've heard of others doing this and I'm sure there's many other things out there that I don't know off the top of my head. You are at a much greater advantage than you think because you got into an accredited residency program and completed the required number of years in graduate medical education to obtain a state license even if opportunities in your specialty/field may not be very promising. You have to take the initiative to find a niche with your background that allows you to capitalize off it to the best of your ability. I don't know what that may be, but I hope something more ideal works out down the road. Best of luck.

 

[partusa]

All I can say is wow. After stumbling on this sub-forum I am surprised how rough the market is for Nuclear Medicine. I thought we had it pretty bad in Pathology and you'll see the regular complaints about the job market over in the Path forums but it's nothing like this. Even we don't have residency PD's publicly announcing that it's a disservice for people pursuing this field as prospects are slim thereafter and as a result choose to close down their respective program like that guy from Baylor. But then again, that may be more do to corrupt leadership in Pathology who'd rather have warm bodies to fill a spot so they can continue to get GME funding, and have trainees do useless research even though putting out too many Pathology grads continues to flood our market.

I noticed you've been posting since around 2010 or longer about the Nuclear Med field. Even though you're an IMG who failed Step 1, I'm surprised you couldn't get into Family Med, Psych, or even Preventive/Occupational Med which would allow plenty of job opportunities. Didn't know it was that tough to even get into those residencies. I guess it's too late for you to go back now, but I'm sure there's other income streams that are potentially more lucrative than relying on hit-and-miss job opportunities in your field. Once you have a state medical license you can do a multitude of things e.g. botox clinics, laser hair removal centers, H&P's for people getting controlled substances (there's a limit per physician as to not raise flags from the DEA), even moonlighting doing basic primary care in walk-in clinics, etc. I haven't pursued these myself, but I've heard of others doing this and I'm sure there's many other things out there that I don't know of the top of my head. You are at a much greater advantage than you think because you got into an accredited residency program and completed the required number of years in graduate medical education to obtain a state license even if opportunities in your specialty/field may not be very promising. You have to take the initiative to find a niche with your background that allows you to capitalize off it to the best of your ability. I don't know what that may be, but I hope something more ideal works out down the road. Best of luck.

Thanks a lot for the post! It's good to see that there is educated and compassionate people in the forum.
I'm working and making decent money, probably more than a family practitioner, but the main problem is the job stability.
I know that I'll find something that will give me job security but the problem is not making money, the problem is the frustation and angryness that this generates.
As you well said I have been writing in the forum about this issue since my 1st year of residency and nothing changed.
Believe me that if I could do something legal to shut down all the nuc med residency, SNM and the nuclear medicine board, would have done it by now.
Nuc med residents pay more than $2000 to take a board examination for nothing. This is another big issue and honestly a rip off.
Radiology residents only need a 6 month rotation and they are ready to read any study and of course they are not forced to take a specific nuc med board, in order to be officially qualified. BTW, rads residents take vacation during nucs rotation since they don't like it (because they don't know how to read the studies, and they don't care either), so those 6 months are not even 6 months of training.
I won't start again with all this issue, since there is no solution.
I posted on the forum in order for med students to know the truth.

 

[shark2000]

to OP:
Sorry for

Thanks a lot for the post! It's good to see that there is educated and compassionate people in the forum.
I'm working and making decent money, probably more than a family practitioner, but the main problem is the job stability.
I know that I'll find something that will give me job security but the problem is not making money, the problem is the frustation and angryness that this generates.
As you well said I have been writing in the forum about this issue since my 1st year of residency and nothing changed.
Believe me that if I could do something legal to shut down all the nuc med residency, SNM and the nuclear medicine board, would have done it by now.
Nuc med residents pay more than $2000 to take a board examination for nothing. This is another big issue and honestly a rip off.
Radiology residents only need a 6 month rotation and they are ready to read any study and of course they are not forced to take a specific nuc med board, in order to be officially qualified. BTW, rads residents take vacation during nucs rotation since they don't like it (because they don't know how to read the studies, and they don't care either), so those 6 months are not even 6 months of training.
I won't start again with all this issue, since there is no solution.
I posted on the forum in order for med students to know the truth.

Let me correct it. It is 4 months and not 6 months. I don't know how did you come to the conclusion that they don't like it. This is a gross generalization.

Also it is ridiculous to say radiologists don't know how to read the scans while almost ALL of the Nucs in community (which is probably 70-80% of the volume in the US) is done by radiologists, many of which are not Nucs fellowship trained.

I feel for you but this problem with Nucs has been the case since 80s or even before that. It is nothing new.

 

[partusa]

to OP:
Sorry for


Let me correct it. It is 4 months and not 6 months. I don't know how did you come to the conclusion that they don't like it. This is a gross generalization.

Also it is ridiculous to say radiologists don't know how to read the scans while almost ALL of the Nucs in community (which is probably 70-80% of the volume in the US) is done by radiologists, many of which are not Nucs fellowship trained.

I feel for you but this problem with Nucs has been the case since 80s or even before that. It is nothing new.

Your name should be changed to troll2000.
A minimum of 4 months by the ABR, you are correct, which is even worse. The rads residents on my university had 6 months on their curriculum. They also had to rotate on nucs to read CT non contrast with FDG contrast, which we call PET/CT, .
The fact that you read 80% of the nuclear medicine studies in the US (I'm assuming that you are either a fresh radiology grad or a resident), does not mean that you read nuclear medicine studies accurately or you know how to read them. I would like to know who did you consult or what did you say or thought the first time you came across the first nuc med study that you read and sign in private practice without supervision. I bet you that you had to use google, took at least 40 minutes and showed it to another radiologist.
The same explanation that you are giving me about the volume can be applied to PET/CT. We read 20-30 scans a day per fellow, including VA hospital scans, meaning 100% of the studies, that means that we should be good reading CT right? but for radiologist, nuclear medicine physicians cannot read CT because we were not trained on CT.
We cannot read CT non contrast which is one modality, but you can read 20-30 different nuclear medicine studies and treat patients with radioisotopes with only 4 months of training. Even cardiologists are required to take a specific board for nuclear cardiology, but of course radiologists are the cream of the cream.
To your last point, just go and read my previous replies!
I won't reply more posts, since my first post was not to generate another long thread with stupid discussions.

 

[shark2000]

Your name should be changed to troll2000.
A minimum of 4 months by the ABR, you are correct, which is even worse. The rads residents on my university had 6 months on their curriculum. They also had to rotate on nucs to read CT non contrast with FDG contrast, which we call PET/CT, .
The fact that you read 80% of the nuclear medicine studies in the US (I'm assuming that you are either a fresh radiology grad or a resident), does not mean that you read nuclear medicine studies accurately or you know how to read them. I would like to know who did you consult or what did you say or thought the first time you came across the first nuc med study that you read and sign in private practice without supervision. I bet you that you had to use google, took at least 40 minutes and showed it to another radiologist.
The same explanation that you are giving me about the volume can be applied to PET/CT. We read 20-30 scans a day per fellow, including VA hospital scans, meaning 100% of the studies, that means that we should be good reading CT right? but for radiologist, nuclear medicine physicians cannot read CT because we were not trained on CT.
We cannot read CT non contrast which is one modality, but you can read 20-30 different nuclear medicine studies and treat patients with radioisotopes with only 4 months of training. Even cardiologists are required to take a specific board for nuclear cardiology, but of course radiologists are the cream of the cream.
To your last point, just go and read my previous replies!
I won't reply more posts, since my first post was not to generate another long thread with stupid discussions.

I didn't say we read 70% in our practice. I said 70-80% of Nucs which is almost all Nucs in private practice (except for cardiac) is read by radiologists and it has been the case for 20 or more years. It is ridiculous to say that for the last 20-30 years most of the Nucs studies have been read inaccurately. That was my point.

The first time I read Nucs in private practice was probably a few years ago when I was moonlighting as a fellow. I didn't use google. But you are right. I had to consult the technologist because I couldn't find the injected dose of radiotracer.

By reading PET-CT you don't become good at reading CT scan. Most PET-CTs are done without contrast and the resolution of the CT is lower than diagnostic CT.

Radiology board has Nucs section integrated into it. Let me explain something to you. I never had a separate exam for Neuroradiology, for body imaging, For US, for chest and ... All of these were one exam which also had Nucs in it. Also I didn't do a neuro fellowship but I read a full gamut of Neuro studies including MRI, MRA, CT perfusion, CTA head and neck, CT soft tissue neck and MR soft tissue neck. Nucs is not any different.

There is not such thing as 20-30 Nucs studies in the private practice. PET-CT is most of what we do. Bone scan, V/A scan, HIDA scan and gastric emptying are the other thing we read. Nothing more. Most cardiac is read by cardiologists but we are doing some at one site which is read by one of our rads who has done it for 20 years. Other fancy studies that you have spent 3 years learning does not exist in private practice.

Anyway, I agree with you that there is not point in arguing more. This kind of argument has been the case for 50 years. Seriously, this battle has been the case since 60s. It is nothing new and you know better than me that it goes nowhere.

The only reason that I replied to you is that you can not question the qualification of someone who is more qualified than you in interpreting PET-CT and is as qualified as you in interpreting a few bone scans and HIDA scans here and there. Be careful. You won't gain anything by questioning other people's qualifications. IMO, PET-CT should not be read by nonrads since the CT part has a lot of details and they are not qualified to do it.

 

[partusa]

By reading PET-CT you don't become good at reading CT scan. Most PET-CTs are done without contrast and the resolution of the CT is lower than diagnostic CT.

IMO, PET-CT should not be read by none rads since the CT part has a lot of details and they are not qualified to do it.

Interesting, right? You should step in front of a mirror and argue to your reflection.

There you go, proof that you have no clue about PET/CT. FYI the low dose non contrast CT on the PET/CT is only for anatomical localization, not for diagnostic purposes. Radiologists that don't have good training in nucs and/or PET try to read the non diagnostic CT, since it's the only part of the study that they know how to read and after reporting the CT, they look at the PET. If nobody explained you before, here you go: PET/CT is mainly used for staging, response to treatment and follow up, so anatomic localization is what the non diagnostic CT is for, that's it, sorry that the CT is not the most important part of the study.
Good luck in your career

 

[shark2000]

Interesting, right? You should step in front of a mirror and argue to your reflection.

There you go, proof that you have no clue about PET/CT. FYI the low dose non contrast CT on the PET/CT is only for anatomical localization, not for diagnostic purposes. Radiologists that don't have good training in nucs and/or PET try to read the non diagnostic CT, since it's the only part of the study that they know how to read and after reporting the CT, they look at the PET. If nobody explained you before, here you go: PET/CT is mainly used for staging, response to treatment and follow up, so anatomic localization is what the non diagnostic CT is for, that's it, sorry that the CT is not the most important part of the study.
Good luck in your career

This is the total BS. Low does non-contrast CT gives lots of other information. I can't count how many times that I found critical things on non contrast CT and also for example I found a metastatic lymph node that was not hot on PET. I have found metastatic lung nodules that were not hot on PET. I have found so many other very important findings. If you haven't learned that not everything that is disease recurrence is not hot on PET and not everything that is hot is not disease recurrence, I am sorry for you.

The argument of "for anatomical localization" is a total BS and is just a way to justify your incompetency at reading CT scan. It is the most stupid thing to say. CT by itself is an anatomical modality.

FYI, when I was in training the Nucs department was all radiologists with Nucs fellowship expect for one person. That person was forced to retire after he missed a big head bleed on the CT part of a PET-CT and a few other misses. But you know. From your perspective, a big head bleed is not important because it is not the purpose of the study.

There is not point in arguing anymore. Suck it up and move on. This is the reality of Nucs: Private practice don't hire Nucs people and academic centers also are more and more kicking their Nucs-only physicians out unless they have research grant. VA system is the only system that you may find some Nucs-only jobs. If you have a temporary job in pp or even a job in academics, be very careful. They may not renew your contract.

Bottom line: Try to find another residency for yourself.

 

[partusa]

This is the total BS. Low does non-contrast CT gives lots of other information. I can't count how many times that I found critical things on non contrast CT and also for example I found a metastatic lymph node that was not hot on PET. I have found metastatic lung nodules that were not hot on PET. I have found so many other very important findings. If you haven't learned that not everything that is disease recurrence is not hot on PET and not everything that is hot is not disease recurrence, I am sorry for you.

The argument of "for anatomical localization" is a total BS and is just a way to justify your incompetency at reading CT scan. It is the most stupid thing to say. CT by itself is an anatomical modality.

FYI, when I was in training the Nucs department was all radiologists with Nucs fellowship expect for one person. That person was forced to retire after he missed a big head bleed on the CT part of a PET-CT and a few other misses. But you know. From your perspective, a big head bleed is not important because it is not the purpose of the study.

There is not point in arguing anymore. Suck it up and move on. This is the reality of Nucs: Private practice don't hire Nucs people and academic centers also are more and more kicking their Nucs-only physicians out unless they have research grant. VA system is the only system that you may find some Nucs-only jobs. If you have a temporary job in pp or even a job in academics, be very careful. They may not renew your contract.

Bottom line: Try to find another residency for yourself.

The more you talk the more I realize that you are still in residency or just finished yesterday and seriously you have no idea of what you are saying. Very inmature and nonsense responses.
I never said that you don't report incidental findings or look for pathological findings on the CT. It's stupid and brainless assume that someone would not look into those findings even if they were non fdg avid. FYI, FDG uptake on nodes and pulmonary nodules depends on multiple factors, not all malignant lymphadenopathies or pulmonary nodules are FDG avid and not all FDG avid are malignant. How did you know that the lymph nodes were malignant? The surgeon just followed your bland impression of cannot rule out malignancy or you operated on the patient with your doctor toyset?
Maybe your buddies in Kinder will believe that story of the head bleed, very childish and stupid. I can tell you stories about radiologists making big mistakes on nucs studies or I can invent them too.
Keep believing that you are qualified and wait for the malpractice suits to knock on your door, then you will grow up.

 

[shark2000]

The more you talk the more I realize that you are still in residency or just finished yesterday and seriously you have no idea of what you are saying. Very inmature and nonsense responses.
I never said that you don't report incidental findings or look for pathological findings on the CT. It's stupid and brainless assume that someone would not look into those findings even if they were non fdg avid. FYI, FDG uptake on nodes and pulmonary nodules depends on multiple factors, not all malignant lymphadenopathies or pulmonary nodules are FDG avid and not all FDG avid are malignant. How did you know that the lymph nodes were malignant? The surgeon just followed your bland impression of cannot rule out malignancy or you operated on the patient with your doctor toyset?
Maybe your buddies in Kinder will believe that story of the head bleed, very childish and stupid. I can tell you stories about radiologists making big mistakes on nucs studies or I can invent them too.
Keep believing that you are qualified and wait for the malpractice suits to knock on your door, then you will grow up.

You didn't have any idea what you were doing when you chose Nucs. It was a very nonsense and terrible decision.

And now you don't know what you are talking about. You are answering your own BS. CT is not only for anatomical localization only and can give diagnostic info also. A few paragraphs before you mentioned that CT is only for localization purposes. It is not "Incidental" findings, it is "the finding". In order to interpret the CT, someone should know how to and Nucs people don't know. period.

Managing a lung nodule depends on many conditions (beyond your understanding). But yes, I biopsy them MYSELF if it has certain criteria. You are not qualified to talk about pulmonary nodules and lymph nodes. Like it or not, radiologists read CT chest, abdomen and pelvis for cancer stating and surveillance all the time and they know how to manage pulmonary nodules and enlarged lymph nodes. Just to give you an idea.

The story of the head bleed is stupid because it was read by a Nucs person and not a radiologist and that is my point. Nucs people are not qualified to read PET-CT because they make stupid mistake. He was not kicked out just because of this one mistake.

By personal attacks you are not going anywhere. You played this game once in 2010 on this forum and it didn't go anywhere.

 

[partusa]

You didn't have any idea what you were doing when you chose Nucs. It was a very nonsense and terrible decision.

And now you don't know what you are talking about. You are answering your own BS. CT is not only for anatomical localization only and can give diagnostic info also. A few paragraphs before you mentioned that CT is only for localization purposes. It is not "Incidental" findings, it is "the finding". In order to interpret the CT, someone should know how to and Nucs people don't know. period.

Managing a lung nodule depends on many conditions (beyond your understanding). But yes, I biopsy them MYSELF if it has certain criteria. You are not qualified to talk about pulmonary nodules and lymph nodes. Like it or not, radiologists read CT chest, abdomen and pelvis for cancer stating and surveillance all the time and they know how to manage pulmonary nodules and enlarged lymph nodes. Just to give you an idea.

The story of the head bleed is stupid because it was read by a Nucs person and not a radiologist and that is my point. Nucs people are not qualified to read PET-CT because they make stupid mistake. He was not kicked out just because of this one mistake.

By personal attacks you are not going anywhere. You played this game once in 2010 on this forum and it didn't go anywhere.

I did not attack anybody, your first post and also others posts in other topics are offensive, childish and brainless. I really doubt that you even finish residency. Real radiologist don't give a f#%* about this topic and they don't have time to argue about this either.

At least we agree on one thing: choosing nucs was a terrible decision and the worse of my life, but unfortunately as I mentioned above being an IMG is not easy and it was the only residency that I was able to get. My first post was to help people, so they don't make the same terrible mistake.
Dr. Mediocre Troll, it was a pleasure to argue with you. I won't reply any more posts from you. Have fun and remember me during your first deposition with the lawyer!

 

[shark2000]

I did not attack anybody, your first post and also others posts in other topics are offensive, childish and brainless. I really doubt that you even finish residency. Real radiologist don't give a f#%* about this topic and they don't have time to argue about this either.

At least we agree on one thing: choosing nucs was a terrible decision and the worse of my life, but unfortunately as I mentioned above being an IMG is not easy and it was the only residency that I was able to get. My first post was to help people, so they don't make the same terrible mistake.
Dr. Mediocre Troll, it was a pleasure to argue with you. I won't reply any more posts from you. Have fun and remember me during your first deposition with the lawyer!

You are not going to get a job by repeating your personal attacks. I don't need to prove to you that I am a resident or an attending in practice. You are miserable and will be miserable the rest of your life.

BTW, they don't invite Nucs doctors to lawsuit cases. Most of the time it is a radiologist. You don't have a chance in that business either.

 

[partusa]

You are not going to get a job by repeating your personal attacks. I don't need to prove to you that I am a resident or an attending in practice. You are miserable and will be miserable the rest of your life.

BTW, they don't invite Nucs doctors to lawsuit cases. Most of the time it is a radiologist. You don't have a chance in that business either.

Ohhh, I feel so sad, let me get a tissue to clean my tears! You calling me miserable? hahahaha!

 

[shark2000]

Ohhh, I feel so sad, let me get a tissue to clean my tears!

I feel for you. It is very hard.

 

[nuclearurology]

Nuclear medicine is a rewarding specialty. Hang in there. keep trying. It will be worth it when you find employment

 

[Vladi123]

Long story short:
I did nucs residency in a University Hospital, also did a PET fellowship in the same place.
I have been out of fellowship for almost 2 years and I was not able to get even 1 interview for nucs.
I have been bouncing around general physicians jobs since the completion of my training. I did home assesments, house calls, medicare stuff with censeohealth but nothing really worked. There is no job stabiltity. I'm constantly looking for the next job. This reality really sucks! I spent years studying, residency, fellowship and I have nothing, no job stability, no future, zero expectations. I'm contemplating the posibility of applying to residency again.
Nobody in medicine really knows how bad is to be unemployed after all the years spent on your training.
This has to stop, residency programs for nucs should be closed, all of them, without exceptions. PD and hospitals use cheap labor and make money from medicare, just from having a couple of residents working for them. They will make you read and report all the studies, write papers, present conferences, presentations, work your ass off for NOTHING!
Residencies are still opened because the abuse the system, as simple as that.
SERIOUSLY, STAY AWAY FROM NUCS!
There are no jobs for pure nuclear medicine physicians, don't let PDs and radiology departments use you.
If you cannot get another specialty and the only option is nucs, do not do it, try to get into psych or wound care or something else.
Honestly my professional life sucks! Don't be stupid and stat away from Nucs.

Hi!
Very serious situation. I understand you very much. I am IMG, and I will have an interview in Nucler Medicine program. After your post reading I don't know what to do...

Did you get a job now? Did you try military?

 

[partusa]

Hi!
Very serious situation. I understand you very much. I am IMG, and I will have an interview in Nucler Medicine program. After your post reading I don't know what to do...

Did you get a job now? Did you try military?

I won't reply here since there are a lot of a**holes laughing about our unfortunate and serious issue. Check your inbox, sending you a PM.

 

[Rads312]

Nuclear medicine is a rewarding specialty. Hang in there. keep trying. It will be worth it when you find employment

you are SO full of ****.

 

[seckinb]

So nucs are unemployed.

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