Switching From EM Into radiology?

[PreMedReap123]

I'm a current M4 pretty much done interviewing for Emergency Medicine this cycle who's having second thoughts about my choice based on the outlook for EM as has been discussed frequently online and also after more introspection, and considering potentially switching to Radiology in the future. It's obviously too late for this cycle, but how doable would this be during my EM intern year if I decided for sure that's what I wanted to do? I'm a US MD, >245 step 1 and around 250 step 2. Also, does anyone know if intern year in EM would count as my preliminary year? I understand this sort of switch is not as rare as I once thought, but still trying to get a better picture of how realistic it actually is and what barriers I'd be up against.

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[cyanide12345678]

I don't know how you would make it happen. But i think it's a good life decision. If you're having second thoughts now, things are not going to get any better over time.

 

[Vandalia]

I'm a current M4 pretty much done interviewing for Emergency Medicine this cycle who's having second thoughts about my choice based on the outlook for EM as has been discussed frequently online and also after more introspection, and considering potentially switching to Radiology in the future. It's obviously too late for this cycle, but how doable would this be during my EM intern year if I decided for sure that's what I wanted to do? I'm a US MD, >245 step 1 and around 250 step 2. Also, does anyone know if intern year in EM would count as my preliminary year? I understand this sort of switch is not as rare as I once thought, but still trying to get a better picture of how realistic it actually is and what barriers I'd be up against.

Have you been to several of the radiology forums and sites like Aunt Minnie to see how radiologists view the future of radiology? Hint: Not good.

If you feel that you would be more comfortable in radiology than EM, then fine. But no one has any idea how the different specialties will play out in five years, let alone thirty.

There are no professions or specialties that have a completely rosy future: Lawyers, Dentists, Pharmacists are jumping out of windows, and even Dermatology is all "doom and gloom" about their future.

 

[JacobMcCandles]

If you're basing your career decision off of forum posts then you're likely going to be unhappy no matter what you do.

 

[g3tb0mbed]

Have you been to several of the radiology forums and sites like Aunt Minnie to see how radiologists view the future of radiology? Hint: Not good.

If you feel that you would be more comfortable in radiology than EM, then fine. But no one has any idea how the different specialties will play out in five years, let alone thirty.

There are no professions or specialties that have a completely rosy future: Lawyers, Dentists, Pharmacists are jumping out of windows, and even Dermatology is all "doom and gloom" about their future.

I've seen the exact opposite where most people in radiology aren't worried about things like AI. It's mostly people outside of the field worrying.

 

[kumatie]

I'm a current M4 pretty much done interviewing for Emergency Medicine this cycle who's having second thoughts about my choice based on the outlook for EM as has been discussed frequently online and also after more introspection, and considering potentially switching to Radiology in the future. It's obviously too late for this cycle, but how doable would this be during my EM intern year if I decided for sure that's what I wanted to do? I'm a US MD, >245 step 1 and around 250 step 2. Also, does anyone know if intern year in EM would count as my preliminary year? I understand this sort of switch is not as rare as I once thought, but still trying to get a better picture of how realistic it actually is and what barriers I'd be up against.

If you are having these feelings now get out of the EM track ASAP, if will only get harder to make this decision the longer you wait. EM is dead and will be the least respected and paid specialty in 10 years.

 

[HemorrhagicShock]

Get out ASAP!!

Radiology is a great option and I echo the comments above that not a single radiologist I know is worried about AI. Though to some extent, AI will function as the "physician extender" or midlevel within radiology, allowing every single radiologist to be more productive per unit time.

Obviously, that could get ugly quick (much like it has within our field). However, based on what my rads friends tell me that isn't within the career time frame of even a current MS4. It's also reasonable to believe that with improved/additional/new? technology medical diagnosis will continue to lean more into imaging-based diagnosis. Do you ever wonder how much diagnosing gets done via imaging these days? I think that will only increase. Radiological utilization continues to skyrocket, and it's all but guaranteed that imaging volume will follow this trend.

Either way, it's a much much much better field with way more potential, way more income-positive fellowship options, and something you could easily do for 30 years. I cannot say the same about EM the way it's practiced today. I couldn't do this for more than 10 years, and I'm in my mid-thirties.

For the love of god, please switch specialties. Don't just do it for yourself, do it for me and the rest of us who are already in too deep!!

 

[Rekt]

Have you been to several of the radiology forums and sites like Aunt Minnie to see how radiologists view the future of radiology? Hint: Not good.

If you feel that you would be more comfortable in radiology than EM, then fine. But no one has any idea how the different specialties will play out in five years, let alone thirty.

There are no professions or specialties that have a completely rosy future: Lawyers, Dentists, Pharmacists are jumping out of windows, and even Dermatology is all "doom and gloom" about their future.

If you're basing your career decision off of forum posts then you're likely going to be unhappy no matter what you do.

This post is the reason for these negative posts. Helping people not make the mistake of going EM. EM is a mess. Literally seeing PGY3 saying they'll take any job right now. Yes, PGY3s that should have easily signed months ago are scrambling to find anything at all.

 

[PreMedReap123]

If you're basing your career decision off of forum posts then you're likely going to be unhappy no matter what you do.

Just to be clear this isn't out of the blue and not just because of forum posts. I had previously decided on Radiology, but only changed my mind back to EM due to feeling like I was abandoning the reason I went to medical school in the first place, to do direct "doctor stuff." But I'm realizing the things I love about medicine are largely the cerebral things, not the patient-centered things. I'm thinking I was foolish to pick EM and chose it more of the thought of how cool it would be to be an EM doc and wanting to be "ready for anything." I think interviewing/ working up a patient is fun, but will I still think that 10 years from now? I thought in rad they don't get tp do procedures, but as it turns out you can get to do plenty if you want. Plus I'm more of a introvert and kind of a nerd, I think I was a fool to not pick Rad all along the more I think about it. Interviewing at 15 places this cycle has only shown me that I'm sorta more of the "intellectual type" then your average EM doc, not that there aren't some.

 

[pkwraith]

Your big concern is job market and you pick Radiology of all specialities? Good luck.

 

[PreMedReap123]

Get out ASAP!!

Radiology is a great option and I echo the comments above that not a single radiologist I know is worried about AI. Though to some extent, AI will function as the "physician extender" or midlevel within radiology, allowing every single radiologist to be more productive per unit time.

Obviously, that could get ugly quick (much like it has within our field). However, based on what my rads friends tell me that isn't within the career time frame of even a current MS4. It's also reasonable to believe that with improved/additional/new? technology medical diagnosis will continue to lean more into imaging-based diagnosis. Do you ever wonder how much diagnosing gets done via imaging these days? I think that will only increase. Radiological utilization continues to skyrocket, and it's all but guaranteed that imaging volume will follow this trend.

Either way, it's a much much much better field with way more potential, way more income-positive fellowship options, and something you could easily do for 30 years. I cannot say the same about EM the way it's practiced today. I couldn't do this for more than 10 years, and I'm in my mid-thirties.

For the love of god, please switch specialties. Don't just do it for yourself, do it for me and the rest of us who are already in too deep!!

So any idea what I'll be up against trying to switch out after intern year? I'm guessing the people at my program are going to hate me?

 

[PreMedReap123]

Your big concern is job market and you pick Radiology of all specialities? Good luck.

There are grads this year going straight into making 500k+/yr working 40-45 hours a week with 10 weeks vacation. Their doom and gloom nightmare scenario would be making what we make.

 

[PreMedReap123]

If you are having these feelings now get out of the EM track ASAP, if will only get harder to make this decision the longer you wait. EM is dead and will be the least respected and paid specialty in 10 years.

So what should my steps be? Its too late this year, so what should I do during intern year to make the jump as smooth as possible?

 

[JacobMcCandles]

This post is the reason for these negative posts. Helping people not make the mistake of going EM. EM is a mess. Literally seeing PGY3 saying they'll take any job right now. Yes, PGY3s that should have easily signed months ago are scrambling to find anything at all.

What's your plan to get out? The way you make it sound you should have jumped ship already. Every occupation is going to have doom and gloom. There is downward pressure on EM compensation but there's downward pressure for all physicians regardless of specialty. Everyone has been crying about the end of medicine for decades. You'll have to adapt but as a physician in the US, you're going to be in good shape for the foreseeable future.

 

[RadsRocks!]

You can match EM, do intern year, and re-apply next cycle for a position starting in 2023 or if someone drops radiology you can get a position starting 2022.

 

[PreMedReap123]

You can match EM, do intern year, and re-apply next cycle for a position starting in 2023 or if someone drops radiology you can get a position starting 2022.

Thank you. So between now and then I can continue deciding for sure if this is what I want to do and get more exposure to both during my intern year. I would just apply through ERAS/ the match then?

 

[namethatsmell]

So presumably you've done radiology rotations, right? Talk with the rotation director and or/radiology program director at your school ASAP. Be honest, humble, and ask for their advice. They will be your best allies right now and should offer you the best advice (or at least better than us) on how to plan to get a rads spot. And who knows...perhaps they know of some radiology spots that may out of the upcoming match that you could still snag.

If you do end up matching to EM, your best hope of snagging a radiology spot is to work your butt of in residency and make an excellent impression. You'll want a great letter from your EM PD. Start to get a feel for your EM PD and aPD and see who may be the most empathetic ally to confide in and ask for help--the timing for when you should do this is open to debate, but try to hold off for a least the first 3-4 months. It'll allow you time to gain some credibility in the program, give you one last chance to decide EM isn't for you, and you'll be less likely to piss off folks off vs if you told them you wanted to jump ship on day 1. Along the way, you need to discreetly reach out the radiology PD or aPD for advice at whatever institution you match to EM at. That program, and your med school program, will probably be your two best shots for landing a rads spot. You may consider ranking EM programs that offer elective time in the pgy1 year so you could do a rads rotation and get a rec letter. Trying to land at an EM program at a place that also has a big rads residency is also a good call. Lastly, consider ranking EM programs with a fancy name attached...rads people will have no idea what the "good" EM programs are, so if you are coming from an EM program at Ivy U that'll probably be a tip factor for getting an interview.

Good luck. If you want this, you'll get it.

 

[Mushdoc]

So presumably you've done radiology rotations, right? Talk with the rotation director and or/radiology program director at your school ASAP. Be honest, humble, and ask for their advice. They will be your best allies right now and should offer you the best advice (or at least better than us) on how to plan to get a rads spot. And who knows...perhaps they know of some radiology spots that may out of the upcoming match that you could still snag.

If you do end up matching to EM, your best hope of snagging a radiology spot is to work your butt of in residency and make an excellent impression. You'll want a great letter from your EM PD. Start to get a feel for your EM PD and aPD and see who may be the most empathetic ally to confide in and ask for help--the timing for when you should do this is open to debate, but try to hold off for a least the first 3-4 months. It'll allow you time to gain some credibility in the program, give you one last chance to decide EM isn't for you, and you'll be less likely to piss off folks off vs if you told them you wanted to jump ship on day 1. Along the way, you need to discreetly reach out the radiology PD or aPD for advice at whatever institution you match to EM at. That program, and your med school program, will probably be your two best shots for landing a rads spot. You may consider ranking EM programs that offer elective time in the pgy1 year so you could do a rads rotation and get a rec letter. Trying to land at an EM program at a place that also has a big rads residency is also a good call. Lastly, consider ranking EM programs with a fancy name attached...rads people will have no idea what the "good" EM programs are, so if you are coming from an EM program at Ivy U that'll probably be a tip factor for getting an interview.

Good luck. If you want this, you'll get it.

this is the best advice so far

 

[AMEHigh]

Does the place you're going for EM have radiology?
I'm not EM or radiology, so I don't have direct experience, but I do know 2 people that switched from 1 specialty in to radiology. 1 person did it at my program after they realized they were miserable about 1 month in to intern year. They talked with the radiology program and were able to switch in to it the next year. I think whether you'd have to repeat intern year is a specific question to programs based on numbers and how many slots they have available.

Don't worry if people will "hate you." You have to do what's best for you and the earlier you figure it out the better.
Good luck to you!

 

[PreMedReap123]

So presumably you've done radiology rotations, right? Talk with the rotation director and or/radiology program director at your school ASAP. Be honest, humble, and ask for their advice. They will be your best allies right now and should offer you the best advice (or at least better than us) on how to plan to get a rads spot. And who knows...perhaps they know of some radiology spots that may out of the upcoming match that you could still snag.

If you do end up matching to EM, your best hope of snagging a radiology spot is to work your butt of in residency and make an excellent impression. You'll want a great letter from your EM PD. Start to get a feel for your EM PD and aPD and see who may be the most empathetic ally to confide in and ask for help--the timing for when you should do this is open to debate, but try to hold off for a least the first 3-4 months. It'll allow you time to gain some credibility in the program, give you one last chance to decide EM isn't for you, and you'll be less likely to piss off folks off vs if you told them you wanted to jump ship on day 1. Along the way, you need to discreetly reach out the radiology PD or aPD for advice at whatever institution you match to EM at. That program, and your med school program, will probably be your two best shots for landing a rads spot. You may consider ranking EM programs that offer elective time in the pgy1 year so you could do a rads rotation and get a rec letter. Trying to land at an EM program at a place that also has a big rads residency is also a good call. Lastly, consider ranking EM programs with a fancy name attached...rads people will have no idea what the "good" EM programs are, so if you are coming from an EM program at Ivy U that'll probably be a tip factor for getting an interview.

Good luck. If you want this, you'll get it.

Thank you this is exceedingly helpful. Unfortunately my medical school does not have it's own programs, we don't have a home hospital, so there's no "home rad PD" to talk to. I haven't done official radiology rotations, I only shadowed a couple during third year. But we do have a radiology advisor, so I will reach out to him. Looking at my EM rank list I think at least my first 8 programs are institutions that also have radiology programs, so that will be helpful. I feel like such an idiot for jumping into EM for the wrong reasons but I'm glad to see I haven't completely locked myself in at this point. Thank you again for the advice!

 

[Franzd'Epinay]

Thank you this is exceedingly helpful. Unfortunately my medical school does not have it's own programs, we don't have a home hospital, so there's no "home rad PD" to talk to. I haven't done official radiology rotations, I only shadowed a couple during third year. But we do have a radiology advisor, so I will reach out to him. Looking at my EM rank list I think at least my first 8 programs are institutions that also have radiology programs, so that will be helpful. I feel like such an idiot for jumping into EM for the wrong reasons but I'm glad to see I haven't completely locked myself in at this point. Thank you again for the advice!

I think the plan you quoted is the most reasonable moving forward.

Another option to consider would be backing out of the match now and extending your medical school graduation. How workable this is depends entirely on your school, though. Can you take a "research year" or something like that where you don't pay tuition for a significant part of the year?

Pros:
- You can go through a full application season and better choose a program that way
- You actually have time to go on interviews
- You could potentially do some official radiology rotations before this academic year ends

Cons:
- (This is the big one and entirely school-dependent) Tuition money?
- Finding something to do to fill up a year (could be a pro)?

 

[Rekt]

Didn't want to post a new thread since somewhat similar, but since we have no jobs to get, how does applying to another residency after finishing EM work? Is there finding issues? I thought I remembered this was kind of an incorrect rumor.

 

[Bea5T]

Your big concern is job market and you pick Radiology of all specialities? Good luck.

Radiology job market is leaps and bounds better than EM. A radiologist at worst is still making better money than your best EM job in big cities. Mid level.encroachment in radiology is in its infancy and isn't gaining ground anytime soon.

Though fellowship IS required. So you must be ready for the 6 years.

 

[dadaddadaBATMAN]

I think the plan you quoted is the most reasonable moving forward.

Another option to consider would be backing out of the match now and extending your medical school graduation. How workable this is depends entirely on your school, though. Can you take a "research year" or something like that where you don't pay tuition for a significant part of the year?

Pros:
- You can go through a full application season and better choose a program that way
- You actually have time to go on interviews
- You could potentially do some official radiology rotations before this academic year ends

Cons:
- (This is the big one and entirely school-dependent) Tuition money?
- Finding something to do to fill up a year (could be a pro)?

More importantly than tuition this costs 1 yr of attending salary. It also puts a red flag on your application at a vulnerable time. It’s hard to apply for another residency while currently in one, but it’s a better position to be in, and it happens semi-regularly.

 

[PreMedReap123]

So my advisor is saying that besides throwing out a few Hail-Mary applications this late in the cycle, I could also try my luck at SOAPing into a radiology position. But that seems highly risky lol.

 

[PreMedReap123]

More importantly than tuition this costs 1 yr of attending salary. It also puts a red flag on your application at a vulnerable time. It’s hard to apply for another residency while currently in one, but it’s a better position to be in, and it happens semi-regularly.

Would taking a research year be a bigger red flag than applying as a current resident in a different field? I don't understand.

 

[dadaddadaBATMAN]

So my advisor is saying that besides throwing out a few Hail-Mary applications this late in the cycle, I could also try my luck at SOAPing into a radiology position. But that seems highly risky lol.

It seems risky because it is.

Applying as a resident from another field is usually not seen as negatively, at least at my program (which was em). It shows that you can actually do the job and if you have a good pd letter it reinforces your capability.

Pulling out the match can happen for a lot of reasons. A lot of them are negative, which leads to the stigma. A pd might also look at your app and wonder if you will change your mind again when you think about rads in a year or three.

If you have a good letter from a pd they know you’ll at least do a good job when you’re there.

Just remember that this is ultimately a job application. An employer likes someone who has been an employee with experience better than a student without it.

 

[PreMedReap123]

It seems risky because it is.

Applying as a resident from another field is usually not seen as negatively, at least at my program (which was em). It shows that you can actually do the job and if you have a good pd letter it reinforces your capability.

Pulling out the match can happen for a lot of reasons. A lot of them are negative, which leads to the stigma. A pd might also look at your app and wonder if you will change your mind again when you think about rads in a year or three.

If you have a good letter from a pd they know you’ll at least do a good job when you’re there.

Just remember that this is ultimately a job application. An employer likes someone who has been an employee with experience better than a student without it.

That all makes sense, thanks. I guess I'm just having trouble picturing getting a good letter from the PD when I'm abandoning the program and putting them in a tough spot? I haven't been a resident before so maybe I'm just not understanding the dynamic. Isn't there a good chance that the PD won't want to write me a strong letter, even if I perform fine?

 

[Rekt]

That all makes sense, thanks. I guess I'm just having trouble picturing getting a good letter from the PD when I'm abandoning the program and putting them in a tough spot? I haven't been a resident before so maybe I'm just not understanding the dynamic. Isn't there a good chance that the PD won't want to write me a strong letter, even if I perform fine?

Your PD will likely understand. Even my faculty sees the writing on the wall wondering what they'll be doing with grads for the foreseeable future since ACEP thinks it's a non issue

 

[dadaddadaBATMAN]

That all makes sense, thanks. I guess I'm just having trouble picturing getting a good letter from the PD when I'm abandoning the program and putting them in a tough spot? I haven't been a resident before so maybe I'm just not understanding the dynamic. Isn't there a good chance that the PD won't want to write me a strong letter, even if I perform fine?

It’s probably not going to make you their favorite resident but view it from their perspective: if they treat you badly you might paste that all over the place and give them a bad rep which leads to a crappy match. If they’re already malignant, they don’t care about that. If they’re like most programs they want you to be happyish and continue to work hard while you’re there. In exchange they get fair warning a while ahead that you’re leaving, they get a person who has an incentive to work for them for now, and a good rep as a program from anyone you talk to. It sucks for them but beats the alternative.

Unless you’re at a malignant surgical program like one of my coresidents who left surgery for em.

 

[PreMedReap123]

It’s probably not going to make you their favorite resident but view it from their perspective: if they treat you badly you might paste that all over the place and give them a bad rep which leads to a crappy match. If they’re already malignant, they don’t care about that. If they’re like most programs they want you to be happyish and continue to work hard while you’re there. In exchange they get fair warning a while ahead that you’re leaving, they get a person who has an incentive to work for them for now, and a good rep as a program from anyone you talk to. It sucks for them but beats the alternative.

Unless you’re at a malignant surgical program like one of my coresidents who left surgery for em.

Gotcha, so sounds like my best bet is just hold tight for now, go through the match for EM and make moves my intern year. I'll try to match internally to my home rad program and if I can't swing that, I guess go through ERAS/ look around for dropped spots. That's good since it gives me time to actually explore programs and of course make sure I'm 100% certain I want to make this move. Idk why my advisor today has jumped on possibilities of me trying the SOAP or delaying graduation. I don't think I've ever gotten great advice from advisors in the past, so I don't think I'm going to listen to her. I already whipped up a radiology personal statement just in case I guess. Thanks everyone for the advice! I feel much better seeing a clear plan for what to do going forward. I'm going to rearrange my rank list with the possibility of pursuing radiology in mind now.

Your PD will likely understand. Even my faculty sees the writing on the wall wondering what they'll be doing with grads for the foreseeable future since ACEP thinks it's a non issue

 

[GatorCHOMPions]

The cerebral people in EM go into academics. In these times and going forward you’ll need to do a fellowship to get a job in academia, so you’ll be investing 4-6 years of training (depending on residency and choice of fellowship) going the EM route to find your happy place based on how you describe yourself. Radiology is a great idea if you aren’t 100% all-in with EM. I’m jumping ship after being an attending for a few years because the job prospects and satisfaction are getting more negative each day. I say this to encourage you that it’s never too late to switch or change things up. I wish I listened to myself more strongly a few years ago. Agree with those who say match intern year and apply for Radiology next cycle. Good luck!

 

[PreMedReap123]

The cerebral people in EM go into academics. In these times and going forward you’ll need to do a fellowship to get a job in academia, so you’ll be investing 4-6 years of training (depending on residency and choice of fellowship) going the EM route to find your happy place based on how you describe yourself. Radiology is a great idea if you aren’t 100% all-in with EM. I’m jumping ship after being an attending for a few years because the job prospects and satisfaction are getting more negative each day. I say this to encourage you that it’s never too late to switch or change things up. I wish I listened to myself more strongly a few years ago. Agree with those who say match intern year and apply for Radiology next cycle. Good luck!

Thank you for contributing another perspective. The more I've thought about it and now talked about it out loud to some people, the more sure I've become that this is what I'm better off doing, even though the path of least resistance right now would certainly be to stay the course and continue on with EM, the stress will be worth it if it sets me up for a more fitting career. Good luck with your change as well!

 

[TheComebacKid]

This forum is really just an echo chamber. Very little concept of what is going on in the outside world.

The dumpster fire that we perceive to be EM, is really just a part of a much larger dumpster fire in medicine right now. It's completely faulty thinking that because EM has it bad that other specialties have it better. It's simply not true. We can talk about pediatrics, internal medicine, surgery (I have close friends in these circles that are all possibly unemployed next year), but since this topic is about radiology we can talk about that.

There is most definitely a push to increase teleradiology services due to cost savings. I agree that the threat of AI is really not a real and palpable one at this juncture. But when ED volumes are down, what do you think radiologists are doing when we aren't ordering pan scans? Ask the radiology residents at your home institution what happened to the number of reads that they were performing? Are Medicare cuts just going to hurt us in EM, but imaging studies are going to be reimbursed just as much if not more? Wrong. Also, the corporatization that is plaguing EM is projected to wreck radiology as well. Midlevels are already encroaching into IR, although I do agree nowhere close to the degree as EM. The list goes on and on...

Do you really think the market forces that have crippled EM have not affected other specialities? You think the people in the C-suite are sparing radiology at the expense of anyone else? Wrong. Everyone is fair game.

Radiology is a great specialty for a variety of reasons. I briefly flirted with doing IR at some point in medical school. That being said, the clinical medicine was and still is a draw to me to EM. If you are having doubts about EM, it's reasonable to contemplate radiology. But you could also just be getting cold feet now that the match is drawing near. That happened to me, as well as a lot of people.

Take your time over the next several months to mull it over. If you end up doing EM for a year and switching, it's not the end of the world. But just like you may end up regretting NOT doing radiology, you may be sitting in a reading room some day wishing you were the one who was clinically correlating.

 

[PreMedReap123]

This forum is really just an echo chamber. Very little concept of what is going on in the outside world.

The dumpster fire that we perceive to be EM, is really just a part of a much larger dumpster fire in medicine right now. It's completely faulty thinking that because EM has it bad that other specialties have it better. It's simply not true. We can talk about pediatrics, internal medicine, surgery (I have close friends in these circles that are all possibly unemployed next year), but since this topic is about radiology we can talk about that.

There is most definitely a push to increase teleradiology services due to cost savings. I agree that the threat of AI is really not a real and palpable one at this juncture. But when ED volumes are down, what do you think radiologists are doing when we aren't ordering pan scans? Ask the radiology residents at your home institution what happened to the number of reads that they were performing? Are Medicare cuts just going to hurt us in EM, but imaging studies are going to be reimbursed just as much if not more? Wrong. Also, the corporatization that is plaguing EM is projected to wreck radiology as well. Midlevels are already encroaching into IR, although I do agree nowhere close to the degree as EM. The list goes on and on...

Do you really think the market forces that have crippled EM have not affected other specialities? You think the people in the C-suite are sparing radiology at the expense of anyone else? Wrong. Everyone is fair game.

Radiology is a great specialty for a variety of reasons. I briefly flirted with doing IR at some point in medical school. That being said, the clinical medicine was and still is a draw to me to EM. If you are having doubts about EM, it's reasonable to contemplate radiology. But you could also just be getting cold feet now that the match is drawing near. That happened to me, as well as a lot of people.

Take your time over the next several months to mull it over. If you end up doing EM for a year and switching, it's not the end of the world. But just like you may end up regretting NOT doing radiology, you may be sitting in a reading room some day wishing you were the one who was clinically correlating.

Thank you for the perspective. Yes unfortunately I wish I could be 100% certain about what I want. Obviously there were things that drew me to EM, I definitely enjoy clinical medicine and directly working people up and I did also do well on my EM rotations, getting a solid SLOE and now I have a rank list a lot of applicants would kill for right now. This is a back and forth I've been going through for over a year now, having previously been dead set on doing radiology. It's just unfortunately now bled over past the point of no return as far as match is concerned. I'm someone that is very self reflective, and I'm having a great deal of difficulty in confidently making up my mind. But currently I'm thinking my personality and temperament is more of a radiologist's. I need to do a lot of soul-searching these coming months to make up my mind during intern year. I'm going to try to spend more time around radiologists to get better perspective. Maybe even talk to a therapist just to get better perspective about myself and what will make me happy.

 

[kumatie]

Thank you for the perspective. Yes unfortunately I wish I could be 100% certain about what I want. Obviously there were things that drew me to EM, I definitely enjoy clinical medicine and directly working people up and I did also do well on my EM rotations, getting a solid SLOE and now I have a rank list a lot of applicants would kill for right now. This is a back and forth I've been going through for over a year now, having previously been dead set on doing radiology. It's just unfortunately now bled over past the point of no return as far as match is concerned. I'm someone that is very self reflective, and I'm having a great deal of difficulty in confidently making up my mind. But currently I'm thinking my personality and temperament is more of a radiologist's. I need to do a lot of soul-searching these coming months to make up my mind during intern year. I'm going to try to spend more time around radiologists to get better perspective. Maybe even talk to a therapist just to get better perspective about myself and what will make me happy.

It’s easy to over think a Career decision. You have to look at some simple aspects of your future career in medicine.
If you chose EM, in 3 years when you graduate from EM residency, I can almost Guarantee you will not have a job.I don’t think people understand how truly terrible the job market is going to get in the next 3-5 years. And all of reasons that you went into emergency medicine will be for nothing.
I would kill to be in your position, go for rads, at least you know you will have a job when you graduate

 

[TheComebacKid]

It’s easy to over think a Career decision. You have to look at some simple aspects of your future career in medicine.
If you chose EM, in 3 years when you graduate from EM residency, I can almost Guarantee you will not have a job.I don’t think people understand how truly terrible the job market is going to get in the next 3-5 years. And all of reasons that you went into emergency medicine will be for nothing.
I would kill to be in your position, go for rads, at least you know you will have a job when you graduate

Sorry but this is god awful advice. Absolutely no evidence that if you if you do EM you won’t have a job and if you do rads you will. The job market fluctuates. Things change. Tomorrow the rads market may be completely decimated for a variety of reasons that we cannot predict.

You would be making a huge mistake to choose a career you are stuck with for the rest of your life based on SDN projections of where the specialty will be down the road. 15 years ago if you were a CT surgeon you could get any job you want. They thought they were untouchable. Until the interventional cardiologists came along and change up the landscape. The job market for CT surgery is nowhere is lucrative as it use to be and much more competitive. Why would we think radiology is immune

OP, you are smart for considering things like your temperament, personality, and overall “fit” for the specialty. Perceived marketability of going into a specialty is based on nothing more than feelings and present day frustration.

Take the next 6 months to fully assess the situation. Enjoy the accomplishment of the match. Be as normal of an MS4 as you can in these times. I found my thoughts on various specialties changed drastically in the short term but over the long term I was able to find some clarity. You will too.

 

[Franzd'Epinay]

Pulling out the match can happen for a lot of reasons. A lot of them are negative, which leads to the stigma. A pd might also look at your app and wonder if you will change your mind again when you think about rads in a year or three.

I don't see how this applies to one case but not the other. In both situations the applicant changed their mind from EM to Radiology.

 

[Franzd'Epinay]

Didn't want to post a new thread since somewhat similar, but since we have no jobs to get, how does applying to another residency after finishing EM work? Is there finding issues? I thought I remembered this was kind of an incorrect rumor.

It depends on what version of the rumor you heard.

To make a long and complicated story short, let's assume you finished EM and are starting a new residency in Radiology at Hospital X. If you were a brand-new Radiology resident (with no previous training), Medicare would pay Hospital X a certain amount of money to train you. In your case, Medicare will pay Hospital X 50% of that figure.

So yes, there are funding differences. No, it's not as extreme as 0 funding.

 

[kumatie]

Sorry but this is god awful advice. Absolutely no evidence that if you if you do EM you won’t have a job and if you do rads you will. The job market fluctuates. Things change. Tomorrow the rads market may be completely decimated for a variety of reasons that we cannot predict.

You would be making a huge mistake to choose a career you are stuck with for the rest of your life based on SDN projections of where the specialty will be down the road. 15 years ago if you were a CT surgeon you could get any job you want. They thought they were untouchable. Until the interventional cardiologists came along and change up the landscape. The job market for CT surgery is nowhere is lucrative as it use to be and much more competitive. Why would we think radiology is immune

OP, you are smart for considering things like your temperament, personality, and overall “fit” for the specialty. Perceived marketability of going into a specialty is based on nothing more than feelings and present day frustration.

Take the next 6 months to fully assess the situation. Enjoy the accomplishment of the match. Be as normal of an MS4 as you can in these times. I found my thoughts on various specialties changed drastically in the short term but over the long term I was able to find some clarity. You will too.

Where the hell have you been practicing? Oh wait you still in residency... I have been 10 years out, the job market year after year has gotten constantly worse. The number of docs applying for one attending position has increased dramatically. Yea, no evidence of cme glut, mid level take over, decreased reimbursement, insane increase in number of residency, all with a relative fixed number of attending jobs.
Does rads have any of these above issues?
I am Curious what the other attending who have been out have to say about the job market predictions, but I can tell you it’s worse then rads

 

[RustedFox]

Where the hell have you been practicing? Oh wait you still in residency... I have been 10 years out, the job market year after year has gotten constantly worse. The number of docs applying for one attending position has increased dramatically. Yea, no evidence of cme glut, mid level take over, decreased reimbursement, insane increase in number of residency, all with a relative fixed number of attending jobs.
Does rads have any of these above issues?
I am Curious what the other attending who have been out have to say about the job market predictions, but I can tell you it’s worse then rads

8 years out here.
Yeah, you're not wrong.
Florida is especially, especially bad.

 

[turkeyjerky]

Where the hell have you been practicing? Oh wait you still in residency... I have been 10 years out, the job market year after year has gotten constantly worse. The number of docs applying for one attending position has increased dramatically. Yea, no evidence of cme glut, mid level take over, decreased reimbursement, insane increase in number of residency, all with a relative fixed number of attending jobs.
Does rads have any of these above issues?
I am Curious what the other attending who have been out have to say about the job market predictions, but I can tell you it’s worse then rads

Yeah. People don't seem to remember that there was a slow, long-term decline in job availability before 2020. It's hard though, since if you're not actively keyed into things, these trends just pass by without you realizing it. Leading to many academic attendings believing that this is a momentary blip and counseling their students poorly.

 

[namethatsmell]

I haven't done official radiology rotations, I only shadowed a couple during third year.

OK, this raises several questions.

First and foremost -- how comfortable are you devoting 4 years to something you've not had a chance to get a real taste of?

Second, where will you get radiology LORs from to apply to rads?

Third, will radiology programs seriously consider a candidate who hasn't actually done a radiology rotation?

A unifying answer to these questions would be to do a radiology rotation ASAP. Even if it's after the match, you need to do everything you can to find a way to do one (or more) before you graduate. Kick *ss on them and get LORs. That will allow your interest in radiology (assuming you still have one after doing a rotation) to hold much more water if/when you try to switch into that field.

And then for the 4th question: is your advisor a practicing physician under the age of 90? It's a bit shocking that he/she would be floating/ supporting the ideas of trying to apply now, SOAP into a spot, or delay graduation...without you having actually done a radiology rotation or having a rads LOR. I think you're wise, as you'd said, to take his/her suggestions with a massive boulder of salt.

At this point, in my armchair anonymous internet opinion, you should go all out for EM and if you don't like it try to switch into something you'd like more. Sure, that sounds like it could be rads. But if, after doing a rotation in it, it's not quite the fit you're looking for than don't hesitate to consider another field.

While it can seem like your future is sealed by matching into a specific field, it's not. People switch into different specialties all the time. Doing some extra time in training isn't that big of a deal if it improves the rest of your career.

 

[Rekt]

Sorry but this is god awful advice. Absolutely no evidence that if you if you do EM you won’t have a job and if you do rads you will. The job market fluctuates. Things change. Tomorrow the rads market may be completely decimated for a variety of reasons that we cannot predict.

You would be making a huge mistake to choose a career you are stuck with for the rest of your life based on SDN projections of where the specialty will be down the road. 15 years ago if you were a CT surgeon you could get any job you want. They thought they were untouchable. Until the interventional cardiologists came along and change up the landscape. The job market for CT surgery is nowhere is lucrative as it use to be and much more competitive. Why would we think radiology is immune

OP, you are smart for considering things like your temperament, personality, and overall “fit” for the specialty. Perceived marketability of going into a specialty is based on nothing more than feelings and present day frustration.

Take the next 6 months to fully assess the situation. Enjoy the accomplishment of the match. Be as normal of an MS4 as you can in these times. I found my thoughts on various specialties changed drastically in the short term but over the long term I was able to find some clarity. You will too.

I don't understand how people don't see how the market actually is. People going just starting to gointo EM have a very real risk of not having a job (or essentially a job that's the equivalent of a midlevel).

There's no rebound for EM for Christ sakes.

It's. Not. Covid.

Just go look at the amount of residencies that have opened in the past four years alone.

 

[ThatSerb]

Your big concern is job market and you pick Radiology of all specialities? Good luck.

what would you suggest then?

 

[PreMedReap123]

OK, this raises several questions.

First and foremost -- how comfortable are you devoting 4 years to something you've not had a chance to get a real taste of?

Second, where will you get radiology LORs from to apply to rads?

Third, will radiology programs seriously consider a candidate who hasn't actually done a radiology rotation?

A unifying answer to these questions would be to do a radiology rotation ASAP. Even if it's after the match, you need to do everything you can to find a way to do one (or more) before you graduate. Kick *ss on them and get LORs. That will allow your interest in radiology (assuming you still have one after doing a rotation) to hold much more water if/when you try to switch into that field.

And then for the 4th question: is your advisor a practicing physician under the age of 90? It's a bit shocking that he/she would be floating/ supporting the ideas of trying to apply now, SOAP into a spot, or delay graduation...without you having actually done a radiology rotation or having a rads LOR. I think you're wise, as you'd said, to take his/her suggestions with a massive boulder of salt.

At this point, in my armchair anonymous internet opinion, you should go all out for EM and if you don't like it try to switch into something you'd like more. Sure, that sounds like it could be rads. But if, after doing a rotation in it, it's not quite the fit you're looking for than don't hesitate to consider another field.

While it can seem like your future is sealed by matching into a specific field, it's not. People switch into different specialties all the time. Doing some extra time in training isn't that big of a deal if it improves the rest of your career.

This is all very sensible advice so thank you. Yes this advisor in question is not actually a physician, she is just in charge of general match/ career advise. I'm aware she's basically useless in this instance. Luckily I reached out to 3 different radiologists connected to my school who I know and all 3 of them have arranged times for me to talk with them on the phone. I'll definitely see if I can try to snag a rads rotation this year through my school. Yes, my plan right now is to proceed as usual for EM, maybe with some adjustments in rank list to help keep my radiology prospects looking better if I do go for the switch. In the mean-time I am getting a plan together and taking the steps necessary to #1 figure my own **** out and #2 do what I would need to do to make me a viable radiology candidate during my intern year. I'm definitely not about to set fire to my 14 program rank list and jump into SOAP lol.

edit: just want to add I am overwhelmed by how helpful and overall supportive ya'll have been. I'm obviously going through a personally turbulent time but the advise here has given me a great deal of clarity so thank you everyone. Aunt Minnie people have been helpful as well.

 

[TheComebacKid]

Where the hell have you been practicing? Oh wait you still in residency... I have been 10 years out, the job market year after year has gotten constantly worse. The number of docs applying for one attending position has increased dramatically. Yea, no evidence of cme glut, mid level take over, decreased reimbursement, insane increase in number of residency, all with a relative fixed number of attending jobs.
Does rads have any of these above issues?
I am Curious what the other attending who have been out have to say about the job market predictions, but I can tell you it’s worse then rads

I never said the job market was currently good. Perhaps you may have misunderstood me. The job market today is terrible. But to make a decision to not pursue a specialty based on projections for where the market will be down the road makes no sense. To act like no specialty will ever rebound also makes no sense. Anesthesia/rads had issues with over saturation, CRNA takeover etc. Things change. Their outlooks aren’t so abysmal anymore.

i am in the cohort of new graduates who applied for jobs this year. I am well aware of the challenges faced in terms of securing a job. I’ve seen firsthand my peers have their contracts pulled, hours cut, etc. in spite of that, I don’t know any EM doc who is out there on welfare because they are unemployed. People are making hard decisions. Taking jobs in less desirable locations for less pay. Adapting to the circumstances. It’s a tough time no question. Mid level creep and decreased reimbursement are a problem for EM. But not just EM. Other specialties are facing the same pressures.

Telling someone to pursue radiology based solely on job prospects (not to mention the fact that I don’t think you are a practicing radiologist) screams to me of “grass is always greener”.

 

[Birdstrike]

I made the decision to be a doctor, 30 years ago. In that time, I've already witnessed numerous of these profession and specialty doom-and-gloom scenarios, come, go, and come again, multiple times, in numerous specialties. Everyone thinks that previous generation had it so much better, they're getting screwed and it's always "Getting worse." It's mostly, type-A, physician personality pessimism gone awry. It'll never change.

Just do what you like. Don't worry about speciality outlooks, or predictions. These things are cyclical and the pendulum always swings back and forth. If you enjoy what you're doing, you'll weather any of these storms. If you don't enjoy what you're doing, no job "future outlook," no matter how rosey, is going to make the job any less miserable.

Ignore the negative Nancy's. They're the same jerks that told you it was impossible for you to get into medical school.

 

[turkeyjerky]

I made the decision to be a doctor, 30 years ago. In that time, I've already witnessed numerous of these profession and specialty doom-and-gloom scenarios, come, go, and come again, multiple times, in numerous specialties. Everyone thinks that previous generation had it so much better, they're getting screwed and it's always "Getting worse." It's mostly, type-A, physician personality pessimism gone awry. It'll never change.

Just do what you like. Don't worry about speciality outlooks, or predictions. These things are cyclical and the pendulum always swings back and forth. If you enjoy what you're doing, you'll weather any of these storms. If you don't enjoy what you're doing, no job "future outlook," no matter how rosey, is going to make the job any less miserable.

Ignore the negative Nancy's. They're the same jerks that told you it was impossible for you to get into medical school.

What were the previous doom-and-gloom scenarios of EM? I'm thinking there was a lot of worry that the ACA would decimate salaries (whereas it actually did the opposite), but anything else?

 

[partypantss]

I made the decision to be a doctor, 30 years ago. In that time, I've already witnessed numerous of these profession and specialty doom-and-gloom scenarios, come, go, and come again, multiple times, in numerous specialties. Everyone thinks that previous generation had it so much better, they're getting screwed and it's always "Getting worse." It's mostly, type-A, physician personality pessimism gone awry. It'll never change.

Just do what you like. Don't worry about speciality outlooks, or predictions. These things are cyclical and the pendulum always swings back and forth. If you enjoy what you're doing, you'll weather any of these storms. If you don't enjoy what you're doing, no job "future outlook," no matter how rosey, is going to make the job any less miserable.

Ignore the negative Nancy's. They're the same jerks that told you it was impossible for you to get into medical school.

I guess it's just hard to ignore when they seem to have so much evidence. As a fourth year med student I see all of these posts from people that are farther along saying how we're going to be screwed in EM and it's difficult to disregard that since I acknowledge my own ignorance and lack of experience compared to current residents/ attendings. Do you think it's possible for our field to find some degree of balance, with caps on amount of midlevels one doc is expected to supervise and whatnot the way anesthesiology seemed to have?