The usual R1 feelings or actually not the field for me?

[Frostheat]

I am based outside of NA. I decided to apply to rads at the last second and matched.

From my previous old posts, you might noticed I was deciding on medicine vs surgery. But I had bad experiences in both and decided on radiology.
I'm currently about 6 months into my first year and my feelings started as neutral and indifferent and now I actually dislike many parts about the daily practice. I was pretty indifferent up until I started taking independant call (On the 5th month). I actually liked radiology in the beginning not for the actual practice but that daytime work had predictable hours.

I hate being the doctors' doctor. I hate that what and HOW I phrase things significantly impact patient care. Basically I hate that I'm absolutely crucial in the care. Medicine ****s up? Easy to cover with vague documentation after. Surgery ****s up? Just label it as postop complications. When I **** up, the whole hospital has to know since everything is documented from the beginning. No one is going back to the patient to retake the history to see if the primary team is liable, but they can easily open up the images and say "wow how did he miss that?"

I hate reading non-acute studies full of chronic pathology during call. I hate having to do the ultrasound exams by myself as someone who has not touched an US probe until my 3rd month into residency as it HEAVILY delays the CT readings, and of course they're always repeated in the morning because they know they can't trust me so it feels like a huge waste of my time and energy. Also doesn't help that every lower limb pain is refered to me for US "Because we cannot rule out the possibility of DVT" or any abdominal pain in a female is referred to me "Because we cannot exclude ovarian pathology". I hate the constant phone calls that actually once distracted me from a critical finding. I hate being disrespected by basically the whole hospital staff.

Outside of call, I feel like I come to work just to for the sake of showing up and fulfilling my resident duties so I get paid. Having amazing coresidents helps honestly and that's the only good I can think of about residency so far. When I go back home I feel no motivation to study mostly anything except emergency radiology topics just for the fear of messing up during call.

So, like what am I even staying for exactly? I see how my attendings are working and I feel absolutely nothing about a future like that. Rads here get about the same pay as other specialties, so even monetarily there is no reason to be excited. And I wouldn't really say that I care about ego as I always like to be in the background and not the center of attention but even after a hard call I get absolutely no recognition except when I miss. Sure, some are content with personal satisfaction but so far I haven't experienced that enough to justify residency.

I don't know. Maybe I'm just burnt out or actually clinically depressed. I applied for a switch to surgical subspecialty on a whim after one of my coresidents joked about the idea to me. Not sure if I'll go through with it, though. Grass is always greener and all that. I know surgical residency sucks a lot more, but being an attending surgical subspecialist seems a lot more appealing to me (Low number of surgical subspecialists and a lot of them are expats so there's a high demand for local graduates, better oppurtinities in private practice, and having more control over your daily schedule and most importantly no one expects you to know everything about the human body).

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[Tiger100]

Some parts of your posts are just "resident's feelings". It will resolve once you are done with residency.

But to be honest, there are several red flags in your post that makes me think rads is not a good fit for you. Without knowing you, my guess is that you won't be happy in rads. I am not saying you will be miserable in the long run esp in an academic job since the hours and the pay are good as an attending and these will satisfy a lot of people esp once you are past 45 and you have your family.

I have seen similar people like you who are OK in radiology but usually in a certain practice settings (not something special) like VA or academics or certain private practices.

 

[Frostheat]

Some parts of your posts are just "resident's feelings". It will resolve once you are done with residency.

But to be honest, there are several red flags in your post that makes me think rads is not a good fit for you. Without knowing you, my guess is that you won't be happy in rads. I am not saying you will be miserable in the long run esp in an academic job since the hours and the pay are good as an attending and these will satisfy a lot of people esp once you are past 45 and you have your family.

I have seen similar people like you who are OK in radiology but usually in a certain practice settings (not something special) like VA or academics or certain private practices.

What are the red flags?

 

[Tiger100]

Again this is my impression from your single post. I don't know you well. But from reading your post, I assume something like Derm, rad onc or certain surgical subspecialties like urology are better fits for you.

 

[Dantes]

I guess it depends how difficult switching is in your country. But you said you had a bad experience on surgery. What made you change your mind?

 

[Frostheat]

Again this is my impression from your single post. I don't know you well. But from reading your post, I assume something like Derm, rad onc or certain surgical subspecialties like urology are better fits for you.

haha I actually applied to switch to urology. Again, not sure if I'm gonna go through with that.

 

[Frostheat]

I guess it depends how difficult switching is in your country. But you said you had a bad experience on surgery. What made you change your mind?

It's fairly easy. I can apply to switch in the beginning of every year with no consequences. However, I still have to ace the interviews.

What made me change my mind? Well the bad experience in surgery (Specifically ENT) were all the airway emergencies I encountered. I'm not squeezy but I actually felt discomfort when dealing with these cases. Head and neck malignancies also have pretty bad complications and relatively poor prognosis. Clinic and the short operations were my favorite part, especially the robotic ones where no one needs to scrub in lol.

 

[tomballunger]

R1 here, hating it in diagnostic but I did the ir rotation and love it enough in ir even with the unpredictable board full of procedure add ons. I hate the huge stacks of plain films and us because i learn nothing other than list clearing and dont like how radiology tends to be a sweatshop where residents are pressured to clear lists. (I'm incredibly weak ct mr wise because r1s at my place barely do ct mr, I one of the few r1s who try to pick up ct mr but the plain film dumps handicap me). I can understand how you're feeling I spent some time as an intern with the surgical subs, and always wished I applied too, particularly to urology (nowhere as many addon procedures, and the surgical subs and urology cases tend to be repetitive and easier to master than ir). But it's super competitive these days and I don't want to rock the boat and risk my safe spot. So I'm just gonna do esir with ir fellowship, thakfully no one in my class wants it. planning to read some diagnostic in the future just to supplement income and generate referrals to ir.

 

[guytakingboards]

R1 here, hating it in diagnostic but I did the ir rotation and love it enough in ir even with the unpredictable board full of procedure add ons. I hate the huge stacks of plain films and us because i learn nothing other than list clearing and dont like how radiology tends to be a sweatshop where residents are pressured to clear lists. (I'm incredibly weak ct mr wise because r1s at my place barely do ct mr, I one of the few r1s who try to pick up ct mr but the plain film dumps handicap me). I can understand how you're feeling I spent some time as an intern with the surgical subs, and always wished I applied too, particularly to urology (nowhere as many addon procedures, and the surgical subs and urology cases tend to be repetitive and easier to master than ir). But it's super competitive these days and I don't want to rock the boat and risk my safe spot. So I'm just gonna do esir with ir fellowship, thakfully no one in my class wants it. planning to read some diagnostic in the future just to supplement income and generate referrals to ir.

Lot to unpack there.

Most of those feelings are standard for R1 year. R1 year is tough. Ironically its the year of the least actually responsibility, but the adjustment phase can be so tough that its just as unpleasant as anything else.

I don't think there's anyone under 60 who loves a long list of PF's and US's. Almost every young trainee prefers CT/MR. Your program sounds not too dissimilar to my resident program. There was an unspoken (well sometimes angrily spoken) agreement that the juniors read the simpler/less pleasant studies like PF's and US while the upper levels did the CT/MR and procedures. The thought being, a first year isn't really gonna contribute to service trying to read CT/MR when they don't have enough context/experience. Meanwhile, someone has to read that ever growing list of PF's/US's.

You will get your time to shine on CT/MR. The important thing to keep in mind is doing enough of that to be safe when you start call, but you will get plenty of CT/MRI later on in residency. And later in residency you still won't want to be reading PF/US....

Just putting it out there.... there's a lot of PF/US being done in general. Most jobs, PP in particular, will have a lot of PF/US. Alot of IR people preferentially chew through those cases cuz you're not likely to get stuck in a super complex PF before you have to go in for a case.

 

[tomballunger]

1 more ir rotation month and a month of diagnostic later, I am so much better at mr and ct body and ct chest. I now have a much stronger knowledge base that I believe in myself, study even more at night, sometimes predictate the outpatient mrs. I have a foundational base now when I'm reading out so attendings are showing me more advanced tips and knowledge. I can prelim cts independently if I get a call before readout or we run out of time for readout, attending agrees with me with few changes, or if it needs stat finalized, I tell the attendin the history and what I see and they tend to agree. and I can field the mr body phone calls with confidence. I simply blow through plain film us, go fast on those, sign those straight over to the attending no readout, use them as a mental break in between studies and all diagnostic attendings have really respected me for that, even the one who tried stepping on me. My er cross section seniors on call send me cts if they're overwhelmed and the patient is already getting admitted, they believe in me. I'm still IR bound and love ir the most, but I feel so much better about diagnostic radiology as a first year.

So for those who don't feel like radiology is for them, try studying up: do crack the core vids, qbanks, then show up to the reading room and grab the cross sections (feel free to choose the easier ones when starting out, as my attending says) blow through the plain films us fast so you have more time. Readout 5 cross sections at a time so it doesnt become overwhelming, youll learn more and get better foundation
You'll feel much more alive. And there's always ir, if you feel the reading room isnt for you, which isn't perfect like urology but it's still very good.

And this is coming from a person who didn't match urology originally, got offered help to get back in during prelim year, but refused since urology is competitive and just chose radiology because it isn't competitive back then and looked ok compared to medicine