Typical day of a radiology resident

[LGMD]

What is the typical day of a radiology resident like?

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[colbgw02]

Show up around 9, sip coffee until 10, look at a few x-rays until lunch, lunch, conference, go home around 2.

Why do you ask?

 

[LGMD]

Just wanted to know. Im a med student, and I don't know much about radiology and I want to know what a radiology resident does in a typical day.

 

[ttumed]

Wow you have a nice program. My program

Morning conference at 7:30
Reading rooms in the morning
Noon conference at 12:00 (duh)
More reading room until 5 ish

Go home, read... and do it again.

This is not a bad thing. There is quite a bit of teaching. Just a little busier than what was mentioned above.

 

[colbgw02]

Wow you have a nice program.

I thought I had made it too absurd to be taken seriously. I guess not.

Show up: 0630
Pre-read/Study: 0630-0730
Conference: 0730-0830
Pre-read/Read out/Dictate: 0830-1200
Lunch/Lunch Conference: 1200-1300
Pre-read/Read out/Dictate: 1300-1600
Conference: 1600-1630
Pre-read/Dictate: 1630-1700

I also study at least an hour each night.

 

[IheartCaffeine]

Which PGY are you guys?

I thought that rads residents were the ones who had to obtain/inject contrast, etc.

Aren't there any sort of interventional things you guys do? US guided biopsies/abscess drainages, etc.?

What are your reading rooms like? Are they comfortable (given how much time you spend there)? Do your eyes ever get tired? If so, what can you do to rest them for a bit?

What modalities do you mainly read? How much MRI experience do you get? Do you ever get to read the newer modalities like fMRI or PET?

Thanks!

 

[whournameiz]

I've heard of some docs reading from home. How is such a thing set up?

Couldn't you just do this from another country and avoid having to pay the income tax like other companies do

 

[WaterAvatar]

I'm sure there are electives where you'd see/aid in interventional procedures even during your residency. The description of an average day given above actually seems kind of dry. I"m sure it's more exciting than you're letting on right??

 

[f_w]

I thought that rads residents were the ones who had to obtain/inject contrast, etc.

Outside of the great empire state of NY, RTs and RNs are allowed to inject IV contrast under 'direct supervision' i.e. the radiologist (or ER physician during off-hours) is in the building but not necessarily within the room.

Aren't there any sort of interventional things you guys do? US guided biopsies/abscess drainages, etc.?

Yes.

What are your reading rooms like? Are they comfortable (given how much time you spend there)?

You would hope so. Depends on the institution and the clout of the radiology chairman.

Do your eyes ever get tired? If so, what can you do to rest them for a bit?

I take a 1 hour lunchbreak for that very reason.

What modalities do you mainly read?

I personally read everything.

 

[f_w]

I've heard of some docs reading from home. How is such a thing set up?

A beefed up PC, a set of FDA approved diagnostic grade monitors, a 10Mbit cable modem, a VPN box and a phone line.

Couldn't you just do this from another country and avoid having to pay the income tax like other companies do

All services provided and billed to medicare beneficiaries have to be provided from within the US. Medicare is typically between 40-60% of your business, so providing services from abroad would limit who you can bill considerably.

If you are a citizen or permanent resident of the US, you have to pay personal income tax on your worldwide income (the details on how this is handled are set down in a number of 'double taxation treaties' the US has with its major trade partners). So unless your are planning to commit tax evasion, you and your company are still going to be subject to US taxes.

 

[colbgw02]

What are your reading rooms like? Are they comfortable (given how much time you spend there)? Do your eyes ever get tired? If so, what can you do to rest them for a bit?

I was actually surprised to learn about all the different aches and pains radiologists get from sitting there all day and all the ways you're supposed to avoid it. Like not having the monitors at our above eye level.

What modalities do you mainly read? How much MRI experience do you get? Do you ever get to read the newer modalities like fMRI or PET?

Some programs, like mine, will have a senior and junior resident assigned to each board. The senior will spend more time reading MRs and, if they choose, procedures. The junior does plain films, CTs, and other manual labor (like barium swallows, which I don't consider a "procedure", and preparing for proceudres - doing limited H&Ps). The senior should, I think, have first dibs though on whatever.

 

[WaterAvatar]

where do you do your residency, colbg?

 

[sepsis]

get in 7:30 - 7:45
sign reports and pre-read till 8/8:15
read/procedures till 11:50
noon conf till 1:30
read out/random confs till 5:00 sometimes, not leaving until 7:00

go home study, eat, sign reports at 10:30

rinse and repeat

 

[ScooterBanks]

7:00-8:00am, read for an hour prior to work.
8:00-11:45am, read studies, check out with attending, dictate.
11:45-1:15pm, conference
1:15-5:00, read studies, check out with attending, dictate.
"try" to read for an hour later at night.

I'd guess that 75% of the programs out there have close to the exact same daily schedule.

 

[Docxter]

Baseline schedule:
7:30-9:00 conference
Then work 9:00 to 5:30-7:30 depending on good day or bad day.

Neuroradiology and IR rotations add an average 1-2 hours to above baseline schedule, e.g. in IR 6:30AM-7:00PM and miss conference, or in neuroradiology start the same as baseline but just stay pretty late.

Nuclear medicine rotation subtract 1-2 hours from baseline schedule.

Add call.

 

[freddydpt]

What about Neuro makes you stay 1-2hr later? I can definitely understand IR.

Baseline schedule:
7:30-9:00 conference
Then work 9:00 to 5:30-7:30 depending on good day or bad day.

Neuroradiology and IR rotations add an average 1-2 hours to above baseline schedule, e.g. in IR 6:30AM-7:00PM and miss conference, or in neuroradiology start the same as baseline but just stay pretty late.

Nuclear medicine rotation subtract 1-2 hours from baseline schedule.

Add call.

 

[Docxter]

What about Neuro makes you stay 1-2hr later? I can definitely understand IR.

The same understanding should lead you to the answer. More work = stay longer.

Different places may have different rotations that are busier. At most places they are IR and neuro. Some other places maybe other subspecialties are busy.

 

[Eugenie98]

If you are a citizen or permanent resident of the US, you have to pay personal income tax on your worldwide income (the details on how this is handled are set down in a number of 'double taxation treaties' the US has with its major trade partners). So unless your are planning to commit tax evasion, you and your company are still going to be subject to US taxes.

Yeah, except you get a $90,000 income exclusion for working overseas, as well as up to a $110,000 exclusion for housing..

 

[whournameiz]

are those exclusions per year?

 

[Eugenie98]

yes, per year. The amount for 2006 is $82,400 and is indexed for inflation starting in tax year 2006.

http://taxes.about.com/od/taxhelp/a/ForeignIncome.htm
http://www.irs.gov/publications/p54/ch04.html#d0e2227

The housing exclusion is a max of $24,720 unless you live in a major citiy or metro area abroad (See http://taxes.about.com/od/taxhelp/a/ForeignIncome_4.htm ) (the cities with their own exclusion amounts are listed at http://www.irs.gov/pub/irs-drop/n-07-25.pdf and http://www.irs.gov/pub/irs-pdf/i2555.pdf)

Country Location Limit on House Expense (daily) Limit on House Expense (yr)
Austria Vienna 78.97 28,824
Bermuda Bermuda 197.26 72,000
Japan Nagoya 103.52 37,786
Japan Osaka-Kobe 145.30 53,036
Norway Oslo 83.76 30,573
Russia Moscow 207.45 75,720
Ukraine Kiev 89.98 32,844
SECTION 4. ADJUSTED LIMITATIONS ON HOUSING EXPENSES FOR LOCATIONS
NOT INCLUDED IN NOTICE 2006-87
Country Location Limit on House Expense (daily) Limit on House Expense (yr)
China Beijing 131.51 48,000
China Shanghai 147.95 54,000
India Mumbai 156.19 57,011
India New Delhi 73.75 26,920
Indonesia Jakarta 103.49 37,776
Qatar Doha 95.30 34,786
Saudi Arabia Jeddah 84.02 30,667
Saudi Arabia Riyadh 84.02 30,667
Switzerland Zurich 105.20 38,398
Taiwan Taipei 122.42 44,685
United Arab Emirates Abu Dhabi 82.12 29,973
United Arab Emirates Dubai 116.31 42,452
United Kingdom Basingstoke 112.60 41,099
United Kingdom Gibraltar 122.24 44,616
United Kingdom Surrey 121.51 44,350
Argentina Buenos Aires 120.27 43,900
Austria Vienna 78.97 28,824
Bahamas, The Nassau 136.16 49,700
Bahrain 120.55 44,000
Barbados 103.29 37,700
Belgium Brussels 124.93 45,600
SHAPE/Chievres 91.23 33,300
Bermuda 197.26 72,000
Bosnia-Herzegovina Sarajevo 74.52 27,200
Brazil Brasilia 86.30 31,500
Rio de Janeiro 96.16 35,100
Sao Paulo 127.40 46,500
Canada Ottawa 107.40 39,200
Calgary 73.42 26,800
Halifax 68.49 25,000
London, Ontario 70.41 25,700
Montreal 138.90 50,700
Toronto 113.70 41,500
Vancouver 106.85 39,000
Victoria 76.71 28,000
Winnipeg 68.22 24,900
Chile Santiago 96.71 35,300
China Beijing 131.51 48,000
Hong Kong 313.15 114,300
Shanghai 147.95 54,000
Colombia Bogota 148.22 54,100
All cities other than Bogota and
Barranquilla 123.01 44,900
Costa Rica San Jose 71.78 26,200
Dominican Republic Santo Domingo 110.96 40,500
Ecuador Quito 81.92 29,900
Guayaquil 84.38 30,800
El Salvador San Salvador 69.04 25,200
France Paris 217.26 79,300
Le Havre 97.26 35,500
Lyon 139.45 50,900
Marseille 117.81 43,000
Montpellier 115.34 42,100
Germany Berlin 132.05 48,200
Bad Aibling 92.05 33,600
Baumholder 98.08 35,800
Berchtesgaden 70.14 25,600
Darmstadt 107.67 39,300
Frankfurt am Main 112.88 41,200
Friedberg 86.03 31,400
Garmisch-Partenkirchen 93.15 34,000
Geilenkirchen 73.97 27,000
Germersheim 81.64 29,800
Giessen 84.38 30,800
Grafenwoehr 69.86 25,500
Limits on Housing Expenses
Limit on Housing Limit on Housing
Country City or Other Location Expenses (daily) Expenses (full year)
Germany (Continued) Hanau 116.44 42,500
Hannover 80.55 29,400
Heidelberg 107.40 39,200
Kaiserslautern, Landkreis 121.64 44,400
Munich 115.62 42,200
Nuernberg 68.22 24,900
Stuttgart 113.97 41,600
Wiesbaden 129.04 47,100
Wuerzburg 93.42 34,100
All cities other than Augsburg, Bad
Aibling, Bad Kreuznach,
Baumholder, Berchtesgaden,
Berlin, Bonn, Bremen,
Bremerhaven, Cologne,
Darmstadt, Duesseldorf,
Flensburg, Frankfurt am Main,
Friedberg,
Garmisch-Partenkirchen,
Geilenkirchen, Germersheim,
Giessen, Grafenwoehr,
Hamburg, Hanau, Hannover,
Heidelberg, Heilbronn,
Kaiserslautern, Landkreis,
Karlsruhe, Kerpen, Koblenz,
Leipzig, Muenster, Munich,
Nuernberg,
Osterholz-Scharmbeck,
Rheinberg, Stuttgart,
Wiesbaden, Worms, and
Wuerzburg 92.60 33,800
Greece Athens 86.85 31,700
Thessaloniki 84.11 30,700
Guatemala Guatemala City 103.01 37,600
Holy See, The 146.58 53,500
Hungary Budapest 89.04 32,500
India Mumbai 156.19 57,011
New Delhi 73.75 26,920
Indonesia Jakarta 103.49 37,776
Ireland Limerick 69.04 25,200
Italy Rome 146.58 53,500
Catania 75.89 27,700
Genoa 103.29 37,700
Gioia Tauro 85.48 31,200
Leghorn 91.78 33,500
Milan 218.63 79,800
Naples 120.82 44,100
Pordenone-Aviano 100.82 36,800
Sardinia 74.79 27,300
Turin 109.32 39,900
Verona 69.86 25,500
Vicenza 101.92 37,200
All cities other than Avellino,
Brindisi, Catania, Florence,
Gaeta, Genoa, Gioia Tauro,
Leghorn, Milan, Naples, Nettuno,
Pordenone-Aviano, Rome,
Sardinia, Turin, Verona, and
Vicenza. 84.11 30,700
Jamaica Kingston 112.88 41,200
Japan Tokyo 234.79 85,700
Limits on Housing Expenses
Limit on Housing Limit on Housing
Country City or Other Location Expenses (daily) Expenses (full year)
Japan (Continued) Akizuki 69.04 25,200
Gotemba 75.07 27,400
Misawa 69.32 25,300
Nagoya 103.52 37,786
Okinawa Prefecture 123.56 45,100
Osaka-Kobe 145.30 53,036
Sasebo 81.10 29,600
Tokyo-to 99.73 36,400
Yokohama 131.23 47,900
Yokosuka 113.42 41,400
Korea Seoul 153.97 56,200
Chinhae 78.90 28,800
Chunchon 73.70 26,900
Kwangju 78.08 28,500
Osan AB 88.77 32,400
Pusan 81.92 29,900
Taegu 92.88 33,900
Tongduchon 72.33 26,400
Uijongbu 101.92 37,200
Waegwan 74.25 27,100
All cities other than Changwon,
Chinhae, Chunchon, Kunsan,
Kwangju, Osan AB, Pusan,
Seoul, Taegu, Tongduchon,
Uijongbu, and Waegwan 83.29 30,400
Kuwait Kuwait City 163.84 59,800
All cities other than Kuwait City 146.85 53,600
Luxembourg 120.27 43,900
Macedonia Skopje 96.99 35,400
Malaysia Kuala Lumpur 96.71 35,300
All cities other than Kuala Lumpur 92.33 33,700
Malta 100.00 36,500
Mexico Mexico City 102.74 37,500
Netherlands Hague, The 150.41 54,900
Amsterdam 144.93 52,900
Brunssum 83.01 30,300
Rotterdam 105.48 38,500
All cities other than Amsterdam,
Brunssum, Coevorden, The
Hague, Margraten, and
Rotterdam. 76.71 28,000
Netherlands Antilles Aruba 90.41 33,000
New Zealand Wellington 73.15 26,700
Auckland 77.26 28,200
Norway Oslo 83.76 30,573
Stavanger 90.41 33,000
All cities other than Oslo and
Stavanger. 91.78 33,500
Panama Panama City 88.22 32,200
Peru Lima 74.79 27,300
Portugal Lisbon 133.70 48,800
Qatar Doha 95.30 34,786
Russia Moscow 207.45 75,720
Limits on Housing Expenses
Limit on Housing Limit on Housing
Country City or Other Location Expenses (daily) Expenses (full year)
Rwanda Kigali 86.30 31,500
Saudi Arabia Jeddah 84.02 30,667
Riyadh 84.02 30,667
Singapore 117.53 42,900
Spain Madrid 99.18 36,200
Rota 85.48 31,200
Valencia 102.74 37,500
Switzerland Bern 139.45 50,900
Geneva 192.60 70,300
Zurich 105.20 38,398
All cities other than Bern, Geneva
and Zurich 90.14 32,900
Taiwan Taipei 122.42 44,685
Thailand Bangkok 100.27 36,600
Turkey Ankara 84.93 31,000
Izmir-Cigli 86.58 31,600
Ukraine Kiev 89.98 32,844
United Arab Emirates Abu Dhabi 82.12 29,973
Dubai 116.31 42,452
United Kingdom London 197.53 72,100
Basingstoke 112.60 41,099
Bath 103.84 37,900
Bristol 78.08 28,500
Cambridge 109.32 39,900
Caversham 187.40 68,400
Cheltenham 111.51 40,700
Fairford 88.49 32,300
Farnborough 130.14 47,500
Felixstowe 110.96 40,500
Gibraltar 122.24 44,616
Harrogate 110.41 40,300
High Wycombe 157.53 57,500
Lakenheath 140.00 51,100
Loudwater 133.42 48,700
Oxfordshire 79.18 28,900
Rochester 101.37 37,000
Surrey 121.51 44,350
Wiltshire 96.16 35,100
All cities other than Basingstoke,
Bath, Belfast, Birmingham,
Bristol, Brough, Bude,
Cambridge, Caversham,
Chelmsford, Cheltenham,
Chicksands, Dunstable,
Edinburgh, Edzell, Fairford,
Farnborough, Felixstowe, Ft.
Halstead, Gibraltar, Glenrothes,
Harrogate, High Wycombe,
Hythe, Lakenheath, London,
Loudwater, Nottingham,
Oxfordshire, Rochester, Surrey,
Welford, West Byfleet, and
Wiltshire. 96.16 35,100
Venezuela Caracas 143.56 52,400
Vietnam Hanoi 128.22 46,800

 

[Eugenie98]

Also, since you're a radiologist, most of your wealth is stored in your brain when you first get out of residency.

IANAL but:

The IRS has also clarified how to expatriate, previously if you had more than I think $500,000 in assets or a tax bill above $100,000 per year average in the list five years before expat, if you moved to say Gibraltar as a high net worth resident and gave up your US citizenship you would be classified as expatriating to avoid taxes and would have to pay taxes on income for 10 years. The IRS could also classify you without having you meet these formal requirements if they felt you were expatriating for tax purposes

Bush and the IRS changed these rules:
1) The rules are now objective and unless you exceed the limits you can expatriate for tax purposes
2) The rules were made more lenient

Now if you have over $2,000,000 in assets or a tax bill of more than $131,000 (for those expatriating in 2006) you will be classified as expatriating for tax purposes and will have to pay tax on income for 10 years. Otherwise you are scot-free.

See http://www.irs.gov/pub/irs-pdf/p519.pdf

I'm not sure as a physician whether I'd be interested in doing that, who knows if night hawk radiology will be around in 20 years, it would be difficult to move back to the US and obtain an license at that point (although I'm sure it could be done, e.g. live abroad with an American citizen significant other and marry her when you guys want to move back to the US and are tired of your James Bond lifestyle)

It's really kind of ridiculous how the rules favor working abroad or becoming an expat, but I suppose most of the people who want to become expats are those who do not benefit from living in the US... hedge fund managers (capital is mobile), insurance managers, and they would find some other way to do it anyhow?

 

[Eugenie98]

Alternatively, if you live in the US Virgin Islands you can take a 90% deduction off your income if you meet certain requirements. I'm not too familiar with this tax measure... but you can do some research on google or contact the USVI.

IANAL, but I believe you need to hire something like 8 USVI'ers, donate $40,000 US to a local charity, and invest at least $100,000 into a business in USVI. Then your USVI source income will have a tax rate of a maximum of 3.5%, and there is no "state" income tax there.

The reading of films should qualify as personal services rendered in the USVI and for source income, at least I think so but IANAL

see http://www.irs.gov/publications/p570/ch02.html

Also, since the USVI is part of the United States (falls under medicaid and USMLE), as a US possession (similar to PR), there should be no issue with doing night hawk there for medicaid.

It's also a cross point for two sets of fiber optic cables going from South America to North America.

Anyone here a tax lawyer? (it's just a hobby of mine)

 

[f_w]

- 90k are exempted, that leaves 350 to be taxed near the top rate.
- the reason the IRS gives you a break on the living expenses in major metro areas abroad is: because it is so f-ing expensive to live there. Yeah, great your living expenses are tax free, go ahead and enjoy that $8000/month rental in London.
- there is a reason well to do professionals and business people quite often turn in their green-card at the consulate once they return to their home country (if the IRS thinks you owe them, return to the US runs the risk of arrest. if you turn in your GC, you don't have to file returns and are free to travel back on business or tourist visas).

 

[Eugenie98]

- 90k are exempted, that leaves 350 to be taxed near the top rate.
- the reason the IRS gives you a break on the living expenses in major metro areas abroad is: because it is so f-ing expensive to live there. Yeah, great your living expenses are tax free, go ahead and enjoy that $8000/month rental in London.
- there is a reason well to do professionals and business people quite often turn in their green-card at the consulate once they return to their home country (if the IRS thinks you owe them, return to the US runs the risk of arrest. if you turn in your GC, you don't have to file returns and are free to travel back on business or tourist visas).

London and Moscow are extremely expensive because of all the hedge fund and oil money respectively...similar to Manhattan...The IRS gives you up to $3,500 a month in allowable deductibles for living in Toronto... Toronto is not that expensive.. there are numerous other cities on the list where they have very high allowed deductibles versus the typical rental cost...

Who wants to live in London anyhow... what are you going to eat.. bangers and mashers while enjoying the fog and rain?

 

[finallyMS3]

how common is it for residents and attendings(private practice) to work weekends? Do most/some/few work weekends?

 

[f_w]

how common is it for residents and attendings(private practice) to work weekends? Do most/some/few work weekends?

Part of every hospital job. Take the number of radiologists in the group -1 as x and you know that you take 1:x weekend call.

 

[nima123]

I'm at a fairly cush program.

8-ish: roll in hung over
8-10: check email, myspace, google news
10-11:30: plow through some bogus dictations always ending in "Cannot rule out (list 3 or 4 things). Recommend repeat study (more revenue for department). Clinical correlation advised (BS yes, but this puts the onus of diagnosis back on the clinicians)
11:30-12:15: bang a nurse or tech in the call room
12:20: roll into conference late with hair messed up, sleep
1-1:30: myspace
1:30-3pm: more bogus dictations
3-3:45pm: workout at hospital gym
3:45-4pm: loiter around med school with pump, try to pick up MS-1s and MS-2s
4pm: go tan, pick up sushi
Evening: try to do AM case of the day, but end up back on MySpace
10pm: Exhausted, sleep.

Is your hospital affiliated with Best Western?

 

[DrGregoryHouse]

I'm at a fairly cush program.

8-ish: roll in hung over
8-10: check email, myspace, google news
10-11:30: plow through some bogus dictations always ending in "Cannot rule out (list 3 or 4 things). Recommend repeat study (more revenue for department). Clinical correlation advised (BS yes, but this puts the onus of diagnosis back on the clinicians)
11:30-12:15: bang a nurse or tech in the call room
12:20: roll into conference late with hair messed up, sleep
1-1:30: myspace
1:30-3pm: more bogus dictations
3-3:45pm: workout at hospital gym
3:45-4pm: loiter around med school with pump, try to pick up MS-1s and MS-2s
4pm: go tan, pick up sushi
Evening: try to do AM case of the day, but end up back on MySpace
10pm: Exhausted, sleep.

Where do I sign up?