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Just curious, haven't really seen too much information in general for what it's like.
Thanks
Thanks
Walk me through a day of radiology residency
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+1, would love to hear the daily schedule of anyone who is currently a resident or has been through residency already if you dont mind sharing
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Where I currently work:
7:15-8:00 Conference
8:00-12:00 Read studies
12:00-1:00 Conference
1:00-4:30 Read studies
Read some (ideally) every night, particularly as an R1.
Interruptions are common, but obviously unpredictable. Generally, you'll also spend a few minutes every day protocoling studies. Depending on your rotation, you'll have some procedures to do as well.
7:15-8:00 Conference
8:00-12:00 Read studies
12:00-1:00 Conference
1:00-4:30 Read studies
Read some (ideally) every night, particularly as an R1.
Interruptions are common, but obviously unpredictable. Generally, you'll also spend a few minutes every day protocoling studies. Depending on your rotation, you'll have some procedures to do as well.
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What about call? Thanks for the response
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As a resident, we had a traditional call schedule. Call started at 4:30 PM and ended when conference began the next morning, which was either at 7 or 7:30. We were expected to stay through conference, so - depending on when you arrived for work - your "shift" was somewhere around 25-27 hours. Sometimes you had to clean things up after conference ended, depending on how much you messed up and your staff. Weekends were broken down into 4 separate 12-hour shifts. We probably averaged 40 calls a year, which began halfway through R1 year for me (the rules are different now).
Where I work now has a nightfloat system, consisting of 5 12-hour shifts from Sunday night through Thursday night. One resident works 5PM-5AM, and a second one shows up for 8PM-8AM. There is a short call resident on from 4:30 through 8. The weekends are similar, in that there are two residents on nights (Fri. and Sat.) and days (Sat. and Sun.). I honestly don't know how much call the residents take, but we have about 10 residents per class, so you could probably do the math, if you really want to.
Where I work now has a nightfloat system, consisting of 5 12-hour shifts from Sunday night through Thursday night. One resident works 5PM-5AM, and a second one shows up for 8PM-8AM. There is a short call resident on from 4:30 through 8. The weekends are similar, in that there are two residents on nights (Fri. and Sat.) and days (Sat. and Sun.). I honestly don't know how much call the residents take, but we have about 10 residents per class, so you could probably do the math, if you really want to.
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Are these elective in terms of picking up more if you wanted to make more money or anything like that? Also are there any opportunities to moonlight in rads? These are probably stupid questions, but I've never really seen information like this available anywhere.
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Moonlighting will depend on your residency. Some places forbid it; some encourage it. The simplest moonlighting is the internal kind, meaning the program will pay you for taking extra call shifts or babysitting a scanner (so they can give contrast). If you are in a large city, you may find it difficult to find opportunities, unless your program already has something set up. That is, residents from eons ago moonlighted, and they just passed down the opportunity to the newer residents, creating a de facto pipeline.
At the time, I probably could have been okay with moonlighting late in R2 year, provided that it was only bread and butter cases (plain films, noncon head CTs, r/o appendicitis abdomen CTs, etc.), but things have changed. I could see some of our current R4s being okay at moonlighting, but not the R3s.
-For one, as is the trend throughout medical education, trainees do less and see less nowadays, so most R2s are less well-prepared for independent practice than an R2 from a decade ago. Along this line of thinking, there is less autonomy. When I took call, I was the only person in the department (apart from techs). I could call the attending, but that was considered weak sauce. In contrast, where I am now, there is an attending in-house 24/7/365. There are pros and cons to each method, but one con of the latter is that residents don't have to really put themselves out there and live with their mistakes the way they used to.
-Secondly, the expectations from the ordering providers have changed. For example, when I trained, you had to bring me brownies to get an MRI at 2AM, even on an inpatient. Now, we're routinely doing MRIs out of the ED (without a plain film, of course). Also, I briefly had to do my own ultrasounds on call, so I had to be convinced it was an indicated study. "Oh, your patient has bilateral lower extremity swelling for three weeks with a known diagnosis of CHF, but you want bilateral Doppler ultrasound to rule out DVT at 3AM? Nope. If you're that concerned, give them a shot of Lovenox and have them come back in 4 hours when the ultrasound tech shows up." Now, there are two techs in house at all time. There's basically no filter. Bottom line, they're going to expect more of you as compared to 10 years ago.
Electives are totally unrelated to moonlighting, and again, this will be residency specific. We give residents a "research/elective" months leading up to the core exam, and then again as an R4 to rotate through something they want to learn more about.
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Makes sense, thanks for sharing!
I did my residency where there was no attending on call with the residents. It was one of the best learning experiences. I learned a lot of radiology by being on call by myself. I also did some moonlighting when I was a fellow. So when I started pp the transition was not that difficult. Unfortunately, this is changing gradually towards 24/7 attending coverage in house.
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My program still has solo call without an in house attending covering a level 1 trauma center. Invaluable experience.
How often do you take call?
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Short call is until what time?
And how much night float?
Sorry for all the questions... Just curious as I'm buried in endless call as an intern and I can't remember the call schedule to the program I matched at
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My program:
Case conference (T,W,R) or physics (M,F) at 7:30.
Work until 11:45am
Lunch didactic at noon
Work until 5pm.
Short call goes until 11pm, which overlaps night person who comes at 7pm to facilitate transition for the night person since it gets busy at that time.
Night float 7pm till 8am.
Case conference (T,W,R) or physics (M,F) at 7:30.
Work until 11:45am
Lunch didactic at noon
Work until 5pm.
Short call goes until 11pm, which overlaps night person who comes at 7pm to facilitate transition for the night person since it gets busy at that time.
Night float 7pm till 8am.
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Short call is split up among the 2-4. Like other programs it is more heavily weighted during year 2. I am not sure how often it is as I am focused on keeping my head above water in all the reading I have been having to do. Depends on the amount of residents as well.
During August-November, R1's do "shadow" call once every other month to learn the ropes of call. Then, starting January, after a plain film test, R1's do plain film call, which is senior resident/attending supervised. At the end of R1 is couple of weeks of "fine tuning" and then the big exam to see if you are ready for real call. Starting R2, you do real call, which like any other good program, is unsupervised (except for an on call attending at home) until the next morning when you go see the attendings to check how you did. Scary, but that is how you learn. There's short call, long call, and weekend call (both weekend days from 8-8). The latter one sucks the most but it is what it is.
During the first 6 months of R1, you get all weekends (except for one shadow call weekend, but you usually get sent home early anyway). Rest of the years you get two day weekends unless you are on call.
Obviously the details of the schedule vary by program. This is just my program.-
My program as an R1:
Mon-Fri 8-5... Conference 12-1 otherwise in the reading room/fluoro etc.
Call is q8 and 24hr with post call day off obviously. No holiday/weekends unless you're on call. And call doesn't start until March (so first 9 months you don't work holidays or weekends)
I absolutely love radiology and enjoy working finally.
Mon-Fri 8-5... Conference 12-1 otherwise in the reading room/fluoro etc.
Call is q8 and 24hr with post call day off obviously. No holiday/weekends unless you're on call. And call doesn't start until March (so first 9 months you don't work holidays or weekends)
I absolutely love radiology and enjoy working finally.
Basic day is conference from 7:30 until 8:15. Work till lunch. 45 min conference at lunchtime. Work till 5 or 6. Procedures mixed in throughout the day. Some rotations have more than others and you can generally be as involved as you want. The volume is fairly good at my program so there isn't too much down time. Most of the day is spent reading cases on your own, dictating, and then reading out with an attending. This pace and the hours in general is soooo much better than intern year. The material is really interesting as well. Every case tells a story and you got to figure it out (cheesy I know).
D
deleted116380
Eh, not all TYs/prelims are that bad. In fact, mine was a traditional IM prelim and I preferred the team work environment compared to being an R1 now. Back then, it was me, co-intern, resident, and a couple med students and the program did an excellent job with getting good residents. We all had fun in the workroom and got stuff done efficiently and made the days go by quick (even though the work sucked). Now I basically work alone next to my attending for readouts and don't have the camaraderie like we did last year and kinda miss that part. Pluses and minuses to each field I suppose...
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do mine for me then
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psh im loving my TY. gotta just find a hidden gem
I am absolutely hating my prelim med year 3 months in. 10 ward months 80-90 hour weeks, no end in sight. It's awful. The people are pretty cool I suppose but most everyone is beat down.
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psh im loving my TY. gotta just find a hidden gem
Not everyone can match into a TY.
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The conventional wisdom is surgery, as surgical management is more applicable to the needed knowledge base for a radiologists. However, that totally ignores the mental health aspect. Personally, if the choice is between a manageable medicine year and a hellish surgery year, then I would choose medicine. I don't think the knowledge gap is sufficient to justify the misery of being a surgical intern.
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Is a surg prelim really that bad? Im strongly considering it at either a small community or Kaiser setting.
I have heard very limited, but good things about it, especially at kaiser. Your not managing as much floor logistics as at an academic center and you are frequently first assist in the OR.
I have heard very limited, but good things about it, especially at kaiser. Your not managing as much floor logistics as at an academic center and you are frequently first assist in the OR.
What is the point of being the first assist in the OR?
I choose medicine internship over surgery any day of the week. In theory, surgery is more useful for radiology. But during surgery internship, in most places you don't see high end cases. The surgery that is helpful for radiology is sub-specialized surgery like surgical oncology, hepatic surgery, orthopedics, Neurosurgery, ENT, vascular surgery, Thoracic surgery and ... General surgery is marginally beneficial at best. It is not worth the pain.
Overall, most of your internship is useless. Just do it because you have to do it. TY >>> Medicine >> Surgery. If a place has a surgery internship that is easier than TY (I doubt it), then do it.
I choose medicine internship over surgery any day of the week. In theory, surgery is more useful for radiology. But during surgery internship, in most places you don't see high end cases. The surgery that is helpful for radiology is sub-specialized surgery like surgical oncology, hepatic surgery, orthopedics, Neurosurgery, ENT, vascular surgery, Thoracic surgery and ... General surgery is marginally beneficial at best. It is not worth the pain.
Overall, most of your internship is useless. Just do it because you have to do it. TY >>> Medicine >> Surgery. If a place has a surgery internship that is easier than TY (I doubt it), then do it.
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This is why surgery is theoretically more useful than medicine. Better to know the surgical approach/when to operate than which of the eleventy billion types of insulin some patient with DIABEETUS has. Key word - theoretically. Most surgical internships are beat downs, filled with lots of floor work and relatively little OR time. If you can find one that breaks that mold, then rock on.
I don't know what surgical internship is like at all institutions, but at ours, the interns are basically the grunts running the floor. They're pretty much medicine interns for post-surgical patients, but they don't do it as well because their attendings don't do it as well (treating medicine problems, I mean).
There's always that theory that, if you're going to do IR, you might want to do a surgical intern year. I find that laughable, however. The main complications of IR procedures are either infection (treated with antibiotics - you'll learn coverage better in medicine) or bleeding (treated with another IR procedure or sent to surgery).
There's always that theory that, if you're going to do IR, you might want to do a surgical intern year. I find that laughable, however. The main complications of IR procedures are either infection (treated with antibiotics - you'll learn coverage better in medicine) or bleeding (treated with another IR procedure or sent to surgery).
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TY > surgery > medicine
Surgery gives you useful experience when talking to surgeons when they come down for wet reads. (Medicine residents almost never come to our reading rooms). You understand what they're looking for when the indication simply reads "s/p ______," which facilitates (and speeds up) your interpretation of the imaging. You anticipate the possible complications of each operation, making you a more efficient radiologist.
I also found it very useful to spend more time than just a 6 week medical student rotation directly visualizing the insides of patients in full color before seeing them only as black and white images. For example, instead of just seeing intraabdominal fat on CT, you can instead imagine the layers of omentum and mesentery folding over each other, which manifests in the way free fluid travels. Watching a few bariatric surgeries helps interpret post-surgical abdomens with all the weird combinations of anastomoses.
Managing vascular patients and watching angiograms and bypasses helps you read CTA run-offs. (Also helps you fight off a few studies from the ED with bogus indications, like a CTA for a patient who clearly does not have critical limb ischemia).
Even if you're not in the OR very much, I think a solid foundation in surgery is useful in generally knowing what surgeons are looking for. They are not known for over-ordering blood tests or imaging tests, and usually do so for very specific reasons (as opposed to daily AM labs on the medicine floors). On morning rounds you will see all the new overnight surgical consults and learn your chief or attending's reasoning for choosing surgery versus additional studies versus nonsurgical management. You will understand what imaging findings matter to them. After all, lot of radiology studies boil down to the inevitable question, "Does the patient need surgery?"
You will understand the limitations of your interpretations. That when a RUQ US appears relatively convincing for acute cholecystitis, a surgeon may decide to wait for a HIDA scan or MRCP or observe the patient if they just don't have the right clinical picture. You will stop fretting so much over whether the GB wall is thick or not.
Doing elective rotations in ENT, vascular, neurosurg, ortho, urology, or CT surgery would definitely be super useful.
I felt medicine was the least useful part of internship when it comes to radiology (but not for answering friends and family's questions). Given how relatively benign radiology residency is, I think a tough year of surgery far exceeds a still tough but mildly less tough year of medicine.
A TY is still best though.
Surgery gives you useful experience when talking to surgeons when they come down for wet reads. (Medicine residents almost never come to our reading rooms). You understand what they're looking for when the indication simply reads "s/p ______," which facilitates (and speeds up) your interpretation of the imaging. You anticipate the possible complications of each operation, making you a more efficient radiologist.
I also found it very useful to spend more time than just a 6 week medical student rotation directly visualizing the insides of patients in full color before seeing them only as black and white images. For example, instead of just seeing intraabdominal fat on CT, you can instead imagine the layers of omentum and mesentery folding over each other, which manifests in the way free fluid travels. Watching a few bariatric surgeries helps interpret post-surgical abdomens with all the weird combinations of anastomoses.
Managing vascular patients and watching angiograms and bypasses helps you read CTA run-offs. (Also helps you fight off a few studies from the ED with bogus indications, like a CTA for a patient who clearly does not have critical limb ischemia).
Even if you're not in the OR very much, I think a solid foundation in surgery is useful in generally knowing what surgeons are looking for. They are not known for over-ordering blood tests or imaging tests, and usually do so for very specific reasons (as opposed to daily AM labs on the medicine floors). On morning rounds you will see all the new overnight surgical consults and learn your chief or attending's reasoning for choosing surgery versus additional studies versus nonsurgical management. You will understand what imaging findings matter to them. After all, lot of radiology studies boil down to the inevitable question, "Does the patient need surgery?"
You will understand the limitations of your interpretations. That when a RUQ US appears relatively convincing for acute cholecystitis, a surgeon may decide to wait for a HIDA scan or MRCP or observe the patient if they just don't have the right clinical picture. You will stop fretting so much over whether the GB wall is thick or not.
Doing elective rotations in ENT, vascular, neurosurg, ortho, urology, or CT surgery would definitely be super useful.
I felt medicine was the least useful part of internship when it comes to radiology (but not for answering friends and family's questions). Given how relatively benign radiology residency is, I think a tough year of surgery far exceeds a still tough but mildly less tough year of medicine.
A TY is still best though.
I only agree with your last sentence.
Most of your other statements are reasonable only on paper, but wrong at many levels in practice. Internship in general is useless. Do a TY. Some people want to convince themselves that the torture of surgery internship was/is not useless.
NOOOOOOOOO! Don't do surgery at a small program!!!!!!!! Go where there are as many of those M'Fers as you can possibly find. The more interns the better...
I'm at a small surgery program, just 3 interns. When I mess something up... guess what! Everyone and their mom knows who messed up.
Edit: I can also tell you from my experience thus far... I am becoming better at reads than some of my med pals going into rads. I look at probably 20+ CTs/XRays any given day. Many of my med prelim year buds don't even come close to this. Plus the dirty little secret is... with the duty hour restrictions (that are loosely enforced) we all work about the same number of hours. The difference? I get to wear scrubs at work for 15+ hours a day.... they get to wear stuffy-ass dress clothes.
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Useless at best. After the first month of radiology residency, its effect will be gone.
Good to hear. I try to look through every imaging study I order (as a prelim IM intern), but with my workload it's pretty much impossible to put any real thought into learning much about reading studies.
I feel like I'm becoming very well prepared to be a great medicine resident, but I'm afraid it will have zero radiology applicability.
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Looking through radiology studies prior to actually studying the particular concepts is pretty low-yield, if not almost completely useless (aside from the very basics like identifying the liver or the heart on CTs). You just look at the images, make a random guess as to what's wrong, then read the radiologist report, look back at the images, then nod at the key images and feel like you learned something when really, all you did was follow the radiologist's arrow signs. I had about 2-3 months of radiology rotations as a medical student/medicine intern, and now that I'm actually in residency, it blows my mind how little I knew about what I was looking at.
I agree with this.
Just do what you gotta do to get through that year, don't worry about rads right now. You'll have more than enough time to learn that stuff when you start.
Again, good to hear.
I'm just afraid I'll show up to my advanced program and they'll be like "uhhh wtf, this guy doesn't know $hit about radiology" because I'll have been balls deep in internal medicine BS for a year
They're all BS years and the rads faculty know that. They expect you to be stupid. You'll learn more radiology in one week as a rads resident than anything you could've learned as a prelim.
Bottom line: do the easiest intern year possible. All the debate of which "what type of internal year will prepare you most for radiology" is useless. After week 2 of rads residency it all equals out.
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How about a list of most cush TY then? Also what are the typical stats needed for a cush TY? I know people say they are competitive, but just want some quantification of that.
I wear a Champion gym shirt, scrub pants, and tennis shoes literally every day. You're not going to one up me. Stahp trying. (and except for the worst call days, I'm never in the hospital for 15 hours)
