What is it like during a Radiology Residency?

[DeltaPlaya]

Do they spend time in the hospital? Any patient contact? A few radiology websites pointed out that there is a lot of time dealt with talking and interacting with patients despite the belief that they don't. Is this true?

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[Apollyon]

Rads residents might spend a bit less time with patients than fellows and attendings in such subspecialties as interventional and neurorads. Residents will actually touch patients for fluoroscopy, and for radiology-guided biopsies. They may - may - also be there for ultrasound (although techs do the lion's share of the actual ultrasounding).

In some facilities, neuroradiologists may do coiling of cerebral vessels, but that's a turf war between them, neurosurgeons, neurologists, and, in very few places, vascular surgery.

The reasons why the fellows get more patient time in certain subs is because they do much more of that discipline, whereas the rads residents go block to block. However, as mentioned, on a general rads month, the resident might be called into the fluoro suite for a tough LP, for example (in my last job, there weren't residents, but the boss of that group was working one night and did a fluoro-guided LP for me - I had hubbed the needle at 5 inches, and he told me he had to use the 7 inch needle - which was so long, it was bowing going in - and barely - just barely - got to the dura. Now that is fat.).

Hopefully some rads residents will report in.

 

[colbgw02]

This should probably be moved to the radiology forum; I'm not sure why it didn't start there.

There is more patient contact than most non-radiology physicians realize, but there is no doubt that it is substantially less than the vast majority of other specialties.

 

[smq123]

Moving to the radiology forum.

 

[penguin24]

Saying that Radiologists get a good amount of patient contact is like saying that Surgeons get a good amount of time off for their family. You might as well say that Pediatricians get paid a good amount of money.

Sure radiologists get some patient contact, but there's a reason for the reputation.

 

[Apollyon]

There is more patient contact than most non-radiology physicians realize, but there is no doubt that it is substantially less than the vast majority of other specialties.

Can you elaborate for the sake of the OP, though? I mean, this post is about as non-committal as can be.

 

[colbgw02]

Saying that Radiologists get a good amount of patient contact is like saying that Surgeons get a good amount of time off for their family. You might as well say that Pediatricians get paid a good amount of money.

Sure radiologists get some patient contact, but there's a reason for the reputation.

Who said this?

 

[colbgw02]

Can you elaborate for the sake of the OP, though? I mean, this post is about as non-committal as can be.

Yeah, that was on purpose. I've found that many non-radiology physicians have a very poor understanding of what radiologists do. People love their preconceived notions, and I didn't really feel like challenging those while this was posted in the general forum.

Most of the time when we see patients, it's because of procedures, but you can see patients really whenever you want. I try, although I often come up short, to introduce myself to several patients while they were still on the scanner. It's good for the specialty, and it gives one an opportunity to get even the smallest amount of additional history, which can be hugely helpful.

It's easiest for me to breakdown radiology patient contact by modality or subspecialty. Here's a list off the top of my head:

Neuro: diagnostic angiograms (angiograms with treatment is usually a neuro IR gig), lumbar punctures, spine biopsies, rarely discograms.

Pediatrics: fluoro (mostly UGIs, VCUGs, and enemas), ultrasound (most pediatric radiology that I know want to scan as opposed to trusting the technologists).

GI/GU: fluoro (esophagrams/UGIs, SBFTs, BEs, HSGs, occasionally VCUGs), CT-guided biopsies.

US: most people will trust their technologist on routine studies, but if I'm brought something out of the ordinary, then I definitely scan; saline sonohysterograms; US-guided biopsies (usually kidney, liver, or thyroid).

MSK: fluoro (joint injections, some places do facet injections, arthrograms), occasionally a CT-guided bone biopsy.

Chest: fluoro (sniff tests), CT-guided biopsies.

Nucs: lymphoscintigraphy, therapeutic radioiodine administration, bone scans (if there's a stress fracture, then I always tell the patient before they leave).

Mammo: a ton of biopsies (stereo, US-guided, MRI-guided), I also speak with every woman that comes in for a diagnostic examination; also, I do a focused breast examination prior to doing any breast ultrasound, and my findings of that examination as well as any relevant history or symptoms the patient reports go into my dictation. For all of these reasons, breast imaging is the closest thing that diagnoistc radiology has to being a clinic.

IR: should be obvious; I consider this basically to be minimally-invasive surgery.

There's not a single day of my radiology career where I haven't done at least one of the above. I'm not trying to delude anyone into thinking radiologists have a lot of patient contact. Most radiologists, myself included, don't want a lot of patient contact, so we're very happy with that aspect of our jobs. However, if that's your thing, then the opportunities are there. As you can tell, these are only opportunities for very short-lived contact dealing with a focused issue. When the woman with the breast lump starts talking about her blood pressure medication, I tell her to go see her PCP.

 

[penguin24]

Who said this?

I've heard a lot of people say this nonsense. This post is similar to the person who starts a new thread in the Surgery forum, it's always titled something like, "I'm very passionate about surgery, but I one day want to start a family, will I ever be able to do both?"

 

[DrBowtie]

Very helpful outline of the subspecialties.

 

[DeltaPlaya]

Ahh I see, thanks for the info. Also are radiologists on call during residencies? I tried searching this and found "yes", "not really", "a lot", and "barely".

I think you guys are more reliable for answers.

 

[colbgw02]

Ahh I see, thanks for the info. Also are radiologists on call during residencies? I tried searching this and found "yes", "not really", "a lot", and "barely".

I think you guys are more reliable for answers.

Radiology residents are definitely on-call. In general, radiology programs require appreciably less call as compared to, let's say, a general surgery or internal medicine program. However, the call, when is does occur, can be brutal. When considering a single night, even radiologists that did preliminary surgery or medicine prefer their internship call to radiology call. And these were largely people that took call before the work hour restrictions, and they were definitely interns before whatever 18-hour BS went into effect a few weeks ago.

 

[Pedsbro]

Radiology residents are definitely on-call. In general, radiology programs require appreciably less call as compared to, let's say, a general surgery or internal medicine program. However, the call, when is does occur, can be brutal. When considering a single night, even radiologists that did preliminary surgery or medicine prefer their internship call to radiology call. And these were largely people that took call before the work hour restrictions, and they were definitely interns before whatever 18-hour BS went into effect a few weeks ago.

Could you elaborate on that part? Does this absolutely depend on what setting you're in? (academic hospital vs community, etc). Or are there similarities between rads resident call everywhere. The only pattern I've seen repeated elsewhere is that there is less call as you go from PGY-2 to 5.

 

[colbgw02]

Could you elaborate on that part? Does this absolutely depend on what setting you're in? (academic hospital vs community, etc). Or are there similarities between rads resident call everywhere. The only pattern I've seen repeated elsewhere is that there is less call as you go from PGY-2 to 5.

It's a little difficult to describe to someone who's never experienced it, but mostly it's just busy. I used sit down at the workstation at 5 pm and, except to take a leak occasionally, I wouldn't get up until 7 am the next morning. I'd grab a snack around midnight and eat it between sentences into the dictaphone. Sleep is a no-go.

You're constantly trying to keep up with the list, and God forbid that the surgeons want to go over a study for 10 minutes or you have to attend to a stat add-on UGI. When you get back to the workstation, the list has shat all over itself so you spend the next 45 minutes racing through studies to play catch up.

Sitting at a desk may not seem like much, but your brain is constantly at work; it can be exhausting, especially if you're trying to go fast. Imagine spending 14 straight hours working on a Rubik's cube and what you'd feel like afterward.

And the pager. The ***-****** pager never stops going off. At most there will be two radiologists on call, usually a first-call (junior) resident for plain films and simple cross-sectional studies and a second-call (senior) for everything else. So it's not like there's an entire team like on surgery or medicine. At my program, there was only one person on call, so everyone calls you. I think my record was 120 pages in a single overnight call (14 hours). I have to have my pager on vibrate because I have a negative visceral reaction to every single ringtone that it generates.

I know it might not sound like much, and maybe it's not. I just know a lot of radiologists who did preliminary medicine or surgery internships who long for the days of their internship call.

I don't think there's any appreciable difference between academic and community programs. They're all busy. Some are busier than others, obviously, but I don't think there are any trends to follow.

 

[a winner is you]

From what I've heard around my hospital, radiology call is generally considered the toughest call in all of medicine.

 

[DeltaPlaya]

It's a little difficult to describe to someone who's never experienced it, but mostly it's just busy. I used sit down at the workstation at 5 pm and, except to take a leak occasionally, I wouldn't get up until 7 am the next morning. I'd grab a snack around midnight and eat it between sentences into the dictaphone. Sleep is a no-go.

You're constantly trying to keep up with the list, and God forbid that the surgeons want to go over a study for 10 minutes or you have to attend to a stat add-on UGI. When you get back to the workstation, the list has shat all over itself so you spend the next 45 minutes racing through studies to play catch up.

Sitting at a desk may not seem like much, but your brain is constantly at work; it can be exhausting, especially if you're trying to go fast. Imagine spending 14 straight hours working on a Rubik's cube and what you'd feel like afterward.

And the pager. The ***-****** pager never stops going off. At most there will be two radiologists on call, usually a first-call (junior) resident for plain films and simple cross-sectional studies and a second-call (senior) for everything else. So it's not like there's an entire team like on surgery or medicine. At my program, there was only one person on call, so everyone calls you. I think my record was 120 pages in a single overnight call (14 hours). I have to have my pager on vibrate because I have a negative visceral reaction to every single ringtone that it generates.

I know it might not sound like much, and maybe it's not. I just know a lot of radiologists who did preliminary medicine or surgery internships who long for the days of their internship call.

I don't think there's any appreciable difference between academic and community programs. They're all busy. Some are busier than others, obviously, but I don't think there are any trends to follow.

when a radiologist is on call, they don't really work in a team like you said, but what usually happens when they are on call?

 

[billclinton]

It's a little difficult to describe to someone who's never experienced it, but mostly it's just busy. I used sit down at the workstation at 5 pm and, except to take a leak occasionally, I wouldn't get up until 7 am the next morning. I'd grab a snack around midnight and eat it between sentences into the dictaphone. Sleep is a no-go.

You're constantly trying to keep up with the list, and God forbid that the surgeons want to go over a study for 10 minutes or you have to attend to a stat add-on UGI. When you get back to the workstation, the list has shat all over itself so you spend the next 45 minutes racing through studies to play catch up.

Sitting at a desk may not seem like much, but your brain is constantly at work; it can be exhausting, especially if you're trying to go fast. Imagine spending 14 straight hours working on a Rubik's cube and what you'd feel like afterward.

And the pager. The ***-****** pager never stops going off. At most there will be two radiologists on call, usually a first-call (junior) resident for plain films and simple cross-sectional studies and a second-call (senior) for everything else. So it's not like there's an entire team like on surgery or medicine. At my program, there was only one person on call, so everyone calls you. I think my record was 120 pages in a single overnight call (14 hours). I have to have my pager on vibrate because I have a negative visceral reaction to every single ringtone that it generates.

I know it might not sound like much, and maybe it's not. I just know a lot of radiologists who did preliminary medicine or surgery internships who long for the days of their internship call.

I don't think there's any appreciable difference between academic and community programs. They're all busy. Some are busier than others, obviously, but I don't think there are any trends to follow.

This is basically how it is where I'm at. Like colbgw said, it's mentally exhausting... like taking a 13-14 hr exam, quickly answering questions and moving to the next one... with constant interruptions from the phone/pager. So then, after dealing with the phone, you have to go back to what you were doing/back track/find where you left off/make sure you don't miss anything.

 

[colbgw02]

when a radiologist is on call, they don't really work in a team like you said, but what usually happens when they are on call?

I don't understand what you're asking.

 

[cowme]

Does a pre med know what call even is?

 

[Pedsbro]

It's a little difficult to describe to someone who's never experienced it, but mostly it's just busy. I used sit down at the workstation at 5 pm and, except to take a leak occasionally, I wouldn't get up until 7 am the next morning. I'd grab a snack around midnight and eat it between sentences into the dictaphone. Sleep is a no-go.

You're constantly trying to keep up with the list, and God forbid that the surgeons want to go over a study for 10 minutes or you have to attend to a stat add-on UGI. When you get back to the workstation, the list has shat all over itself so you spend the next 45 minutes racing through studies to play catch up.

Sitting at a desk may not seem like much, but your brain is constantly at work; it can be exhausting, especially if you're trying to go fast. Imagine spending 14 straight hours working on a Rubik's cube and what you'd feel like afterward.

And the pager. The ***-****** pager never stops going off. At most there will be two radiologists on call, usually a first-call (junior) resident for plain films and simple cross-sectional studies and a second-call (senior) for everything else. So it's not like there's an entire team like on surgery or medicine. At my program, there was only one person on call, so everyone calls you. I think my record was 120 pages in a single overnight call (14 hours). I have to have my pager on vibrate because I have a negative visceral reaction to every single ringtone that it generates.

I know it might not sound like much, and maybe it's not. I just know a lot of radiologists who did preliminary medicine or surgery internships who long for the days of their internship call.

I don't think there's any appreciable difference between academic and community programs. They're all busy. Some are busier than others, obviously, but I don't think there are any trends to follow.

Thanks! You're the first radiologist to give me a no-nonsense answer to that question.

 

[DeltaPlaya]

I don't understand what you're asking.

nvm it was a misunderstanding, I don't have any questions lol thanks

 

[bulletproof]

It's a little difficult to describe to someone who's never experienced it, but mostly it's just busy. I used sit down at the workstation at 5 pm and, except to take a leak occasionally, I wouldn't get up until 7 am the next morning. I'd grab a snack around midnight and eat it between sentences into the dictaphone. Sleep is a no-go.

You're constantly trying to keep up with the list, and God forbid that the surgeons want to go over a study for 10 minutes or you have to attend to a stat add-on UGI. When you get back to the workstation, the list has shat all over itself so you spend the next 45 minutes racing through studies to play catch up.

Sitting at a desk may not seem like much, but your brain is constantly at work; it can be exhausting, especially if you're trying to go fast. Imagine spending 14 straight hours working on a Rubik's cube and what you'd feel like afterward.

And the pager. The ***-****** pager never stops going off. At most there will be two radiologists on call, usually a first-call (junior) resident for plain films and simple cross-sectional studies and a second-call (senior) for everything else. So it's not like there's an entire team like on surgery or medicine. At my program, there was only one person on call, so everyone calls you. I think my record was 120 pages in a single overnight call (14 hours). I have to have my pager on vibrate because I have a negative visceral reaction to every single ringtone that it generates.

I know it might not sound like much, and maybe it's not. I just know a lot of radiologists who did preliminary medicine or surgery internships who long for the days of their internship call.

I don't think there's any appreciable difference between academic and community programs. They're all busy. Some are busier than others, obviously, but I don't think there are any trends to follow.

Quoted for truth.

Resident at busy large, city level 1 trauma center here. I thought ICU call was as bad as it got until I started taking Radiology call. When its bad, its terrible. The phone never stops ringing, emergent esophograms pop up, scanners throwing complex ct neck after complex ct facial bones or ct abd/pelvis at you, "can I just get a quick read", "please hold", stat reads on panscans for gsw after MVA after stab to neck. Is it tonsillar or peritonsillar? ,can we do an ultrasound real quick? hang on while I get the phone please, "Hello Radiology, I just need a quick read on an arch, MRN....""please hold", yes, your picc line is at the cavoatrial junction......whats that? no the effusion looks the same as the march 3rd study.'

Everyone "just needs" something, and the NICU,PICU, MICU A, MICU B, 7 West, pre-op, vascular, Trauma, ER A, ER B, Er holding, OB/gyn etc. all have your number. Add to this the coordinating of complex studies,calling in techs for nucs or MRI, dealing with other people who are angry that some study isn't read or whatever etc., and the need to dictate quickly to prevent the ER from calling incessantly. You must be fast, polite, efficient, and miss nothing. People will question your reads, "Yes, I know the patent was in a car accident but that is a limbus vertebrae and that is calcification of the anterior longitudinal ligament. I appreciate your concern, and that of your attending but I'm not calling fracture."

It can be relentless, and when I'm done with a 12 hour shift it can take hours to "comedown" and then I crash, usually milling over some case or other on my way to sleep.

I love my chosen field, but the call can be brutal.