what should i be studying now?

[badasshairday]

Start rads in July. I'm feeling very inadequately prepared for the reality that will hit me on July 1 2013. Any tips?

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[shark2000]

You will feel inadequate in the next 4 years. Middle into you fellowship, you will feel better. Then in the last week of your fellowship, again, when you compare yourself to the attending next to you, you feel really really inadequate.

But, you have to start your first job. First it is difficult. Eventually, you will realize that though you have a lot of inadequacies, you are good enough to save lives or address important findings.

 

[badasshairday]

You will feel inadequate in the next 4 years. Middle into you fellowship, you will feel better. Then in the last week of your fellowship, again, when you compare yourself to the attending next to you, you feel really really inadequate.

But, you have to start your first job. First it is difficult. Eventually, you will realize that though you have a lot of inadequacies, you are good enough to save lives or address important findings.

Thanks. I realize that I will continue to have this feeling. but should I be reading anything now while I finish out internship?

 

[yeeseng]

I have the same question... Starting rads in about two months. My prelim doesn't allow rad electives, And I have a hard schedule that doesn't really give me any time to do Much reading outside of medicine. At what level of knowledge do programs expect incoming residents to have? How do I get to that level?

 

[shark2000]

Read anatomy. It is the backbone of radiology.

You can start take a look at your first rotation material. For example if it is GU, you can start reading about common GU entities like trauma, renal stones, IVPs, renal masses, bladder masses, hematuria, ..... Or importantly you can read about basics of renal imaging esp US and CT protocols like NECT, phases of contrast in CT, IVP protocol, ....

Also try to start making bridge between clinical questions and applications of imaging modalities soon in your residency. For example, what is the indication of renal US versus MRI? If a patient has RCC, how should you follow it up or protocol the f/u study? Even if you do not read MRI in your first year, you have to know its indications.

 

[fun8stuff]

You don't have to read anything, but if you want to you could read things like Felson's chest xray book, fundamentals of body CT... certain chapters of brant and helms (neuro, msk). Whatever you have for your first rotation. Focus on anatomy and getting an overview. I didn't read anything... rest your brain and enjoy the rest of intern year!

 

[cowme]

Highly recommend reading fundamentals of body ct by Webb.

 

[samsoniter]

I recommend some of the online resources that can help you get down the basics:
http://www.learningradiology.com/
http://www.radiologyassistant.nl/en/p42023a885587e/welcome-to-the-radiology-assistant.html
and cases from Aunt minnie and ACR case in point
e anatomy is also worth a look at

 

[myhandsarecold]

Highly recommend reading fundamentals of body ct by Webb.

I second this, straightforward, high yield, quick read

 

[badasshairday]

Soooo, I found out I start on ultrasound! Any tips? I have no idea what I'm looking at when I see ultrasound (beyond placing central lines)

 

[cowme]

ultrasound: the requisites is the mainstay for residents

 

[shark2000]

Soooo, I found out I start on ultrasound! Any tips? I have no idea what I'm looking at when I see ultrasound (beyond placing central lines)

The scope of practice of US is very diverse and different. Some departments do vascular and high risk OB. There are places that US department does MSK US, though in many places MSK is doing. And US procedures, esp US guided biopsy is done in many places by US department. Breast US is done always by breast imagers.

My recommendations:
Read about basics of US. What is echogenic, what makes the echos and basics of doppler. Artifacts and system settings.

Read about hepatic and biliary system and pelvic in your first rotation. I doubt your program have you do OB or peripheral vascular on your first rotation.

Try to sit with a good faculty and review the images with them. Ask them many questions. Everybody is doing US, but a good sonographer is really a great value.

Involve yourself in basic procedures like para, thora and thyroid biopsies as soon as you can. These are basic procedures of general radiologist.

IMPORTANT: try to learn how to hold the probe, to work with the system, to find the target organ and target lesion, to focus on the lesion and to align the probe in desired planes. You don't need to learn to scan in high quality, but you have to be able to find a target lesion in liver and align the probe and be able to hold still on it. This is more difficult than you think at first. This is the fundament of doing US guided procedures either liver lesion biopsy or breast biopsy. No brainer, but takes time to learn. I think US rotation is a very good oppotunity to master this skill.

 

[TheRealDrDorian]

I have the same question... Starting rads in about two months. My prelim doesn't allow rad electives, And I have a hard schedule that doesn't really give me any time to do Much reading outside of medicine. At what level of knowledge do programs expect incoming residents to have? How do I get to that level?

Start rads in July. I'm feeling very inadequately prepared for the reality that will hit me on July 1 2013. Any tips?

Read anatomy. It is the backbone of radiology.

You can start take a look at your first rotation material. For example if it is GU, you can start reading about common GU entities like trauma, renal stones, IVPs, renal masses, bladder masses, hematuria, ..... Or importantly you can read about basics of renal imaging esp US and CT protocols like NECT, phases of contrast in CT, IVP protocol, ....

Also try to start making bridge between clinical questions and applications of imaging modalities soon in your residency. For example, what is the indication of renal US versus MRI? If a patient has RCC, how should you follow it up or protocol the f/u study? Even if you do not read MRI in your first year, you have to know its indications.

Same boat here. Starting my rads in July on MSK. I've tried to read some of B&H, but can't see the utility in reading about Neurorads when my first Neuro rotation is next spring...

I've basically tried to organize what books I want to use for rotations. Most mentors I've talked to say try to use sources that you'll use again come board prep time. That being said, short list of intro things I plan on using.

- E-anatomy (http://www.imaios.com/en/e-Anatomy)
- StatDx (obviously)
- RadPrimer (http://www.radprimer.com/resident/)
- Case Review Series (e.g. http://www.amazon.com/General-Vascular-Ultrasound-Review-Series/dp/1416039899)

I also realize this is completely wishful thinking...

 

[155HE]

I am just finishing up my PGY-2 year, and I can attest to the fact that it is completely normal to feel totally unprepared for first year. However, looking back on the past 12 months, it's astonishing to realize how much I have learned. The only things I did to prepare for first year were a) read Felson's, and b) pay attention and try to learn as much as I could during internship.

For badasshairday, if you're starting with ultrasound, my advice is to know how to perform the scans that you will be reading. At my institution, we (the residents) have to perform all the ultrasounds on call (for inpatients and the ED)--we do not have the luxury of nighttime or weekend ultrasound techs. Our first ultrasound month is spent scanning like a tech, learning how to do all the exams. The imaging findings are totally dependent on how the scan was performed. Knowing how to do the scans will help you interpret the findings. This was also a good time to learn physics. I don't know how your program works, but if you are able to spend some time scanning your patients, you will be a better radiologist for it later.

Once you actually start PGY-2 year, try to study every night, and try to grab as many studies in the reading room as you can. The more you read, the more you know, and you won't see what you don't know.

For first year, focus on some more basic texts: Webb's Fundamentals of Body CT, Brant and Helms, Requisites (for MSK, Ultrasound, Neuro, Nucs), Donnelly's Fundamentals of Pediatrics, and Fundamentals of Body MRI (newer book--much like Webb). Try to look up articles on "http://www.yottalook.com" for specific topics...like ectopic pregnancy, penile MRI, etc.

RadPrimer and StatDX are amazing assets, if your program has a subscription. My second time through my core rotations I studied the Case Review Series.

For physics...Huda...Huda...Huda. Also, the Imaios site has some good physics resources, especially for MRI.

Again, it's totally normal to feel underprepared and overwhelmed. However, don't feel pressured to study too much before you start...enjoy your last days of internship and bask in the warm comfort that you will never have to round on a Medicine ward ever again.

 

[Elixir86]

Thanks 155HE! That was actually reassuring and comforting to hear all that from a recent PGY-2 graduate. Good luck with next year.