Why choose radiology ?

[shark2000]

---

Members don't see this ad.

Here is my opinion on the reasons you should and you should not choose radiology for.

Why you should choose radiology:

1- Minimal patient contact: This is a great advantage. The more experienced clinician you are, the more you find patient contact painful. Naive medical students are excited about playing doctor. Patient contact sucks.

2- Diversity: Nothing beats radiology. The pathology is great. In the world of monotonous pp medicine, you see more challenging cases in a day that any other fields sees in a week or even in a month.

3- Challenging: Probably the most cerebral field of medicine, if medicine is cerebral at all. Every interesting case will eventually or even at first finds its way through radiology.

4- Possibility of working for long years: There are radiologists who work in 60s as efficient as young ones or even better. With decrease reimbursement in all fields of medicine, no matter what field you choose, you won't be able to retire after 10-15 years of work.

5- Tremendous options: If you are tired of Brain, you can do body or MSK. If you want to add diversity to your practice you can do mammo or pain management.

6- Increasing dependence of medicine on imaging. It will grow more and more. The volume now is stagnant, but it will increase in the future.

7- Job satisfaction: Better than most medical specialties. Nevertheless, if you don't like the field, you will not have the job satisfaction.

Reasons you should not do radiology for:

1- Money: Don't do medicine at all, if you are looking for money. You will live comfortable, but will not become rich, no matter what field you choose. You have to work the rest of your life. Do whatever you enjoy.

2- Lack of interest: Obvious, but often ignored. If you can not tolerate working in a silent room on your own for hours, don't do it.If you enjoy patient contact, don't do radiology. This is a deal breaker.

3- IR: Don't do radiology for IR. If you are surgical type and you want to screw the rest of your life doing IR, do something that has more stability with better hours and less turf issues.

4- Perceived life style: Radiology is not a life style field anymore. If you think about life style, half of medical fields have better lifestyle. Don't look at the residency and think this is the way that we work in pp.

5- If you don't want to study hard, don't do it. It needs a lot of reading the rest of your life.

 

[shark2000]

It is the best field of medicine. But if you miss patient contact, that most radiologist don't or esp if you can not work on your own in a silent room for long hours with only periodic phone calls, don't do it. Radiology is no an easy job.

 

[penguin24]

Keep in mind to the med students out there:

-Sitting behind somebody as they read cases (painful), is not the same thing as reading the case yourself (cool).

On my M4 rotations I could barely stay awake shadowing Rad residents/attendings, but I have never fallen asleep at the workstation when I am reading the cases.

 

[fizzle]

I didn't even bother doing a diagnostic radiology rotation before applying to radiology. I spent a month in IR instead, got to participate in a bunch of cool procedures, and received a great letter from one of the IR docs. If this option is available to you, then I'd definitely recommend it over a diagnostic radiology rotation, where I knew I'd accomplish nothing and be bored out of my mind without demonstrating my competence to the radiologists. This is, of course, assuming that you have already previously demonstrated interest in radiology and know what you're getting yourself into with the residency.

 

[greg1184]

Keep in mind to the med students out there:

-Sitting behind somebody as they read cases (painful), is not the same thing as reading the case yourself (cool).

On my M4 rotations I could barely stay awake shadowing Rad residents/attendings, but I have never fallen asleep at the workstation when I am reading the cases.

Agreed. As a now fellow once told me, it is like watching someone play video games. This guy was the inspiration for me going into radiology.

 

[deleted116380]

I was fortunate to be exposed to radiology (both DR and IR) as an MS1 and was pretty involved with both at that time...almost on a weekly basis. My 4th year DR rotation confirmed my decision go to into rads and I can't see myself in any other field of medicine. If this for whatever reason doesn't work out, I'd go into research in radiology anyway.

As far as the the work hours and pay, radiology as with most of medicine will always be compensated well over the average american job and the work hours are just a part of it. If someone is looking to make millions a year working 6 hours a day with every other Friday off...not gonna happen. I think there is/was a survey asking how people decided to go into a field and potential earnings was not ranked high at all. It wasn't for me either.

P.S. Go Niners!

 

[shark2000]

I've heard this quite a few times now so I'm curious...how are you pp rads defining a "lifestyle speciality?" My rad buddies in pp tell me they have 8-5 hours, have call once a month, and make >350k/yr. I realize that they work hard while there (probably harder than I can even imagine), but even so that's definitely a lifestyle specialty. Comparing it to my friends and family in gas, ophtho, and derm (only those who make the same money), it's a better lifestyle than almost all of the gas people, most ophtho, and about half of derm.

Going in at 8 and leaving at 5 or 5:30 with 375k plus another 100k in benefits seems like a good gig to me. (Assuming you can find a job 😛) But I do agree that it shouldn't be the only reason since there are other specialties that can provide a similar lifestyle.

I don't know specifically about your group. But these days most groups are covering the hospital 24/7. Also the pace of work is very fast.

Derm and ophtho are much better life style. Don't even compare it. There are always exceptions.

This is from JAMA 2003 work hours per week:

http://www.medfriends.org/specialty_hours_worked.htm

GAS: 61 hours per week. The pace of work is slower. I agree this is a hard work.
Derm: 45 hours/week.
ER: 46 hours/w
Ophtahlomoloty: 45 hours/week
ENT: 53 hours/weeek
Urology: 60 hours/week
Radiology: 58 hours /week

Consider that we are much busier than 2003, but many other fields are just slightly busier. We have done it by increasing the pace. So the hours/w may not be that much higher now.

Some fields never work nights or weekends like Derm, Plastics, even ophtho in most practices. In some fields most can skip working nights like ortho, urology, ENT. In radiology in 2003 most could skip working nights. Now you have to work nights, otherwise you will lose your contract.

I'd rather do what I do than any other field, but regarding life style this is at best in the middle of the road. I still see docs of other fields hanging around in the doctors lounge, something that we never ever have time to do.
This is what we have chosen: Faster pace and denser work but controllable hours. But even in this situation you see that we work longer hours than family docs or most other fields (see above) and now we have to cover nights and evenings. Even if you compare it to GS, they worked 60 hours/w. They are known as the hardest working group in the hospital.

 

[XerxesOfPersia]

Agreed. As a now fellow once told me, it is like watching someone play video games. This guy was the inspiration for me going into radiology.

Agreed - rads definitely is not a spectator sport.

 

[shark2000]

The problem with this comparison is that they are not making the same money, which is why I mentioned that above. For example, ophthalmology starting salaries are HALF of a starting rad salary, on average. You can say the ophtho working 45 hours a week (and making 225k) has a better lifestyle, but that's not actually true since the compensation is way lower. For an ophtho to make rads salaries, they have to subspecialize in retina. Retinal surgeons definitely have a worse lifestyle than an average radiologist. They have a rigorous 2 year fellowship and plenty of emergencies/urgencies in pp. If you don't control for compensation, the comparison becomes meaningless...I can say that an academic radiologist has the best lifestyle.

I agree that derm in general has a better lifestyle than rads, but again...when it comes to the dermatologists who make >$400k who I know, they are working the same or more hours as rads (8-5 as well, but they also have to do practice-building activities that rads in general do not, have less flexibility with location and have less vacation). They have the option to work part-time, but again that's not comparable since the compensation drops off significantly. ER, ENT, and Urology are not comparable to rads IMO...their lifestyles may be better than IR but not comparable to an average DR. This isn't even getting into a discussion on vacation...rads has more than any other specialty, including derm.

I started this post to encourage students into rads. But some facts are facts.

1- Starting salary for ophtho is notoriously low, as low as family doctors and it has been like this for more than a decade. But after 2-3 years of practice, it jumps up exponentially. Your statement is irrelevant. Per hour these days they make more than rads.

2- Retinal surgeon makes more than rads for sure. A retinal surgeon can make 50% more than an IR (and DR) if he works the same hours.

3- I still don't know where you find your statements from. I showed you numbers in JAMA.
Since 2003 radiology pay per procedure decreased more than ortho, but the work load also increased more so we can maintain our income compared to them. In 2003 an ortho worked 58 hours and made 323 and a rads worked 58 hours and made 263. An ENT worked 53 hours and made 242. And most ENTs don't go to the hospitals in the middle of the night.

4- The major problem is radiology has been traditionally considered easy field and this was true in 80s. But this is not any more. Yes, it is not ICU or cards, but it is tougher than many other fields in pp.

5- In radiology there is no such thing as part time these days and they will not be anymore. If a derm want to make more, he/she can by putting more hours. But if a rads can make less, he/she can't, unless you work only nights.

6- If you think you can work 8-5 and make even close to those numbers, good luck. By the way, I have a friend who is a retinal surgeon. He is on call once a week and he barely gets called. He works 4 day a week 7am- 6pm, no weekends and no evenings. He graduated 2 years ago and he makes 30% more than what I make. I work 7am -7 pm, 5 days a week, have one month of nights a year, work both days every 3rd weekend and tons of evenings (5pm to midnight) in place of many days.

7- I did most of my medical training including medical school, residency and fellowship in one large coastal academic center and know a few people almost in every field. I still believe that radiology rocks. But not because of better hours or less stress. Because you don't have to deal with patients. But regarding pay per hour, there are tons of fields with better pay/hour. I have easier residency than most of them hour-wise, now I have harder pp work than most of them.

8- Unfortunately you are biased by your limited experience with a local group. They may or may not do fine. But I am 100% sure, sooner or later they have to start covering evening and nights. Otherwise, they will lose their contract to a group that is willing to do so. Outpatient imaging will be history in 2-3 years. All of this is true if they don't become a hospital employee which is a different animal by itself.

9- Many specialties are making similar pay/hour as rads. In rads you can not decrease your number of hours at least in competitive market. In other fields you may.

 

[badasshairday]

optho salaries are low only when they start out building a practice and patient base (or when they are junior associates making a bunch of money for there senior partner). Then as shark pointed out, salary jumps.

Retinal surgeons make a great living. True emergencies are rare. often time the emergencies can be treated in 24 hours after presentation (barring a young patient with a detached retina, which is pretty rare anyways).

 

[DrBB]

what about the horrible job market and the new boards format?

 

[badasshairday]

what about the horrible job market and the new boards format?

both kind of crap right now. VIR and mammo is hot right now, six years from now, who knows.

Personally I think doing 24/7 mammo all day would be kind of boring. VIR is cool, but too many people are doing it just for employment and are not practicing it the way they should to get high end procedures.

 

[XerxesOfPersia]

what about the horrible job market and the new boards format?

New boards format is a pain but thankfully I won't be the first class to go through it. Even then I think it's more of a pain just because it's a big change from the norm. Several other specialities aren't board-certified until well after they finish residency anyway - EM I believe is up to 1 year, not sure about others.

I hope 5 years from now I don't have to take my foot out of my mouth, but I'd still probably would have chose rads over the other specialties. Main reason I picked it is because of the limited patient contact and controllable hours. Besides, I'm not going to be a hospitalist or family medicine doc simply because they have a better job market or they were the "hot" field when I applied.

 

[cowme]

The main pain for boards is that you have to take the oral boards equivalent in the beginning of private practice.

Rather than have 100% daily prep from attendings for 3 months in residency, you are studying on your own in your free time while working a new job (or worse, unemployed and looking for a job)

 

[DrAwsome]

optho salaries are low only when they start out building a practice and patient base (or when they are junior associates making a bunch of money for there senior partner). Then as shark pointed out, salary jumps.

Retinal surgeons make a great living. True emergencies are rare. often time the emergencies can be treated in 24 hours after presentation (barring a young patient with a detached retina, which is pretty rare anyways).

Talking about retinal surgeons is like those people who talk about becoming a millionaire with only a high school education and pointing to Bill Gates and Zuckerberg. They are the exception. MOST ophthalmologists are not retinal surgeons. There is what, 5 spots every other year or something miniscule like that for retinal surgeons? You probably have a higher chance of getting into derm or rad onc than a retinal fellowship. So the chance of getting one of those spots is miniscule. Vast majority of ophthos don't make retinal surgeon salaries.

 

[deleted116380]

Talking about retinal surgeons is like those people who talk about becoming a millionaire with only a high school education and pointing to Bill Gates and Zuckerberg. They are the exception. MOST ophthalmologists are not retinal surgeons. There is what, 5 spots every other year or something miniscule like that for retinal surgeons? You probably have a higher chance of getting into derm or rad onc than a retinal fellowship. So the chance of getting one of those spots is miniscule. Vast majority of ophthos don't make retinal surgeon salaries.

5? You sure? My cousin matched into a top retina fellowship last month. He interviewed at a number of places and I'm sure that number was more than 5. I don't talk with him about specifics as we don't really talk about work outside of work. He said reimbursements are pretty crappy for ophtho, but I don't remember which cases in particular he was referring to. Maybe cataract stuff from his early residency years.

I also remember him telling me about some fellowship up north in Canada or close to where fellows don't get paid. They do the training for no benefits just to get the opportunity to have trained there. Crazy stuff.

 

[DrAwsome]

5? You sure? My cousin matched into a top retina fellowship last month. He interviewed at a number of places and I'm sure that number was more than 5. I don't talk with him about specifics as we don't really talk about work outside of work. He said reimbursements are pretty crappy for ophtho, but I don't remember which cases in particular he was referring to. Maybe cataract stuff from his early residency years.

I also remember him telling me about some fellowship up north in Canada or close to where fellows don't get paid. They do the training for no benefits just to get the opportunity to have trained there. Crazy stuff.

No, I'm not sure about the 5 but it's some similarly small number of people and I believe the fellowships are every other year. this was the discussion I had many years ago with some people going into ophtho talking about retinal surgery. So yes retinal surgeons can make lots of $$, but they are a small % of ophthos. It's like talking about orthodontists in dentistry, which is only 3-4 or so per class. So while your cousin may have matched, and good for him, there are not that many spots. So it's silly to extrapolate a whole field to a handful of people who get in every year.

 

[DrAwsome]

Your comparisons are inappropriate. You entered private practice radiology at the lowest point in arguably the last 20 years, certainly in the last 10. In the midst of this rads "recession," you also did one of the least marketable subspecialties (MSK). To make matters worse, you decided to stay in a desirable coastal metropolis. You cannot compare one of the least competitive/marketable rad subspecialties in the worst job market in 20 years with the most competitive ophtho subspecialty (retina) in a normal or even below average ophtho market. Of course your job is going to suck in comparison. Also, between family, friends, and colleagues, I know about 75 retinal surgeons. I even rotated with a few of them for 2 months. Your (and other posters) understanding of their work schedule is wrong...hardly any of them work less than 60 hours a week and certainly not in their first few years in private practice. Retina clinic also runs at a breakneck pace...from first hand experience with both rads and retina, I'd argue there's more time pressure there than in pp rads. A few months ago while reading about the job market, I joked to a few of them that I should have done retina instead of rads and they said they wish they did rads instead because there's more money in it.

While I'm not in rads, I do concur with you Dumb. I'm coming from derm, and while some derms DO make bank, they are not the derms working 7-3pm. One of my preceptors in derm worked from 6:30pm to about 6pm daily and saw like 50 patients a day. He made a ton, but he worked at breakneck speed, to the point that he had to do his notes at home because he couldn't finish, did not take lunches, and had to stay well over an hour or two late to finish the patients. I also had a preceptor who worked 9-3pm or so, and he made FM type salaries. So I do agree with you that for regular 8-5pm hours, rads salaries are still pretty high up and you can certainly find pretty high salaries in the 400k+ in less desirable areas. My sis who is going into rads has been looking at jobs and in our area they are in the 375-450k range, mostly in the midwest and an hour or so from major cities.
Numerous of my sister's preceptors/attendings also worked in the 45-50 hour range, not 60 plus.

Just saying.

 

[cowme]

Your comparisons are inappropriate. You entered private practice radiology at the lowest point in arguably the last 20 years, certainly in the last 10. In the midst of this rads "recession," you also did one of the least marketable subspecialties (MSK). To make matters worse, you decided to stay in a desirable coastal metropolis. You cannot compare one of the least competitive/marketable rad subspecialties in the worst job market in 20 years with the most competitive ophtho subspecialty (retina) in a normal or even below average ophtho market. Of course your job is going to suck in comparison. Also, between family, friends, and colleagues, I know about 75 retinal surgeons. I even rotated with a few of them for 2 months. Your (and other posters) understanding of their work schedule is wrong...hardly any of them work less than 60 hours a week and certainly not in their first few years in private practice. Retina clinic also runs at a breakneck pace...from first hand experience with both rads and retina, I'd argue there's more time pressure there than in pp rads. A few months ago while reading about the job market, I joked to a few of them that I should have done retina instead of rads and they said they wish they did rads instead because there's more money in it.

Just wanted to clarify that MSK is actually pretty marketable, especially at a place that gives a lot of procedural experience.

In terms of marketability, it probably goes: IR and Mammo (both in their own league), followed by MSK > Neuro > Body > Peds >>>>>> Nucs

 

[shark2000]

Your comparisons are inappropriate. You entered private practice radiology at the lowest point in arguably the last 20 years, certainly in the last 10. In the midst of this rads "recession," you also did one of the least marketable subspecialties (MSK). To make matters worse, you decided to stay in a desirable coastal metropolis. You cannot compare one of the least competitive/marketable rad subspecialties in the worst job market in 20 years with the most competitive ophtho subspecialty (retina) in a normal or even below average ophtho market. Of course your job is going to suck in comparison. Also, between family, friends, and colleagues, I know about 75 retinal surgeons. I even rotated with a few of them for 2 months. Your (and other posters) understanding of their work schedule is wrong...hardly any of them work less than 60 hours a week and certainly not in their first few years in private practice. Retina clinic also runs at a breakneck pace...from first hand experience with both rads and retina, I'd argue there's more time pressure there than in pp rads. A few months ago while reading about the job market, I joked to a few of them that I should have done retina instead of rads and they said they wish they did rads instead because there's more money in it.

1- I make the same as the IR guy and more than the breast imager who entered the practice around my time. So your argument about my subspecialty is incorrect. If I take extra shifts that is available in my group but I don't want to do, I can make more than IR.

2- You guys know me. I always said rads rocks. But believe me, pp rads is difficult. You guys don't have any idea about reading 150 studies a day and be responsible for it. I myself as a fellow had a very wrong idea about it, till I started to moonlight.

3- The reason that radiology looks easier on paper, is the fact that unfortunately rads have emphasized on shorter hours but faster pace of working in the last 20 years. This has resulted in relatively controllable hours compared to other fields. On the other hand, it has also resulted in decreased pay because the CMS always look at pay per hour.

4- If you talk about pay per hour, many fields are doing better than us. But I won't trade radiology for any of them in 100 years. That was the summary of what I wanted to say.

 

[ar2388]

i would choose rads over derm in a heartbeat... patients and gross skin stuff and most of the time its acne you are dealing wtih. ick!!

 

[DrBowtie]

Rads = no family care meetings that eat an hour of your day.