• SDN Site Updates

    Hey everyone! The site will be down for approximately 2 hours on Thursday, August 5th for site updates.

  • How To ACE Your Medical School Interview

    In this webinar hosted by SDN with experts from BeMo Academic Consulting, you will learn a simple five-step process to help you translate your interview invitation into an acceptance.

abefromann

Junior Member
10+ Year Member
15+ Year Member
Mar 15, 2004
174
5
Somewhere in OH
Status (Visible)
Hey guys --
Just narrowing specialties down here as a third year. What do you current radiology residents (and students) love about the field? And how did you arrive at the realization that you wanted to pursue it?
 

nutcancer

Full Member
10+ Year Member
Dec 20, 2006
144
2
Status (Visible)
i'm really interested in the answer to this question as well. i've tried asking this and the response is generally poor. everyone on here acts like rads is what they wanted to do since they came out of their mother's wombs.

i'm interested in it because patient care is not nearly as satisfying as i thought it would be. and i just want to be like, f it, i'll just read images for a living. the pay is amazing for the hours. and i'll be able to see interesting pathology quickly.
 

lola111

New Member
10+ Year Member
May 15, 2006
4
0
Status (Visible)
I thought I wanted to do primary care coming into medical school, but I found it completely unrewarding during third year rotations. You just have to decide if you would like doing radiology. I realized that I loved it, and then I looked at the rads faculty and residents, and they love it too, at least much more so than people in other specialties. Then, I had attendings in other fields tell me to do radiology. That sealed the deal for me.
 
About the Ads

cdql

Full Member
10+ Year Member
7+ Year Member
Mar 19, 2006
958
4
38
Boston
Status (Visible)
  1. Medical Student
I'm also interested in seeing the responses. Any disadvantages as well to this career choice?
 

werewethere

Full Member
10+ Year Member
5+ Year Member
Feb 9, 2007
213
1
Status (Visible)
  1. Resident [Any Field]
I'm also interested in seeing the responses. Any disadvantages as well to this career choice?

There are two problems with the work itself
1) You're not a primary service, so you are dependant on the other services for work. Now its not a problem, but as more doctors try to get reimbursement for reads (i.e. neurologists for neurorads) and as services try to take procedures from IR (i.e. many previous and future turf wars), having to count on the services for referrals can become a little sketchier.
2) You don't get the psychological response from positive feedback when you're involved in direct patient care (no one is ever going to tell you "you're amazing, you're the best doctor, you saved my life" etc) Somehow, the disadvantages of patient interaction may outway this.
 

f_w

1K Member
10+ Year Member
5+ Year Member
Jan 30, 2005
2,900
7
Status (Visible)
I used to have some Unix and programming skills which got me involved in some nuclear medicine research during medical schoo and for the year afterwards. At that time, I was still bent on becoming a 'real doctor' with patient care and such. 'Sitting in a dark room all day' seemed like the last thing I wanted to do. So I started a residency in a patient care centered field but after 2 years in the trenches I realized that 'sitting in a dark room all day' is one of the perks of radiology, not a drawback.

And while I don't have a lot of patient interaction (outside of interventional procedures, biopsies, consults, mammography, ultrasound), I and my referrers know the radiology contribution in the care of our patients. And yes, once in a while we get a postcard or a gift basket because patients realize it as well.
 

nutcancer

Full Member
10+ Year Member
Dec 20, 2006
144
2
Status (Visible)
There are two problems with the work itself
1) You're not a primary service, so you are dependant on the other services for work. Now its not a problem, but as more doctors try to get reimbursement for reads (i.e. neurologists for neurorads) and as services try to take procedures from IR (i.e. many previous and future turf wars), having to count on the services for referrals can become a little sketchier.
2) You don't get the psychological response from positive feedback when you're involved in direct patient care (no one is ever going to tell you "you're amazing, you're the best doctor, you saved my life" etc) Somehow, the disadvantages of patient interaction may outway this.

#1 is a little bit scary. cardiology already OWNS its imaging. maybe i should go into cardiology and read echos for a living? dammit, i want the imaging lifestyle!!

turf wars are scary for IR because they don't have their own patients! also lets not forget the theoretical risk of outsourcing. the saving graces will be newly developing technologies and new amazing IR procedures.
 

MD Dreams

Senior Member
10+ Year Member
15+ Year Member
Dec 13, 2001
426
1
Status (Visible)
It has been my experience that the society of interventional radiology is NOT a very proactive one. I say this because, although they state it, there is no such thing as a clinical pathway. Furthermore, the direct pathway seems very disorganized and if it is equally as difficult to get into as traditional radiology, they'll have a difficult time recruiting individuals.

On the other hand, the society of vascular surgery seems very aggressive. I contacted them once and the next day they had a detailed answer for me, not the case with the society of interventional radiology who never replied back. Also the PD's in vascular surgery are alot better at writing back, they seem to want to attract candidates!

This is just my observation and I may be mistaken. However, if it is true, I don't think IR will last too long.
 

f_w

1K Member
10+ Year Member
5+ Year Member
Jan 30, 2005
2,900
7
Status (Visible)
turf wars are scary for IR because they don't have their own patients! also lets not forget the theoretical risk of outsourcing. the saving graces will be newly developing technologies and new amazing IR procedures.

Turf wars are only scary for the classic radiology based interventionalists that sit in their angio suite and wait for the cases to be rolled through their door (or as a colleague put it: wait for the roasted quails to fly into their mouth).
There are enterpreneurial customer service based IR groups developing which are not tied to the restraints of being part of DR groups. They go out and have their own offices and market directly to the referrers in primary care, nephrology, urology and CV surgery. Neither PCPs nor CV surgeons are terribly fond of VS and cards and are often happy to have an alternate place to refer their PVD cases to. Same with uterine artery embos, in many parts of the country the womb is still owned by the FPs, they have no interest to loose patients to gynnies who are all too happy to whack out uteri at the first sign of a fibroid. Also, with UAE there is a considerable self-referral by patients who have seen Oprah or heard about Condoleeza Rice (we even had someone who self-referred for 'the cheney procedure' and turned out to be a good candidate).
 

nutcancer

Full Member
10+ Year Member
Dec 20, 2006
144
2
Status (Visible)
f_w are you IR or planning to pursue it?

i find it hard to believe a PCP will refer any patient with PVD to an IR doctor over an invasive cardiologist or a vascular surgeon -- i know i certainly wouldn't. cards owns (or will own) every atherosclerotic-related problem below the jaw. and vascular surgery training will incorporate IR-like training into it speciality, further taking away from the cut. patients, as dumb as they are, would rather go to a person wih extensive surgical training than in radiology.

i think IR can be sole proprietors of things like biliary stuff, chemoembolization, RF ablation, UAE...just not PVD stuff...

i hope i'm not hating on IR. i think any field where you can do so much change with minimal intervention is amazing. but the fact remains not a lot of people want to do IR (be it for the lifestye or the turfwars). i just wanted to make the point that they will lose all PVD-related turfwars. its a shame how bastardized that internists trained to think and medically treat can traet with surgical interventions. and regarding canvassing PCPs for referrals, that's a turn off -- not really hope-inspiring!
 
  • Like
Reactions: 1 user

f_w

1K Member
10+ Year Member
5+ Year Member
Jan 30, 2005
2,900
7
Status (Visible)
f_w are you IR

Yes.

i find it hard to believe a PCP will refer any patient with PVD to an IR doctor over an invasive cardiologist or a vascular surgeon -- i know i certainly wouldn't.

Well, that is the pattern that emerges in full-service IR only practices.

cards owns (or will own) every atherosclerotic-related problem below the jaw.

Actually, interventional cards sits at the end of a referral chain just like IR or VS.
At this time, many patients see cards first as they look at the pump (which tends to give out first) and manage to pick every fruit off the procedure tree (renals, carotids, iliacs, SFAs) before the patients have to go on to a CV or VS to receive actual treatment.
The wildcard in this is the advent of noninvasive coronary imaging. At this point, if one of my internists has an abnormal nuclear stress test, the patients have to go to cards for the coronary angio. Coronary CTA will allow general internists to triage their patients into the ones going to interventional cards vs the ones going to CV directly. Same in PVD, we can work up a claudicator or nonhealing ulcer to the point that they either go directly for an endovascular approach or to VS for a bypass. No cards required.

and vascular surgery training will incorporate IR-like training into it speciality, further taking away from the cut.

The PVD cake, none of the VS I know who do endovascular work will do TACE or any of the biliary/uro work.

patients, as dumb as they are, would rather go to a person wih extensive surgical training than in radiology.

Or a cardiologist with zilch surgical training ;)

Patients go where their PCP sends them. And PCP send where they get something back usually respect, referrals and a sense of remaining involved in the patients care.

Here is the 'sociogram' for your typical higher level community hospital:

-- CV hates cards (for putting them almost out of business and leaving them with either the f-ed up endovascular failures or the multi-morbid multi-vessel poor surgical risks)

-- VS hates cards (for skimming off the cheap and cheerful TASC-A and B lesions and leaving them with the multi-morbid single-runoff rotting feet)

-- IM hates cards (for making oodles of money while being just another internist but mainly for holding on to their patients by having their PA do all the hypertensive and diabetes management afterwards)

-- FP hates everyone (because they buy into that thing that 99% of medical problems can be managed by a FP)

If you provide good service, back-referrals and a little bit of ego massage, you can carve out a lucrative niche in that setup.

i think IR can be sole proprietors of things like biliary stuff, chemoembolization, RF ablation, UAE...just not PVD stuff...

Nobody will be sole proprietor for PVD, and that is not what any area in medicine about. It is about competing for business and the people already doing clinical IR manage to hold on to their share of the PVD pie.

The currency in community specialty medicine are referrals, if you see the PVD patient first, do a diagnostic angio and decide that this patient is better served with a open fem-pop or fem-far, you send them to you favourite VS, if during their pre-procedure workup they turn out to have CAD, you send them direcly to your favourite CVS.

i hope i'm not hating on IR.

Well, maybe not hating, but probably a bit misinformed. Sounds like you spent too much time in bad company (around cardiologists).

but the fact remains not a lot of people want to do IR (be it for the lifestye or the turfwars).

Don't let the fact that the majority of IR fellowship positions remain unfilled make you believe that nobody goes into the field. The top fellowships consistently fill and there are more than enough graduates to fill the few full-time IR positions that come up every year.

and regarding canvassing PCPs for referrals, that's a turn off -- not really hope-inspiring!

So, who DO you want to canvass then ?
 

UnderDoc

Member
7+ Year Member
15+ Year Member
Aug 16, 2003
35
1
By the banks of the long tidal river
Status (Visible)
In response to the OP, everyone's motivation for pursuing a given field should be, by definition, personal. Surverying others' motivations is lower yield than, for example, getting involved in radiology electives or research and seeing for yourself.

That said, my reasons for going into radiology were manifold. For one thing, I enjoy the sort of thought processes involved in making a radiologic diagnosis. Better radiologists (just like better anythings) are not merely pattern recognition machines, but synthesize all of the information available on a study to reach an accurate diagnosis. While excellent clinicians express the same capacities, it was my experience as a med student that so much of clinical medicine involves trudging through impossible social issues, keeping pt's entertained enough not to sue you and completing reams of mindless paperwork, to the exclusion of real intellectual engagement.

Secondly, it dawned on me that though my interest in medicine was borne primarily of a desire to aid others, clinical practice might not be the most effective way to do so. Imaging (especially in this era of withering physical exam skills and rapid CT scanners) is increasingly the means by which patients receive their diagnoses. On any given evening in the ER, I will likely make important contributions to the care of many times the number of pt's than I could ever manage to see myself.

Thirdly, there are broad opportunities in a field as cutting-edge and rapidly evolving as radiology. You can become a full time IR and adopt the surgeon's swagger or read teleradiology studies from a chalet in Zurich. There are new avenues both in diagnostic imaging (some of the developments in molecular imaging, for example, are heralding an era of Star Trek-esque diagnostic accuracy) and intervention (like the increasing role of radiofrequency, microwave and cryoablation in cancer care). Moreover, b/c radiology is so initimately aligned with technologic advancements, there are few fields that are likely to advance more rapidly or towards more horizons.

Some reasons not to go into radiology -- seriously, don't do it for the lifestyle since it is dwindling, and liable to get worse as more govt budget cuts come down the pike. Don't do it for the money - for the same reason. And don't do it just b/c you're an anti-social dweeb who thinks dark rooms might offer some respite from the rest of humanity. The pathologists in the basement would be happy to have you.
 

nutcancer

Full Member
10+ Year Member
Dec 20, 2006
144
2
Status (Visible)
f_w: yes, i have been influenced by cardiologists, its the only other field i'm considering. i think its in the lead 51% to 49% rads. i'm just a btich 3rd year student, so you're right, i don't really know what i'm talking about. i just echo what i hear from my elder classmates or docs. IR is not very popular amongst entering rads residents (but this is probably due to lifestyle as opposed to dwindling opportunity). but it is on the losing end of the generalized term 'turf wars.' but with advancing technology, i think IR can come up with/improve upon some already amazing procedures.

under_doc: thanks for posting your reasons, that is what i'm looking for and you're right it wasn't as helpful. its best to have actual experience in the different fields. after 60% of MS III (w/o having done IM or surgery yet), i realized an imaging lifestyle (no patients, money, free time) is what i want. i guess i'm just thinking about the best way to achieve that. i'm torn between going into what is definitely my passion (cardiology, learning-wise) and something else like DXRADS. i suppose i should just go into cards and fellow in echos.
 

f_w

1K Member
10+ Year Member
5+ Year Member
Jan 30, 2005
2,900
7
Status (Visible)
but with advancing technology, i think IR can come up with/improve upon some already amazing procedures.

Actually, the change in practice paradigm will do more to ensure the future of IR than the development of 'amazing new procedures'. New procedures will be adopted by other specialties in no time, there is certainly no monopoly on using image guidcance for interventional procedures.

-- Look at UAE: For 15 years gynnies have been telling their patients that it is quackery, now that the evidence is there prooving that it is superior to hysterectomy for a good number of patients, they suddenly change their tune: Their recent statement is that 'UAE is the procedure of choice, but only if done by a GYN' ROFLMAO.
-- Look at coiling of cerebral aneurysms: For 15 years NS has been telling everyone that it amounts to quackery. Now that the evidence is there that the neurological outcomes are far superior, neurosurgeons are suddenly quitting private practice to go back into INR fellowships so they can do it themselves.
-- Look at endovascular AAA repair: For 15 years VS has been telling everyone that EVAR amounts to quackery. Now that the evidence is in that it is the procedure of choice for a subgroup of patients, VS is hell-bent on incorporating it into their fellowships.
 

nutcancer

Full Member
10+ Year Member
Dec 20, 2006
144
2
Status (Visible)
its cool man, its a great field. its not like you'll ever come close to starving. and you can always carry that coveted 'surgeon swagger.' like i said, its lifestyle (busy hours) that deter some rads applicants i kno, not really the turfwars.
 
About the Ads
This thread is more than 14 years old.

Your message may be considered spam for the following reasons:

  1. Your new thread title is very short, and likely is unhelpful.
  2. Your reply is very short and likely does not add anything to the thread.
  3. Your reply is very long and likely does not add anything to the thread.
  4. It is very likely that it does not need any further discussion and thus bumping it serves no purpose.
  5. Your message is mostly quotes or spoilers.
  6. Your reply has occurred very quickly after a previous reply and likely does not add anything to the thread.
  7. This thread is locked.