Are you considering a career as a radiologist? With so many specialties to choose from and your future on the line, it’s one of the toughest decisions medical students have to make.
This guide will cover the pros and cons of becoming a radiologist, from being a ROAD specialty to dealing with unappreciative physicians to what the reading room is like.
There are so many varying factors to weigh when choosing a specialty, including years of training, whether or not you perform procedures, level of patient interaction, typical practice setting, the people you’ll work with, how much you’re paid, work-life balance, and more.
This series takes a deep dive into the career of a radiologist from the perspective of Dr. Kevin Jubbal. He outlines the factors he considered and why he ultimately did not choose radiology as his specialty. That said, rest assured that this guide includes both sides of the story, outlining the pros and cons of pursuing radiology.
For a completely unbiased look at radiology, including more details into the daily life of a radiologist and the exact steps to take to become one, also check out our guide to How to Become a Radiologist (So You Want to Be…)
Radiology Pros — What I Liked
1 | Subject Matter Relevance
As a radiologist, you’ll spend your shifts reading images that come in from all over the hospital, enabling you to see a wide variety of pathologies. You’ll see a number of the diseases you learned about in med school, so it doesn’t feel like you’re limited to one specialty. Each day there’s a broad range of pathology, not just one thing or one organ system.
Radiology is also intellectually stimulating because you’re using everything at your disposal to figure out what’s wrong with the patient. However, this means you need to have an excellent base in anatomy to understand normal variations, as well as a strong understanding of pathophysiology to know why diseases present the way they do on images.
As a radiologist, you also get to spend your days solving puzzles, using the information you’ve learned from med school and residency, doctor’s clinical notes, and the image in front of you to determine what’s wrong.
And because you’re doing all of this to come up with a diagnosis, your role as a physician is essential. Without your expertise, it may take considerably longer for a doctor to come up with a diagnosis, if they even manage to do so. That’s why some people call the radiologist the “doctor’s doctor” since many doctors will refer to you for help.
Essentially, you’re getting the theory of medicine without some of the practice.
Radiology is also one of the more tech-heavy specialties. You get to combine medicine with state-of-the-art technology, which is always evolving, and therefore, always interesting.
2 | Less Admin Work
Radiologists work more pure clinical hours than other specialties, such as internal medicine. Personally, I didn’t want to go into IM largely because of the social work involved and the immense amount of extra administrative work—like charting. There’s other things I like more about radiology than IM too, like the fact radiologists don’t obsess over sodium.
In radiology, you’re mainly writing and dictating imaging reports, but in other specialties, you’re dealing with notes, insurance claims, social work, disposition, and more. These aren’t problems for radiologists, especially if you’re working mostly in diagnostic radiology.
It’s not just about avoiding things that are unpleasant, but also feeling like the time you’re spending at work is actually meaningful and relevant. This will go a very long way toward preventing burnout.
A greater proportion of your time at work as a radiologist is actually productive and challenges your brain in the way that you trained during med school and residency. You don’t feel drained thinking that you’re wasting time and mental resources on paperwork that simply isn’t a good use of your energy.
3 | Lifestyle
Radiology is one of the “ROAD” specialties, which are traditionally known in the medical community for their relatively more balanced lifestyles. The other three ROAD specialties are ophthalmology, anesthesiology, and dermatology.
However, this doesn’t mean all other specialties have poor lifestyles. There are many other specialties where you can still enjoy quite a nice work-life balance.
Check out the Best Doctor Lifestyle Specialties.
While radiology’s lifestyle isn’t what it used to be, especially with the increasing load of images being ordered by providers, it still gives physicians a solid work-life balance. It’s reasonable to expect to work 60 hours per week in residency and a bit less than that as an attending. Of course, this will vary based on your practice type and location.
Especially with teleradiology becoming more popular, radiologists can start reading images from the comfort of their home.
Compensation is also excellent for the hours worked and the intensity of those hours. According to the 2024 Physician Compensation Report from Doximity, radiologists make $531,983 a year, placing them number 9 on our list of the Highest Paid Medical Specialties in 2024 (All Over $500K).
4 | Procedures
There are two main pathways you have as a radiologist. You typically decide which path you want to take before residency due to the fact that there are different ways to go into these specialties.
The first is diagnostic radiology, which focuses on doing and reading images. It’s what you expect of a typical radiologist.
The second is interventional radiology, which is procedure-based. IR physicians do more complex procedures that are minimally invasive, using catheters and wires.
The procedures in interventional radiology are very diverse, and you get to perform them all over the body. In one day, you can be draining a biopsy, treating cancer, saving ischemic limbs, and more.
However, this variety can be a double-edged sword, as you’ll sometimes be taking cases from other specialties, and unfortunately, there are times when these physicians will try to give you their more difficult cases.
For example, if a lung nodule is a little bit challenging for a pulmonologist, they might decide to call IR instead of trying to biopsy by bronchoscopy. Of course, this is something that can happen occasionally, not a generalization of what usually does.
Also, many procedures performed by IRs are vascular procedures, so you might be performing procedures that are otherwise done by vascular surgeons or interventional cardiologists, which sometimes leads to “turf wars” between the specialties.
With diagnostic radiology, you’re not scratching that same procedure itch as interventional radiology, and that is a con for me, as I like to work with my hands.
Check out our guide on Diagnostic Radiology vs Interventional Radiology: What’s the Difference?
5 | Collaboration with Colleagues
While you won’t have as much patient interaction as some specialties, such as family medicine, you do get to frequently speak on the phone with other physicians—sometimes they’ll come to the reading room too—and you’ll discuss their patients and the results of their exams.
You get to talk about medicine all day without having to dumb down the technical terms because you’re speaking with a fellow physician.
I heard a story of a radiologist who read a chest CT for PE in a patient with leg swelling and shortness of breath. There was no PE, but the radiologist felt confident it was likely sarcoidosis based on the clinical notes and imaging. He called the referring clinician and asked if it was typical DVT swelling or if it was red, painful, bumpy, and possibly bilateral—perhaps erythema nodosum. It turned out the radiologist was right, and they got the patient properly diagnosed.
That’s pretty amazing and shows some of the great aspects of radiology, as you’re making a true difference in patient care, you’re working with fellow physicians as colleagues and collaborators to best serve patients, and you’re solving clinical puzzles using the various pieces of information available to you.
Keep in mind that not all radiologists necessarily do this, but it’s what I view as one of the beautiful aspects of the specialty.
Rather than just saying, “the liver is abnormal, and I don’t know why. Clinical correlation is recommended,” you could dive deeper and say, “the liver looks abnormal, but based on the labs and patient presentation, I think it could be X or Y, and the following lab/imaging study/tissue sampling would help clarify the diagnosis.”
Radiology Cons — What I Didn’t Like
1 | Sitting in Reading Rooms
The stereotype of diagnostic radiologists is that they sit in dark reading rooms all day, staring at computer screens in near silence or dictating their readings. The reading room is basically a dark room with fancy computer monitors where radiologists can read their images in a more ideal setting.
Of course, that’s not the full picture, and they are doing other things too, but the stereotype is there for a reason—this is often a substantial part of a diagnostic radiologist’s day.
Disclaimer: This isn’t me trying to say the reading room is this dark, scary part of the hospital. In fact, I think it’s one of the more interesting places, where you find a number of laid back people just listening to music with their cool, optimized set-ups. It just isn’t the place for me, and it’s not how I envisioned my medical career.
I want less time in front of computer screens and less time sitting stationary.
2 | Patient Care
There are two main drawbacks for me when looking at radiology from a patient-oriented perspective.
The first of these is patient interactions. While there are subspecialties in radiology that give you more face-to-face time with patients, such as breast radiology and interventional radiology, a great deal of time in radiology residency and practice is spent in the reading room, as we just discussed. And even when you do get patient interaction, it’s still far limited compared to other specialties.
The other main drawback is your involvement in the patient’s care. Again, this depends on your subspecialty of radiology and may not apply to the more procedure-heavy subspecialty of IR.
As a diagnostic radiologist, you’re essential to the patient’s care because you’re helping the primary team reach a diagnosis, but that’s where your role ends. You aren’t involved in what happens after that, so you don’t really get to treat patients. You also don’t get the opportunity to develop any patient-doctor relationships because these patients are coming to you for a specific test and nothing else.
Keep in mind you do still get patient interaction with fluoro exams, ultrasound, interventional studies, and nuclear studies, but the level of patient interaction is reduced compared to many other specialties.
It’s also important to remember that this drawback is sometimes overstated since patient interaction isn’t a pure positive. While most patients are pleasant, there are a handful that are quite difficult or rude who will add more stress to your life. And if you’re worried about being isolated, remember that you’re still interacting regularly with other physicians.
3 | Training Length
You will spend at least 5 years in residency to become a radiologist, which is on the longer side. While some surgical specialties are 6 or 7 years, such as plastic surgery and neurosurgery, I always felt like 5 was a bit long for the field of radiology.
That said, I’m basing that on my limited knowledge of radiology. Radiology is an incredibly detailed specialty that requires a great deal of experience to do properly. And I think a large part of this can be attributed to the fact that medical school does a poor job preparing you for radiology.
You need to have a massive knowledge base to succeed in radiology. Essentially, you need to know the majority of things that can be seen on imaging, including zebras. You’ll need to know metabolic disorders, phakomatoses, congenital disorders, and so on.
You’ll also learn details that usually only clinical subspecialists know, like the types of fibrotic lung disease, types of fractures, and not only the different types of cancer, but which cancers can or can’t be reasonably differentiated on imaging.
View our complete medical specialty competitiveness index.
4 | Unappreciative Physicians
While it’s generally a pleasant experience interacting with other physicians, it’s not terribly uncommon for your reads to sometimes be disregarded by the referring physician if they don’t agree with you.
Many specialists are reading their own scans and then using the radiologists for confirmation. If you provide a contradictory opinion, they may simply ignore you.
While imaging is very important, the radiologist isn’t always mission critical for certain decisions. You’ll often see surgeons wheeling patients back to the OR based on their own reads before radiology looks at the image. You also see similar instances in the ICU and some neuro or stroke services too.
5 | Personality Type
Diagnostic radiology seems better suited for introverts than extroverts, and I’m slightly extroverted.
But ultimately, any specialty is going to be hard work, and you want to choose a specialty whose reward energizes you. When you love the ups, then the downs are much easier to endure.
For some people, that means a full shift of pathology and digital patients and helping your physician colleagues. However, while this is not as physically exhausting, it can certainly be mentally exhausting.
It can be a grind going through images and feeling pressured to read faster and faster. There also isn’t much ebb and flow to the day—you just have to be on. While you’ll get a break to eat, right after that you’re back to being on, cranking out readings for another several hours.
For me, the wins and ups of radiology weren’t strong enough to overcome the drawbacks I found with the specialty.
That’s ultimately what you want to decide for yourself when you’re choosing a specialty, and what this series is about.
Keep in mind that the relative importance and weight of each of these pros and cons is going to be highly personal. You and I may agree that the patient care is a drawback of the specialty, but while it may be a 6/10 for me, it could only be a 2/10 for you. If that’s the case, you’re going to find radiology much more appealing than I do.
Is Radiology the Right Career for You?
Overall, radiology provides the joy of critical thinking and medical diagnosis together with an excellent work-life balance and a salary of over $500K a year. You get to avoid the pain of excess admin and paperwork and regularly interact with your physician colleagues.
But on the negative side, face-to-face time with patients will be limited, you’ll spend the majority of your day in a dark room reading images for physicians who may not appreciate your work or medical opinion, and you may feel pressure to read faster and faster depending on the demand.
At the end of the day, only you can decide whether or not the pros outweigh the cons.
If you want to learn more about radiology, check out So You Want to Be a Radiologist and So You Want to Be an Interventional Radiologist.
