The Insiders Scoop – Radiology

Name: Anonymous

Specialty/Interests: Radiology

Current Position: PGY-2, R-1

1 | What drew you to radiology?

I decided to pursue radiology because as a field I felt that it best captured the two main reasons why I pursued medicine – a love for science and the desire to help others. Radiology is a beautiful blend of physiology, anatomy, and pathology. It covers all systems, which allows you to see a variety of cases every day. In addition, every radiology study that is completed directly impacts patient care. Every dictation eventually leads to an action or non-action. While being a very cerebral field, radiology also has a nice blend of procedures which is not only limited to interventional radiology. In fact, most sub-specialties within radiology have their own subset of procedures, which allows for a nice mix of tasks throughout the workday. 

2 | What do you like the most about radiology? The least?

I genuinely love the breadth of radiology. It really brings out the most interesting parts of medicine and allows you to apply everything you learned in medical school. For those who genuinely love learning, radiology is one of those fields you could never get bored in. There are so many diseases to learn that are barely touched upon in medical school but are necessary to know for radiology boards. In addition, the variety is amazing. When you are on call, you could be diagnosing a ruptured ectopic pregnancy via ultrasound in one moment, followed by calling the primary medical team about an epidural abscess with cord compression visualized on MRI. In radiology residency, you are responsible for covering all topics of medicine.

The downside of radiology is that you are rarely in control of the treatment plan outside of interventional radiology. As a radiologist, you are much more a team player than the star of the show. We often contribute during conferences and tumor board, but the ultimate decision of what happens to the patient is in the hands of other specialties. Also, as much as you are helping the patient, you do not see the gratitude that comes with daily patient interaction.

3 | What advice would you give to students interested in radiology?

As much as I recommend shadowing a radiologist, it’s important to note that watching a radiologist do their job and actually doing radiology are very different. It can be incredibly mundane watching someone else dictate. However, radiology becomes much more fun and intellectually stimulating when you actually have the freedom to look through the images yourself and formulate your own diagnoses. When you are on radiology rotations, try to engage with the radiologist to understand their thought process on how they arrive at certain conclusions. That will give you a better sense of what it’s like to be a radiologist, as well as the skills required to be a radiologist.

4 | Do you have any concerns about job stability, given the advances in machine learning diagnostics?

The short answer is no. I think there is generally a poor understanding of radiology’s role in medicine. Imaging is a vital part of patient care. As clinical medicine progresses, it will become more reliant on imaging. Radiologists must go beyond simple pattern recognition and bring the entire clinical picture together. As cliched as it sounds, being a radiologist is being a “doctor’s doctor”. Radiologists offer a lot of guidance to the other services. Saying that artificial intelligence will take over radiology because of a computer being able to detect an abnormality on a scan is grossly underestimating what radiologists offer. It would be the equivalent to saying artificial intelligence can take over internal medicine because a computer system can formulate a diagnosis and treatment plan based on reported symptoms and lab results. I have no doubt that artificial intelligence will one day play a huge role in radiology. However, in the near future, I believe artificial intelligence will only serve as an aide rather than a replacement.

5 | What was the transition like between medical school and residency?

Like a handful of other specialties, in order to become a radiologist, you need to do one year of clinical medicine. This can be completed through a preliminary medicine year, preliminary surgery year, or a transitional year. Therefore, transitioning into residency is no different than if you were to go from medical school into internal medicine or surgery, depending on which route you choose. However, there is a big change when transitioning from your preliminary year into radiology. This is partly because there is less of a focus on radiology during medical school, and even less so during your preliminary year. There is a lot that you can apply from your preliminary year to radiology, in terms of understanding what question our clinical counterparts are trying to answer with imaging.  However, transitioning into radiology was like starting medical school all over again and was easily the hardest part of my training thus far. There is so much material to learn and relearn. Everyday reading is essential to mastering radiology.

6 | What is a typical day like for you?

I wake up early around 5 am to make breakfast for my fiance who is in a surgical sub-specialty. When he leaves for his morning rounds, I’ll watch the news in the background while studying in my pajamas. I’ll study for about 25 minutes at a time with 5-minute breaks in between. During those breaks, I’ll do household chores like load the dishwasher or tidy up the living room. I can usually get almost 2 hours of studying in before I get ready to leave the house. We usually have a morning lecture at 8:15 am, although sometimes we do start at 7:30 am. Lecture time is a mix of didactic and going over interesting cases. After lecture ends around 9:00 am, the residents will mingle for a short period of time and grab coffee before dispersing and heading to their respective rotations. The hours between 9:00-12:00 am varies depending on what rotation you are on. For example, if you are on MSK or mammography, most of the time you are in the reading room but there are a handful of biopsies interspersed in between cases. If you are on your fluoroscopy or IR rotation, then you are predominantly doing procedures all day. The business of the day fluctuates day to day depending on the number of add-ons and scheduled procedures. Some days we have noon lecture and grand rounds. If nothing is scheduled, the residents will try to grab lunch together in the resident lounge around noon. The day usually ends around 5 pm. When I get home, occasionally I’ll study, but for the most part, I’ll take the night off, cook dinner, and go to bed by 10 pm. 

7 | How do you maintain your work-life balance?

Making a schedule and sticking to it is the easiest way for me to maintain a work-life balance. My personal calendar has everything from blocked out studying time to household chores. I find that if I can plan my day down to the hour, I can accomplish a lot more. Time with family and friends is incredibly important to me, so I try to accomplish as much during the week so that I can spend quality time with them on the weekends. Time with the people I love serves as the motivation to get everything done as efficiently as possible. I will admit that being a first-year radiology resident does not make it difficult to balance work and life. However, as I start taking call and adding on more responsibility as I progress through residency, I am sure this will change.