so you want to be a radiologist you like
the idea of
sitting in a dark room looking at x-rays
and
steering clear of patient contact let's
debunk the public perception myths of
what it means to be a radiologist
and give it to you straight this is the
reality
of radiology dr jubal
medschoolinsiders.com
welcome to our next installment in so
you want to be in this series we
highlight a specific specialty within
medicine such as radiology
and help you decide if it's a good fit
for you you can find the other
specialties on our so you want to be
playlist
if you want to vote in upcoming polls to
decide what future specialties we cover
make sure you are subscribed if you'd
like to see what being a radiologist
looks like
check out my second channel kevin dubal
md where i do a second series in
parallel called
a day in the life we'll be doing a day
in the life of a radiologist
soon when a patient comes in with a
specific complaint
unless that problem is skin deep you
can't actually see what the problem is
with your own eyes
for example only a few causes of the
commonly presenting complaint of
abdominal pain can be diagnosed with
just history
physical exam and lab tests fortunately
the field of diagnostic radiology exists
whereby we can use powerful machines to
visualize what is occurring
inside the body radiologists are experts
in interpreting these images
and leverage the power of these machines
to both diagnose and
treat disease imaging modalities are
used by most physicians in most
specialties
anytime a non-radiologist physician
orders an
imaging study a radiologist will analyze
the images and provide their assessment
which helps the ordering provider guide
the appropriate care to the patient
but radiology isn't just about reading
images
some radiologists use these imaging
technologies to
improve the precision of certain
procedures for example
a suspicious mass in a patient's kidney
can be sampled through an
ultrasound-guided needle biopsy
rather than surgical excision and while
the common stereotype suggests
radiologists are shy socially awkward
don't like talking to people and just
sit in a dark room all day
that's far from the truth radiologists
aren't isolated and
sitting by themselves in reading rooms
while not as high
energy as the hospital floor or
operating room physicians regularly
visit
or call the reading rooms for assistance
with their patients
and because radiology is a comparatively
low acuity field compared to
other specialties reading rooms are
often laid back and
jovial in nature but radiologists work
isn't confined to just reading rooms
while most spend their time in reading
rooms they can also perform several
procedures
ranging from life-saving procedures such
as embolizing or ablating
cancers with radiation infused particles
to management defining procedures
such as taking a biopsy of a mass in
deep
areas of the body that no scalpel can
safely reach
there are a few ways to categorize
radiology thanks to a flexible job
market
radiologists can choose to be more
reading room focused or
patient-facing non-procedural
radiologists choose to spend the large
majority
if not all of their time in the reading
room on the other hand you can choose to
be heavily procedural
as every subspecialty within radiology
involves procedures and provides the
opportunity to be patient-facing either
in the procedure suite at the bedside or
in clinic
procedures are particularly common
amongst breast radiologists
interventional radiologists and
musculoskeletal radiologists
as an academic radiologist your
responsibilities will include
a combination of reading films teaching
residents and conducting radiology
related research
many academic radiologists also have
their own clinic where they evaluate and
manage patients
your clinical duties will generally be
at a slower pace compared to
private practice to accommodate time for
teaching
research and clinic in private practice
or community based practices
the large majority of your time will be
spent in the reading room
and your primary responsibility will be
in completing reads of imaging films
in an accurate and timely manner you'll
be spending less time performing
procedures
related to your subspecialty training
after four years of medical school
radiology residency is a total of five
years
the first year or interim year is either
a preliminary or
transition year whereby you obtain
clinical training focused on
various internal medicine or surgical
rotations
this internship is often performed at a
different institution
the subsequent four years are dedicated
to your radiology training
this means as a pgy1 or postgraduate
year one
you'll be an intern and as a pgy2 you'll
be in your second year out of medical
school
but in your first year of radiology
training or r1
we call these advanced programs as they
provide training beginning with your
pgy2 year
other specialties that include advanced
programs are anesthesiology
ophthalmology radiation oncology and
dermatology
most other specialties include
categorical residency programs
whereby you spend your entire training
period at one institution
and begin training in your intended
specialty in the first year
for example when i was in plastic
surgery residency it was a six-year
program
all at one institution and i had plastic
surgery exposure even in my first month
diagnostic radiology is middle of the
pack in terms of competitiveness
with an average step one in recent years
around 240
and an average step 2 ck in the mid to
high 240s
from our competitiveness comparison
table radiology ranks at 14 out of 22.
if you go directly to an interventional
radiology residency program
it's a bit more competitive with average
step 1 in the mid 240's
and an average step 2 ck in the mid
250's
considering board scores and other
factors from the nrmp official data
this places interventional radiology at
7 out of 22 in terms of competitiveness
medical students that typically apply to
radiology
are friendly laid-back and humble
individuals who understand the
importance of work-life balance
these are also often the intellectual
and curious students
as diagnostic radiology is heavy on
thinking
and light on the clinical application of
medicine if you enjoyed your
pre-clinical years of medical school
more than your clinical years you may
prefer the intellectual aspect of
medicine
after radiology residency you can
sub-specialize further with fellowship
all of which
are one year in duration except for ir
interventional radiology
or ir for short is the most procedure
heavy radiology subspecialty
procedures are minimally invasive
performed using wires and catheters
you can cure cancers stop
life-threatening hemorrhage
salvage critical limbs and reverse
disabling genital urinary conditions
through an incision
merely centimeters long this is the
busiest and fastest paced of the
radiology subspecialties
while you can do this as a two-year
fellowship after completing your
radiology residency
you can also go directly into an
integrated interventional radiology
residency
after medical school which is a six year
path
neuroradiology is for those who are
highly intellectual
have a passion for learning and are
driven by curiosity
the job of a neuroradiologist is to
diagnose pathologies involving the brain
and spinal cord
and guide clinical decision making
diagnosing strokes is one of the most
important responsibilities you can
additionally pursue a
neuro-interventional fellowship
afterwards if you're interested in more
procedural interventions with the brain
and spinal cord
breast radiology is heavily
patient-facing whereby you'll hold
clinic performing mammograms and
biopsies on primarily female patients if
you find a cancerous lesion you'll refer
to hematology oncology or surgical
oncology for the next steps depending on
the type of cancer
this has the best lifestyle of all the
radiology subspecialties
as there are no breast emergencies
requiring overnight call
pediatric radiology is for those who
enjoy the pathology of pediatrics but
not necessarily
the clinical aspect the pathology in
this patient population
is unique including intussusception
whereby the colon telescopes on itself
and as a pediatric radiologist you'll be
administering the air enema for
treatment you'll also see manifestations
of rare congenital diseases
more so than just about any other field
with msk radiology
your responsibilities will revolve
around sports medicine and orthopedics
in both diagnosis and management
as a result you'll be working side by
side with the orthopods
it's a highly procedural field with
joint injections for pain
joint aspirations for diagnosis and
kyphoplasties to treat vertebral
fractures
body imaging and mri is the workhorse of
radiology
and the backbone of the hospital these
are the experts in cross-sectional
imaging
meaning ct mri and ultrasound to
diagnose diseases found in the chest
abdomen and pelvis this is a procedure
heavy subspecialty
with biopsies drainages aspirations
cancer cryoablations
and cancer radiofrequency ablations
there's a lot to love about radiology
radiology is one of the road lifestyle
specialties standing for
radiology ophthalmology anesthesiology
and dermatology
it's not hard to maintain a good
work-life balance and you'll be well
compensated for your work
making an average of 427 thousand
dollars per year
as more specialties are relying less on
the physical exam
and more heavily on imaging to make a
diagnosis or monitor a disease
your input is crucial and you'll know
you're making a difference in that your
voice is being heard
given the lower acuity work environment
the atmosphere is lower stress
and colleagues are more amicable and
collegial compared to higher stress
specialties
you may not appreciate this now but you
certainly will the farther along you are
in training
there's less nonsense and bureaucratic
sludge to work through
your daily tasks as a radiologist have a
direct impact on patient outcomes
whether it's helping to diagnose a
disease or provide an intervention
as a consultant you won't have to deal
with the difficulties of
healthcare delivery such as arguing with
insurance sorting out patient
disposition
meaning where they go after they are
discharged from the hospital
dealing with non-compliant patients or
pleading with consultants to evaluate
your patient
lastly radiology is an innovative field
and you'll be able to play with new toys
and gadgets
while some are afraid of artificial
intelligence replacing the job of
radiologists
it will likely augment and make their
job easier rather than
outright replace them while radiology is
a great field it is far from perfect
you won't be on the receiving end of
gratitude from patients
after making the critical diagnosis that
allows the primary physician to best
manage them
this is because as a radiologist you are
less commonly seeing patients in person
but rather
remotely through images if you crave
patient interaction or continuity
radiology will not be able to provide
these elements
just like its name implies diagnostic
radiology
is all about identifying the problem
much less often are you the one fixing
the problem as that's the ordering
physician's responsibility
unless you're in interventional
radiology if you like the satisfaction
of being the one to solve the problems
or treat the disease
diagnostic radiology may not be able to
provide that for you
and while the stereotypes that
radiologists are introverted and awkward
are not necessarily true they're
unfortunately pervasive in the public
eye how can you decide if radiology is a
good field for you
those who thrive and are happiest in the
field tend to be curious
and enjoy the intellectual aspect of
medicine if you like puzzles
radiology is essentially that the
diagnosis is right in front of you and
you simply have to piece together the
information to find it
if you value work-life balance with time
outside the hospital
and high compensation you can have your
cake and eat it too with radiology
but make sure you enjoy the day-to-day
of what radiologists deal with
namely reading images which may leave
some of the more outgoing or
adrenaline-fueled individuals feeling
unfulfilled
if you have a big ego radiology may not
be for you
you have to be okay knowing that you'll
often be under-appreciated
with many patients not necessarily
knowing you were involved in their care
but your non-radiology physician
colleagues will find your help
indispensable
big shout out to the radiologists at med
school insiders that helped me in the
creation of this video
if you'd like to work with one of them
one-on-one and bolster your application
as a future medical student or
radiologist
visit medschoolinsiders.com to learn
more thank you all so much for watching
if you enjoyed this video check out our
so you want to be playlist where you can
find the other three
road specialties namely ophthalmology
anesthesiology
and dermatology much love and i will see
you guys in that next one