Ask a radiology attending anything

[freak7]

Hey there @Jalby . At the hospital I'm at many docs have told me not to even consider going into Rad because it's full of dinosaurs who refuse to retire so the market is actually quite saturated. How true do you find this to be? Do you think that in 8 years a good chunk of the dinosaurs will get hit with a metaphorical meteor opening up a good chunk of jobs?

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[Jalby]

Hey there @Jalby . At the hospital I'm at many docs have told me not to even consider going into Rad because it's full of dinosaurs who refuse to retire so the market is actually quite saturated. How true do you find this to be? Do you think that in 8 years a good chunk of the dinosaurs will get hit with a metaphorical meteor opening up a good chunk of jobs?

Well, there are a TON of old people out there. And it could affect your earnings. There are a lot of partner type places where everybody gets paid the same, no matter the work, and the old people get huge benefits because of this. You might be able to do twice the studies, but you get screwed because of it.

I get paid by the study. And the thing I have found is that the old people cannot compete with the speed anymore. There might be a pan scan with a chest, abd, pelv, csp, tsp, lsp, and head, and they will do the chest and you end up doing all the other studies. And I make a lot more than the old timers where I work.

So to answer your question, yes, and it might screw you. Also I have heard of younger people forming their own radiology group, bidding on contracts for hospitals, and kicking out the old timers who have no specialties.

 

[Seldon]

@Jalby, as a radiologist, what do you think about the longevity of your specialty? I can't imagine anything happening to you, but considering the state and acceleration of technological development, do you think that current and future medical students should be concerned about specializing in radiology?

Thanks for doing this AMA, it's really nice of you to take the time to do this.

 

[QuentinT88]

@Jalby thanks for doing this!

In all honesty, do you find being a radiologist to be boring? If you are spending the majority of your shift in front of a computer with no interaction with people, I'm sure it can make the work seem mundane, no?

With that said, do you think that your pay / lifestyle compensates for the boredom?

 

[Jalby]

@Jalby, as a radiologist, what do you think about the longevity of your specialty? I can't imagine anything happening to you, but considering the state and acceleration of technological development, do you think that current and future medical students should be concerned about specializing in radiology?.

I see nothing that I think will allow computers to take over for us. The studies are to complex. Best case scenario is you get computer aided diagnosis like you do for Mammo, but even those suck. So at least in the next 21 years that I plan on working, I know I will probably be safe.

But part of the reason I work so much now is because I don't know what will happen in the future. I want to get as much $$$ as I can early so that I can coast for the rest of my life. I don't need to work to give my children a better inheritance.

 

[Jalby]

@Jalby
In all honesty, do you find being a radiologist to be boring? If you are spending the majority of your shift in front of a computer with no interaction with people, I'm sure it can make the work seem mundane, no?

With that said, do you think that your pay / lifestyle compensates for the boredom?

Well, I am here on SDN when I am supposed to be working. Thankfully, there are TONS of things to keep me entertained. I listen to the soundtracks of every musical and at 4 AM the LA Times gets published. And "Mundane" studies means easy $$$$. $17 per head CT.

 

[freak7]

I listen to the soundtracks of every musical and at 4 AM

Please tell me you enjoy Hamilton

 

[JPSmyth]

Earlier in this thread you answered my question saying IR is a dying field. I would imagine this is because of the turf war with vascular surgery and interventional cardiology?

There are like 70 residency programs (unless I am misremembering) that are integrated IR programs which at the end lead to board certification in diagnostic and interventional radiology. Let's say someone goes through this training, but the work for IR is scarce. Can this person fall back on their diagnostic radiology skills and work doing reads, like you do?

If so that would be ideal

 

[Jalby]

Please tell me you enjoy Hamilton

I can sing every single line of it.

 

[Jalby]

Earlier in this thread you answered my question saying IR is a dying field. I would imagine this is because of the turf war with vascular surgery and interventional cardiology?

There are like 70 residency programs (unless I am misremembering) that are integrated IR programs which at the end lead to board certification in diagnostic and interventional radiology. Let's say someone goes through this training, but the work for IR is scarce. Can this person fall back on their diagnostic radiology skills and work doing reads, like you do?

If so that would be ideal

And nephrology and OB/Gyn. Every single specialty out there is taking the IR procedures back and doing them in house. Some OB/Gyn learns how to embolize uterine fibroids and suddenly that is all they do and they become the best at it.

I'm not sure what will be in the integrated pathway, but I assume someone will be able to fall back on reading without a problem.

 

[JPSmyth]

And nephrology and OB/Gyn. Every single specialty out there is taking the IR procedures back and doing them in house. Some OB/Gyn learns how to embolize uterine fibroids and suddenly that is all they do and they become the best at it.

I'm not sure what will be in the integrated pathway, but I assume someone will be able to fall back on reading without a problem.

https://www.sirweb.org/learning-center/ir-residency/

Those are the pathways for an IR residency/fellowship. I'm going to be doing some shadowing in IR soon and if it's something that I really love, I'll see how the field looks during my 3rd year. At least I can always fall back on doing diagnostic rad which is still awesome from what I hear both in this thread and in the real world

Thanks for the input!

 

[Jalby]

https://www.sirweb.org/learning-center/ir-residency/

Those are the pathways for an IR residency/fellowship. I'm going to be doing some shadowing in IR soon and if it's something that I really love, I'll see how the field looks during my 3rd year. At least I can always fall back on doing diagnostic rad which is still awesome from what I hear both in this thread and in the real world

Thanks for the input!

Oh wow. So am I reading this right in that the standard IR fellowship that can be done after residency will cease to exist?? That's groundbreaking.

 

[libertyyne]

Do you measure how long it takes you to read an image of a specific modality? Do you try to improve on your own speed, by looking at the average read times. Considering you are probably reading images from different hospitals and different scanners does the quality of the image vary widely what sort of adjustments do you have to make?

How would I know I would be good at DR? Or is it like surgery where it can be taught and improved upon by practice?

 

[JPSmyth]

Oh wow. So am I reading this right in that the standard IR fellowship that can be done after residency will cease to exist?? That's groundbreaking.

Yeah, looks like the 1 year fellowship will be gone in 2020.

I am reading a lot about IR turf wars with other specialties but the field seems to be pretty confident in its existence into the future, since these integrated residencies will start in 2020. And I think 70 hospitals will have these

 

[Jalby]

Do you measure how long it takes you to read an image of a specific modality? Do you try to improve on your own speed, by looking at the average read times. Considering you are probably reading images from different hospitals and different scanners does the quality of the image vary widely what sort of adjustments do you have to make?
How would I know I would be good at DR? Or is it like surgery where it can be taught and improved upon by practice?

I know exactly how long it takes me to read each kind of study. There are subtle difference in quality, but not that much. And since I get paid by the study, I try to improve my speed as much as possible. I have ~1500 voice macros so I can produce almost any report in 10-15 seconds. that is what slows most people down. So I do a 5 second glance, put in the study I think it is, and modify as needed with the standard modifications.

If you are good at computers and very good at solving puzzles, you will be good at DR. You can figure out how to be more and more efficient and save yourself time. I didn't think about that when I entered the field, but it has paid off big time becaus eI am good at both. If I had ended up in Surgery there isn't much I could have done and I would make the same as most surgeons.

 

[Jalby]

Yeah, looks like the 1 year fellowship will be gone in 2020.

I am reading a lot about IR turf wars with other specialties but the field seems to be pretty confident in its existence into the future, since these integrated residencies will start in 2020. And I think 70 hospitals will have these

I look at it more like a hail mary to save the specialty. The field has to play confident. There is no other option.

 

[Jalby]

Dpes anybody know where I can find a link to these 65 programs?

 

[TheRevenant]

Oh wow. So am I reading this right in that the standard IR fellowship that can be done after residency will cease to exist?? That's groundbreaking.

A couple of months ago, I shadowed an IR attending (first year out of fellowship) who said that the IR residency training is evolving to look more like surgical residency rather than DR residency. I'm not sure how much truth there is in that claim, I'm not motivated to verify the claim until after I am accepted to medical school

Here's a question for you @Jalby: I asked that same attending about the occupational hazards associated with IR. He said that every IR doc will eventually develop cataracts. Do you know to what extent this is true?

 

[Jalby]

I asked that same attending about the occupational hazards associated with IR. He said that every IR doc will eventually develop cataracts. Do you know to what extent this is true?

I have noooo idea. I know I would have developed major back pain from always having to wear the lead if I did IR for a long time.

 

[JPSmyth]

http://www.scvir.org/clinical/IR_DR_cert.shtml

Dpes anybody know where I can find a link to these 65 programs?

61 programs according to this site

 

[freak7]

I can sing every single line of it.

So you're a tenor then?

 

[radsgrad]

Jalby, I just happened across your thread and found a lot of great info, I get the sense you and I are pretty similar. I am a current 4th year med student, set on orthopedic surgery since some early exposure in year 1. After an actual orthopedic rotation and some soul searching I believe radiology is a much better fit for me, if I am honest with myself and what I want from a career/life.

One of the most appealing things to me is the potential of a job with the Night Shift hours. My question to you is how common are those kinds of positions in radiology? You sounded like it was kind of your only option for being in the place you want to live, so are they considered less desirable and readily available, or is the demand for night radiology too low?

I don't really care too much about working from home or in a dark room somewhere else, but I am and always have been a creature of the night and I would love a job with your hours.

 

[Epicurusall]

Jalby, I just happened across your thread and found a lot of great info, I get the sense you and I are pretty similar. I am a current 4th year med student, set on orthopedic surgery since some early exposure in year 1. After an actual orthopedic rotation and some soul searching I believe radiology is a much better fit for me, if I am honest with myself and what I want from a career/life.

One of the most appealing things to me is the potential of a job with the Night Shift hours. My question to you is how common are those kinds of positions in radiology? You sounded like it was kind of your only option for being in the place you want to live, so are they considered less desirable and readily available, or is the demand for night radiology too low?

I don't really care too much about working from home or in a dark room somewhere else, but I am and always have been a creature of the night and I would love a job with your hours.

Jalby left SDN

 

[Roxas]

@Jalby what's your issue with psychiatrists? Or was it just that one particular user?

 

[Jalby]

@Jalby what's your issue with psychiatrists? Or was it just that one particular user?

I have problems with the one who was a d&*k to me in 2011. Outside of that, I think they are great.

 

[BigBoss]

Do you have an idea of what the demand for rad is going to be like 10 years from now, and is the location of practice something you have considerable control over? (By the way, are you still working nights?) @Jalby


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[acslater99]

1. How much Physics is done during residency? I am interested in this field but I hate physics, should stay far from this specialty?
2. Do you feel like you have a great work-life balance?

 

[Matthew9Thirtyfive]

How much Physics is done during residency? I am interested in this field but I hate physics, should stay far from this specialty?

Rad onc is probably a better fit.

 

[DoctorSwagger]

Do you play fortnite


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[RNtoMD87]

Does it get boring ever only reviewing radiographs and not being able to interact with patients, etc?

 

[Jalby]

Do you have an idea of what the demand for rad is going to be like 10 years from now, and is the location of practice something you have considerable control over? (By the way, are you still working nights?) @Jalby


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I am working nights. I should be working righ tnow, instead I am talking to you guys.

The demand for radiologists is really high right now. When I got hired it was hard to get a job. It has shifted so that it is the other way around. The good news is, I got a raise because my company is terrified I would get another offer.

I personally work at night so I can live wherever I want. I do teleradiology. So I am in Los Angeles and get to have a great life.

 

[Jalby]

1. How much Physics is done during residency? I am interested in this field but I hate physics, should stay far from this specialty?
2. Do you feel like you have a great work-life balance?

1. I use absolutely zero physics right now. It was useless having to take that board exam. It also will be different for future rads than what I had. When I took the board exam, they had about 300 total questions for a 75 question test. About 60 questions on each test would be repeats, so everybody memorized the questions and nobody actually actually learned the subjects.

Literally every radiology resident was cheating the entire time:
Exclusive: Doctors cheated on exams - CNN

2. My work life balance is AMAZING. I have season tickets to LAFC and the Chargers, I am heavily involved in local politics, and have a great time doing fun stuff. All that being said, being 39 and no kids helps. That will change next year tho. But I am not giving up my season tickets for the kids.

 

[Jalby]

Do you play fortnite

I wish I did. All my free time is taken up with gym, television, and sports. I spend soooo much time reading about the Chargers and LAFC.

 

[Jalby]

Does it get boring ever only reviewing radiographs and not being able to interact with patients, etc?

Nope. Not at all. When I get bored I have about 15 internet sites I go to, including this one.

As for interacting with patients, I never think about it at all. This is my normal life. No patients. I actually did like it and was good at it at. In my fellowship I ended up with the most letters and e-mails from patients saying I was the best doctor they met in their stay. (14 total). But I also got 2 saying I was the worst ever and they hated me. So I would rather do without it.

The best thing I can tell people in order to get good reviews is to go by your first name in fellowship with the patients and not as Dr. sdfuhsjkadfh. Granted, you have to be able to show you know exactly what you are talking about to get away with it because they might not trust you, but if you can do both the patients will love you.

 

[RNtoMD87]

So my mental image of someone that's a radiologist is a physician that does nothing but interpret radiographs all day and has almost no patient interaction. Interacting mostly with other professionals such as radiologic technicians. Is this correct? I don't want to rule any field out, especially until I get to medical school but I guess I don't understand the professional appeal of it, and it seems dull. But I'm sure I just need to know more about it.

Browsing internet sites just seems like a personal hell to me. I do it to pass the time while I'm at work, but I long for a more exciting job. One reason I want to go to med school. I mean every now and then you have a decompensating patient, or a code that makes you feel alive, but other than that... man.


My father was an X-ray technician and I really don't understand the appeal of that job. He simply said "well they trained me in the Army, and at least I was in out of the cold, and the heat."

 

[RNtoMD87]

I wish I did. All my free time is taken up with gym, television, and sports. I spend soooo much time reading about the Chargers and LAFC.

Do you bodybuild/powerlift?

-Powerlifter here with a little bodybuilding thrown in for SOME aesthetics

 

[Jalby]

Do you bodybuild/powerlift?

-Powerlifter here with a little bodybuilding thrown in for SOME aesthetics

I did. i also ran a bunch. But then I got plantar fasciatis and couldn't run and put on 30 pounds. Now all I do is cardio until I am not longer enlarged.

 

[RNtoMD87]

Cardio doesn't really help me lose weight. I just get a huge appetite.

 

[buckoh24]

Do you have the ability to work from home as well? I do radiology research and I can remote in if I want to (well....if I had a computer capable of doing it) but I didnt know if attendings could do the same. My PI and friend (PD of a radiology program) are tying to push me to go into rads so I may see you if you go to RSNA or SNMMI!

 

[Jalby]

Do you have the ability to work from home as well? I do radiology research and I can remote in if I want to (well....if I had a computer capable of doing it) but I didnt know if attendings could do the same. My PI and friend (PD of a radiology program) are tying to push me to go into rads so I may see you if you go to RSNA or SNMMI!

I'm working from home right now. Well, kinda working.

 

[Siromas]

@Jalby, you are #goals.

I'm matriculating to a school in LA this fall. Can I be like you when I grow up?

 

[buckoh24]

I'm working from home right now. Well, kinda working.

Our lab got in trouble by our PI cuz like 5 of us are full time and Im the only one who cant remote in and the other 4 would only show up to the lab like.....1-2 days a week lol

 

[BigBoss]

1. I use absolutely zero physics right now. It was useless having to take that board exam. It also will be different for future rads than what I had. When I took the board exam, they had about 300 total questions for a 75 question test. About 60 questions on each test would be repeats, so everybody memorized the questions and nobody actually actually learned the subjects.

Literally every radiology resident was cheating the entire time:
Exclusive: Doctors cheated on exams - CNN

2. My work life balance is AMAZING. I have season tickets to LAFC and the Chargers, I am heavily involved in local politics, and have a great time doing fun stuff. All that being said, being 39 and no kids helps. That will change next year tho. But I am not giving up my season tickets for the kids.

Do you know if the board exam is still as difficult with a heavy physics emphasis and do people still memorize repeats? (By the way, that snitch resident in the article you posted really ruined it for everyone, didn't he?)

 

[Jalby]

@Jalby, you are #goals.

I'm matriculating to a school in LA this fall. Can I be like you when I grow up?

Send me a DM when you are about to start your fellowship. I'll hire you.

 

[Jalby]

Do you know if the board exam is still as difficult with a heavy physics emphasis and do people still memorize repeats? (By the way, that snitch resident in the article you posted really ruined it for everyone, didn't he?)

I have noooooo idea what is currently on the Physics exam. There are only so many Physics questions you can ask. And honestly, it was an open secret that everybody was cheating. The ABR knew this. Every program director knew it. And really it just ruined it for you guys.

I'll be honest, there is no point to most radiologists knowing the level of physics they tested on. And if you knew the answer to the 300 questions they could ask, you knew most of the things you would see in every day practice.

Same goes for the written tests. If you knew the 600 questions, you knew the vast majority of what you needed to know in practice.

 

[Jalby]

Send me a DM when you are about to start your fellowship. I'll hire you.

Assuming I haven't been kicked from the forum by than, of course.

 

[Jalby]

Hey Dr Jalby,
My name is Jordan. I am a Rad Tech here in southern Utah. I am taking the MCAT this summer and I hope to apply within a year or two to medical school. I have a question as far as research goes. I have 0 experience with research. Other than that my EC's are good. Any ideas on some areas of radiography that need research?

I would love to become a rad one day; I am trying to make that happen slowly but surely. Thank you for your post.

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Man, I have noooooo idea. I am thankfully done with research forever. I'm sorry. I wish I could help you out with an idea.

 

[BigBoss]

Hey Dr Jalby,
My name is Jordan. I am a Rad Tech here in southern Utah. I am taking the MCAT this summer and I hope to apply within a year or two to medical school. I have a question as far as research goes. I have 0 experience with research. Other than that my EC's are good. Any ideas on some areas of radiography that need research?

I would love to become a rad one day; I am trying to make that happen slowly but surely. Thank you for your post.

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You need research to get accepted, but it doesn’t have to be radiology related.


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[buckoh24]

You need research to get accepted, but it doesn’t have to be radiology related.


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How much research is needed typically? I’m finishing up my first gal year as a clinical research assistant in rads and have 1 abstract and if I have to reapply, I’ll have about 4-5 more (not sure about publications). Apparently what you do after graduation counts towards residency apps so I think this will all roll over.

 

[BigBoss]

1-2 long-term meaningful research experiences in undergrad is fine. The research you do in undergrad/post-grad does count towards residency, but the research during medical school is more important.


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