A career in Clinical Radiology

Clinical Radiology is an exciting and rewarding career using imaging to help with the diagnosis and treatment of patients, but why choose radiology?


What is clinical radiology?

Clinical Radiology is a hospital based medical specialty using imaging to diagnose, monitor and treat various disease processes.  It is a very rewarding career as much of the time is spent diagnosing medical conditions and working with other specialties to help plan a patients treatment.  For a basic overview read What is a radiologist?

Most junior doctors will not have had the chance to do a radiology placement in their training and this accounts for the emphasis on a good understanding of the specialty in the radiology application and interview process.  As a specialty, we are looking for intelligent trainees able to work within a multi disciplinary team with good observational, communication and practical skills.  A good understanding of general medicine and surgery is important.  The rewards are high with a career where your skills are valued both by your clinical colleagues and your patients.  The massive growth in applications of radiological imaging and image-guided treatments has resulted in a worldwide shortage of trained radiologists so you will certainly be in demand!

 

Look into a career in radiology

Look into a career in radiology

 

Why radiology?

Radiology is a fascinating specialty, incredibly diverse in both subspecialty and day-to-day workload. If you like a puzzle, practical procedures, and being exposed to a broad range of pathologies, radiology may be the right career choice for you.

Pros and Cons

Pros
  • Problem solving for clinicians
  • Often the first to come up with the correct diagnosis for the patient
  • Technology driven specialty
  • 1:1 consultant teaching is commonplace
  • Radiology is now thoroughly established as the cornerstone of diagnosis, so much so that in some major trauma centres, 'straight to CT' policy applies for suitable inbound cases
  • Hugely varied caseload. Radiologists are one of the last 'generalists'
  • More or less all of the interesting cases in the hospital comes into contact with the radiology department at some point
  • Integral role in MDTs
  • Excellent work life balance
  • Private work
  • No bleep (mostly)
Cons
  • No patient ownership
  • 'Service specialty'
  • Dependent on other specialties for referrals
  • Is radiology becoming a commodity?
  • Parts of radiology being eroded by other specialties e.g. cardiac, vascular intervention
  • More work i.e. more scans, with less radiologists, putting pressure on the workforce
  • Patient follow up can be difficult
  • Varying threats and issues, including teleradiology and skill mix

 

Personal Attributes - Do you have what it takes?

Personal attributes and skills that lend themselves particularly well to radiology include:

  • Spatial awareness and observational skills, attention to detail
  • Good grounding in general medicine and surgery
  • Hand-to-eye co-ordination
  • Leadership abilities, particularly for MDTs
  • Communication skills
    • With colleagues and other clinicians when discussing requests and imaging options
    • With patients, for example when having to consent for procedures etc
    • Excellent written English, for report clarity
  • Self-starter type personality; lots to learn and lots of exams so need to be motivated
  • Organisational and prioritisation skills
  • Being comfortable with IT is a bonus
  • Being aware of your limitations

 

The RCR asking trainees what attracted them to clinical radiology (from the RCR YouTube page)

 

Myths associated with radiology

The myths!The truth!
1. Radiologists have no patient contact... Ultrasound lists, biopsies/drains, fluoroscopy and intervention are just some of the varied patient interactions.  Sessions are allocated to reporting examinations and attending MDTs of course, but depending on the subspecialty, patient contact can feature in all sessions or limited to only one or two a week.
2. You have to understand physics... There is some physics to learn yes, but you certainly don't need to have a physics degree to be a radiologist.  Much of it is applied during day-to-day work rather than theoretical knowledge and following the First FRCR Physics exam the intensive theoretical learning is (mostly) over!
3. I find it difficult to spot things on regular x-rays, so how could I interpret an MRI?!... Radiologists definitely don't start on day 1 able to read x-rays competently, or MRIs or anything else.  Although the first year is a very steep learning curve, the training programme is well structured and over 5 years the necessary skills and competencies are gained.  Independent reporting of x-rays and performing ultrasound don't tend to happen until after the first year, so don't worry!
4. Radiologists are thinkers rather than do-ers... It's true that radiologists are problem solvers and must synthesise often limited clinical information with the imaging to provide diagnostic input.  This is a valuable skill, but it is important to acknowledge the practical aspects of radiology.  Ultrasound requires excellent hand to eye coordination, and is technically demanding to learn.  Not to mention radiologically guided biopsies, drains, injections, or contrast studies, to name a few.
5. There's too much to learm and too many exams... This is probably (almost) true!  Radiology is very academically demanding, with six exams to pass before the FRCR is awarded.  So if you are not a big fan of exams, you may want to reconsider radiology as a career.  Radiologists have to be probably the best general anatomists in the hospital, as well as having an excellent grasp of medicine, surgery, women's health, paediatrics, and everything in between.  It is probably understandable then, that there are so many exams to cover all of these topics.  But it is achievable, with a bit of hard work!
6. I don't know what to expect from radiology at the start; I've not worked in a radiology department before... The first year is probably the toughest year, and most of the time it feels like being a spare part.  This can be particularly difficult to deal with when coming to radiology from a previously senior role with lots of responsibility.  Very little is expected from you initially, and the first year is aimed at getting you through the first FRCR exams and preparing to go on call from the second year (in most places).  A taster week will provide you with an invaluable insight into the day-to-day job of a radiologist.

 

'Playing Games' by James at poormd.com - image reproduced with permission of the rights holder

'Playing Games' by James at poormd.com

 

Find out more, and what to do if you considering a career in radiology

Below are some of the activities you could do to find out more and show an interest in radiology which may help you in the future with job applications.

 

  • Visit your local radiology department

    • Speak to the radiologists and registrars to find out what they do.  They will be happy to offer their views and can help you improve your CV/application or help arrange any audits / taster weeks.  It can also help you to get your face known.  Take any opportunity to sit in on reporting sessions and attend radiology MDT meetings.

 

  • Arrange a radiology taster week

    • Talk to the Radiology Training Programme Director or a College Tutor to arrange this.  You should aim to see as many different aspects of radiology as possible and ask lots of questions.  You must request a letter of proof to confirm you did a taster week.  In some trusts it may be difficult to arrange a taster week, however you should aim to at least spend 5 days within the radiology department (even if the days are spread out over a month, for example).

 

  • Undertake a mixture of mainstream acute care clinical posts in Foundation Years

    • Although most applicants apply directly from FY2, you may want to gain extra experience by spending a period of time in acute care clinical specialties such as core medical training (CMT), core surgical training (CST) or paediatrics before applying.  Either route has its pros and cons.  Coming straight from FY2 eliminates undertaking any unnecessary clinical experience.  On the other hand, having CMT / CST enhances your clinical knowledge and gives you the time to develop your skills and CV. Entry directly from FY2 is the most common route.

 

  • Consider an elective in a radiology department

    • Either as a student or during foundation training.

 

  • Attend radiology courses / teaching / events / conferences

 

  • Get involved with a radiology audit or research project

    • This can lead to a presentation or poster and even prizes!  Each department will have lots of radiology audits available for you to do.  Make sure you do a proper audit with clear standards and that you have a supervising consultant radiologist experienced in doing good quality audits or research.  Read more about improving your CV.

 

 

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