Radiologically

Seeing is believing

Radiologically.org provides resources to help you succeed in your Radiology ST1 interviews as well as FRCR materials with reviews. 

Registrar's the Name, Radiology's my Game.

Even though I have just started as an ST1 radiologist, the assumed responsibility can be rather daunting.

Expectations arising from being a registrar involve prioritising scan requests and negotiating with fellow colleagues for a better investigation to answer a clinical question. Appropriately prioritising scans have great impacts on the care of patients, as it would facilitate earlier diagnosis and management. All hospitals have limited resources - time, scanners and of course, radiologists! As a result, inappropriate prioritisation can have devastating consequences. 

Being attached to a trauma center, scenarios such as below is very common:

A young patient involved in a road traffic collision (RTC), low GCS and hypotensive.

Immediately, my thoughts were -

Is this patient well enough to be scanned? Should the patient go straight to theater without being scanned?

Discussing with my referring colleagues, I was able to elicit more clinical details regarding the haemodynamic status and airway protection (low GCS). 

There have been many situations where patients crash whilst being scanned and I do wonder if they may have survived if they had gone straight to the operating theater. Furthermore, when concerned about low GCS affecting airway protection issues, an anaesthetist should always be present. What if the airway becomes compromise mid-scan? Will an airway competent clinician arrive in time to prevent hypoxic brain injury or aspirations?

As a radiologist, our role most certainly extends beyond "just looking at scans".

Ultimately, we are clinicians who make safe clinical decisions with contingency plans for patients.

 

This is all in being an incredible registrar in Radiology. Never compromise patient's safety. 

The challenge of being an ST1 Radiologist

Within the first month of being an ST1 Radiologist, I realised immediately that it is going to be very challenging in comparison to being an ST1 in Emergency Medicine (EM).

When I started working in A&E as an ST1 (2012), the majority of the cases were relatively straightforward since medical school and the 2 years of foundation training had prepared me well. The bread and butter of A&E included chest pains, minor illnesses, MSK injuries, neurological deficits etc, all of which had one would have most certainly come across prior to EM training. After completing 2 years of ACCS training (ICU, EM, Acute Med), I was fairly confident with almost all acute conditions and was able to manage them appropriately with minimal senior input. I was also able to independently insert central/art lines, chest drains etc.

However, during the first month of being an ST1 Radiologist, I quickly understood how little anatomy I had remembered from medical school and my poor knowledge of pathologies reflected in radiological imaging. I felt completely inadequate and out of my depth in this new specialty. Frequently, when being tested on anatomy in an ad-hoc fashion by consultants, I had to get used to phrases like "I don't know". This provided me with motivation to learn more anatomy.

Within weeks to months of learning anatomy, I slowly gained an appreciation for the relationship between normal and abnormal structures. This gradually allowed me to spot pathologies during reporting sessions. My first cross-sectional reporting was on a CT-Abdo/Pelvis  of an 18 year old, male with a right iliac fossa pain. Within minutes, I was able to spot a focal area of abnormality in the right iliac fossa. With a few more minutes, I realised that there was an appendicolith, thickening of the appendix, small amount of surrounding free fluid and thickening of the right lateral anterior renal fascia. My final diagnosis of an acute appendicitis was later approved by the supervising consultant. Despite making such an easy diagnosis, that was truly an incredibly satisfying moment but also helped me recognise that I have a long journey of learning ahead before gaining the same feeling of appropriate level of confidence I once had in A&E. 

 

Welcome to Radiologically!

Hi there, thanks for coming to our new website dedicated to all things radiology. We have some high hopes for the potential of this website, and ultimately we would love for it to become a hub for junior radiologists.

Over the next few months we will be adding plenty of new content and exciting features that hopefully will be really helpful both for recruitment and interview problems, and for training/teaching/learning issues as well.

Who are we and why have we decided to do this? From the 'about us' page you may have seen that we are two radiology registrars, training in different deaneries, and both passionate about radiology. We have a unique perspective as we belong to both academy and non-academy training schemes and ultimately want there to be an excellent resource for junior radiologists to learn, share information and discuss issues. 

We look forward to hearing from you; on how we can improve, and what you would like to see on here, so do get in touch with us via the contact form to let us know what you think.