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
- Problem solving for clinicians
- Often the first to come up with the correct diagnosis for the patient
- Technically 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
- 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
- Lucrative private work
- No bleep!
- 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, 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
- Grounding in general medicine and surgery
- Hand-to-eye co-ordination
- Leadership abilities, particularly for MDTs
- Communication skills
- With colleagues and other clinicans 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
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 FRCR part A physics exam the intensive theoretical learning is (mostly) over!
3. I'm can't 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 is 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 is underestimated as needing 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 eleven 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 is invaluable in providing insight to the potential day-to-day job of a radiologist.