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Preparing Residents to Enter the Market A High Yield Review
I’ve started to create a manual for my junior residents to prepare them for a world of Radiology when they graduate. I want them to be better informed and to make the best decisions as to make them the happiest and most successful. All the while I too will be learning along the way.
Topics include:
1. Resume building and or examples.
2. Things to look for and avoid in a contract.
3. Breaking down the meaning of RVU and other must know core business definitions.
4. Expectations of academic vs hospital employed vs private practice, of small vs large groups, of Teleradiology etc.
5. Lifestyle Recommendations – i.e. rent and live like a resident, never get (or make sure to get) Lasik, etc.
There is a plethora of great advice out there, so I will certainly be organizing and using that. Still, if anyone has any of their own great advice they’d like to share, links to articles that highlight these concepts or ideas in well presented/organized manners or ideas for any additional things I should include in this guide: I’d be more than happy to hear it!
Very proud to be a part of this community; it’s helped me a great deal. Hopefully I can return the favor one day.
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33 Replies
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Good idea.
“Delayed gratification tends to lead to trainees focusing too much on income and vacation when evaluating job opportunities. If a practicing radiologist’s greatest stress is insufficient income, he’s doing something wrong. Look at the bigger picture.”-
If you’re going into a small private practice, do an IR or mammo fellowship. Or both.
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Anyone who has light IR/procedural skills and mammo skills is going to be marketable. Hands-on skills cannot be outsourced to cheap tele.
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Yeah but then you actually have to do those things… 😛
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I have an interest in body/light IR but I’ve talked to 2 different groups and they said only their IR people do procedures. The body people don’t…
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1. To OP, great idea; will be very worthwhile. This is the kind of stuff is what the forum should be about; not the benefits of herd immunity. Thanks in advance for your effort.
2. As far as light IR skills; the demands of a practice change. IR typically doesn’t want to do simple stuff; lp’s, arthrograms, simple drainages, thyroid biopsies etc. Always good to have an alternative, especially as new contracts pop up [maybe a small hospital] or with personnel changes [IR people leave.] It is not difficult to get back onboard for such procedures, if motivated. One problem with current radiology is that there are so many radiologists who are needle phobic; especially with many not even wanting to leave their basements. I think some are are even afraid of doing simple fluoro. So I think being a real radiologist is a valuable skill.
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Quote from Takayasu
Anyone who has light IR/procedural skills and mammo skills is going to be marketable. Hands-on skills cannot be outsourced to cheap tele.
Mostly applies to small practices in small less desirable places. Radiology in cities and suburbs is becoming more and more sub-specialized.
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Quote from Flounce
Good idea.
“Delayed gratification tends to lead to trainees focusing too much on income and vacation when evaluating job opportunities. If a practicing radiologist’s greatest stress is insufficient income, he’s doing something wrong. Look at the bigger picture.”
What is the bigger picture?-
What should residents do extracurricularly to make themselves more attractive to private groups? At work, I focus on working hard and learning as much as I can, but other than that what can I do to shore up my CV and make me an appealing hire?
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Question should be what [i]they [/i]can do to make themselves more attractive to you. About ‘deferred gratification’ said by someone older-that can easily be taken as a statement to induce self doubt or intimidation by those who want cogs to work for their company store. You can always safely change jobs for something that works better in your life (build or keep your references) .
Also, try to get 1099 income. You can then legally defer your money into a self-designed retirement plan, and drop two income brackets while you do it. In 10-15 years, if you dont get divorced or buy a McMansion , there is a good chance you will be a multi-millionaire before the age of 50. Then you will have the freedom to do whatever you choose, without having a hospital system or someone wanting you to do something you dont. -
Quote from Aurum
What should residents do extracurricularly to make themselves more attractive to private groups? At work, I focus on working hard and learning as much as I can, but other than that what can I do to shore up my CV and make me an appealing hire?
It won’t be about your CV. It is about doing the things that make yourself liked by others. That includes being a team player, showing you are trust worthy, have a generally likeable personality. The best private practice jobs will fill before your CV even hits a desk in their offices.-
“As a first year on rotation, you may feel that you are there to learn and the attendings are supposed to teach you. But you will have learned more by the end of that year if you conform to the expectations of the attendings, e.g. if they want you to help answer the phones so they can focus on readouts with fellows and other residents, you do it. To argue otherwise – that it’s not actually your job to answer the phones but it’s their job and actually they should be spending more time teaching you – is technically correct but counterproductive to argue. (Sounds like marriage, eh?) Whether in training or in practice, first you learn to get along, then you learn radiology and how to get where you want to go. E.g. If an attending wants you draft reports that make it easier for them to get through their day, because otherwise they have to spend more time editing your draft or redictating part sof it – it’s common sense to help them so they can help you, whether in the form of spending more time teaching you or putting in a good word to someone from your future fellowship or job inquiring about you.”
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How a resident gets complimented to other attendings/practices:
Youll like them. Nice, works hard, doesnt complain.
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I would tell them that even if they don’t get their dream job right out of fellowship, they should treat their first job like it is their dream job – work harder than most, come a little early, be willing to stay late if needed, add value to the referring docs, don’t be a problem child, do good work and do their fair share of admin work. Then when their dream job does have an opening, they will get great recommendations.
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Quote from 2BRads
I would tell them that even if they don’t get their dream job right out of fellowship, they should treat their first job like it is their dream job – work harder than most, come a little early, be willing to stay late if needed, add value to the referring docs, don’t be a problem child, do good work and do their fair share of admin work. Then when their dream job does have an opening, they will get great recommendations.
+1
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There is an excellent market for efficient body imagers that can read cross specialty and cross modality. No IR nor Mammo needed.
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CV design is built on what practice you’re looking at going into. If it’s PP, then keep it to 3 pages. If it’s academics, then your first year medical student award might have value on page 38.
Write a cover letter. Be professional at all times- pre-interview, talking to the practice manager, the techs, etc… some places do see value in having someone that is easy to work with.
Similar to what hospital-rad said… know thyself. If you like more days of work with more coffee breaks, then find that job. If you want to work harder and work less days, then do that one. There are many jobs in between.
The biggest mistake people make IMO is limiting their location. That will limit what jobs you can take. If you’re willing to move, then you can always go where the grass is greener.
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Quote from Hospital-Rad
What is the bigger picture?
Bigger picture is that your day to day happiness with the work, the pace of work, the people, the location, etc, contribute more to your daily happiness than seeing another 80K pre-tax.
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Quote from Flounce
Quote from Hospital-Rad
What is the bigger picture?
Bigger picture is that your day to day happiness with the work, the pace of work, the people, the location, etc, contribute more to your daily happiness than seeing another 80K pre-tax.
I agree with your statement about happiness but you can’t make a generalization. People are different and chase different things in life. There are people who find happiness in making another 80K pre-tax instead of having a slower workflow. Anyway, different stroke for different folks. That’s the main reason that no philosopher is the history of the world has been managed to find “the magic key to happiness”.My recommendation to residents is to try to know themselves better. Read some books. Do some moonlighting during residency and fellowship. These things help to know themselves better. If they want more money, that’s fine. If they want better lifestyle, that’s fine. The key is to know what you want, whether you want to buy a car or you want to get your first or your fifth radiology job.
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I make the generalization because I think most of us go through a phase – as 30 year old+ radiology fellows looking at a number of different job options – whereby we focus on compensation and vacation time to a degree that many of us later come to feel was suboptimal. I’m not trying to impose a value judgement, I’m just giving trainees a heads-up, which is the purpose of advice.
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This has already been enlightening and helpful. Very grateful thank you.
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Agree with Flounce, as usual.
Try to figure out if you rather have a job that are at work more, but less busy while there. Or busier while there, but more time off.
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Quote from Flounce
I make the generalization because I think most of us go through a phase – as 30 year old+ radiology fellows looking at a number of different job options – whereby we focus on compensation and vacation time to a degree that many of us later come to feel was suboptimal. I’m not trying to impose a value judgement, I’m just giving trainees a heads-up, which is the purpose of advice.
Great advice. It is easy to overlook factors other than pretax money and vacation, and then regret in the future when it is too late.-
I agree. This is all great advice.
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Theres no way to know anything for sure about a job except location, vacation and money. They could also lie or things could change. Plenty of scumbags in radiology.
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OP, agree that this is a great idea for trainees. Still boggles my mind that even basic information about radiology-as-career is not given to trainees.
Couple of points that have stuck in my head over the years.
– your first job is not necessarily going to be your last. Don’t be afraid to bail in a 2-3 years if you see something not right in your group or your future being messed with. Until you are sure you have found a steady place to land job wise, stay current on what the job market looks like and trends.
– when starting that new position, for at least the first 6 months to a year, keep your head low (ie. don’t get involved in practice politics), be helpful, cordial, and adaptable. When you go on vacation, your absence should be noticeable (eg. increased TAT or calls from clinicians asking for you).
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Quote from Flounce
Good idea.
“Delayed gratification tends to lead to trainees focusing too much on income and vacation when evaluating job opportunities. If a practicing radiologist’s greatest stress is insufficient income, he’s doing something wrong. Look at the bigger picture.”
I have divorced friends that don’t have the luxury of decreasing their expenses as you do due to court ordered expensive maintenance / child support payments. They would disagree with your statement above-
Quote from JTG
I have divorced friends that don’t have the luxury of decreasing their expenses as you do due to court ordered expensive maintenance / child support payments. They would disagree with your statement above
Everyone lives in their own world.
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Quote from HazzyKo14
I’ve started to create a manual for my junior residents to prepare them for a world of Radiology when they graduate. I want them to be better informed and to make the best decisions as to make them the happiest and most successful. All the while I too will be learning along the way.
Topics include:
1. Resume building and or examples.
2. Things to look for and avoid in a contract.
3. Breaking down the meaning of RVU and other must know core business definitions.
4. Expectations of academic vs hospital employed vs private practice, of small vs large groups, of Teleradiology etc.
5. Lifestyle Recommendations – i.e. rent and live like a resident, never get (or make sure to get) Lasik, etc.There is a plethora of great advice out there, so I will certainly be organizing and using that. Still, if anyone has any of their own great advice they’d like to share, links to articles that highlight these concepts or ideas in well presented/organized manners or ideas for any additional things I should include in this guide: I’d be more than happy to hear it!
Very proud to be a part of this community; it’s helped me a great deal. Hopefully I can return the favor one day.
Great idea; I’m happy to be a reviewer or contribute material which would probably be more involved than a simple AM post.
Where to start? each of these could be a book or at least a few book chapters.
Why limit this to rad residents? Reading over the posts on “american physicians” “american radiologists”, and “Physician side-gigs” groups on fb, probably every physician needs a primer on these subjects.
Also, why do a book? most people today are reviewing audio or video materials as you can do listen on the go…
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Can someone explain to me the general concept behind RVU production?
I understand the AVG RVU per year is around 9k. That a younger attending just out of fellowship should be starting at 8k (at least) and that some insane high volume attendings crank out 15-20+K. But that is the extent of my knowledge.-
Quote from HazzyKo14
Can someone explain to me the general concept behind RVU production?
I understand the AVG RVU per year is around 9k. That a younger attending just out of fellowship should be starting at 8k (at least) and that some insane high volume attendings crank out 15-20+K. But that is the extent of my knowledge.
Each type of study has an RVU conversion factor, i.e. Head CT without contrast = 0.85 RVU. CXR = 0.15 RVU. CTA head = 1.75, etc…Go to: [link=https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/PhysicianFeeSched/PFS-Relative-Value-Files]https://www.cms.gov/Medic…S-Relative-Value-Files[/link]
There are multiple zip files which have the CMS conversion factor for everything in medicine. It’s cumbersome so you’ll have to search through, but the file inside each zip that you want is the PPRRVU excel folder.
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I just enjoy writing books haha. Other modalities are currently a little less accessible as I am still trying to focus the majority of my efforts on core review and such. One day perhaps!
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Quote from HazzyKo14
I just enjoy writing books haha. Other modalities are currently a little less accessible as I am still trying to focus the majority of my efforts on core review and such. One day perhaps!
Sorry, what I mean is specifically related to physician contracts. The general lack of knowledge on what the pitfalls of signing the wrong kind of contracts is quite scary….
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