[namaalamry_845]

Part of the challenge in Radiology is starting fresh with a completely new subject. With that said, sitting in a reading room is energizing to some and draining to others. Difficult to answer as everyone has different personalities.

[btomba_77]

It probably won’t be fulfilling until clinicians start coming to *you* for answers.  
 
Depending upon your radiology knowledge, social skills, and practice situation that can be anytime from around R2 to never.
 
But don’t mistake [i]watching someone else [/i]practice radiology as being the same as practicing radiology.   (Just like watching someone play video games is a lot less fun than playing it yourself)

[Unknown Member]

Residency and fellowships were all stressful for me and not rewarding or enjoyable. I was at top academic programs around people with big heads and egos, running with the big dogs and had to work like hell just to keep up with them, felt like I was treading water for 6 years, my stress levels were through the roof twice a day when we had conferences, with numerous smaller stress peaks throughout the day during readout when challenged by attendings in front of the other residents and fellows. It sucked, and – I later learned – more than half my residency class had taken Pepcid or protonix at some point for gastritis from the stress. (not all radiology training programs are this bad)

It turned around a bit when I got out and was working independently – not getting pimped all the time – and I saw my paycheck. (Borat: “Niiiiicccceeee.”)  It was a hard but good gig.

But practice was still stressful in the beginning because I was unaccustomed to the volume and I was being scrutinized by the radiologists, technologists, and clinicians. Come early, stay late. 

It took a few years to earn their respect, and then it got a little better because they would give me the benefit of the doubt if I missed something. Clinicians would call me to look at cases my partners already dictated because they wanted to know what I thought. It creates more work for you, but it is an ego boost. I started giving out my personal mobile phone numbers to the really good surgeons and clinicians, so they could get a hold of me easier. 

The work then got easier when I figured out what to say when I didnt know the answer – and that’s normal, to sometimes see weird stuff and not have a diagnosis but still be able to issue a helpful report – and I also realized that the world didnt sit on my shoulders : the clinicians are generally good at following up on results and reaching out if my report didn’t jive with what they were seeing, sifting out the chaff to find the wheat in our reports. Saw that lots of what we stress over in our reports have little clinical significance. Just because our attendings in training decided to grade injuries in some convoluted scheme that MGH loves doesn’t mean that the surgeons in our hospitals found it useful. Sometimes less is more.
 
Yeah work was still busy, but no longer so hard in the draining, white knuckle on handrails sense. And maybe I also stopped caring about the details so much, not to say that was a good thing for my patients, but it was good for my mental health. 

It then got better when I got involved in group leadership, strangely. Yes I had to take on more admin responsibilities and was more harried, but I was helping out radiologists and took part in coming up with the rotation schedule – (being able to assign cush or sh*t rotations to your colleagues is true power, right?) – and both radiologists and techs sometimes came to me with various issues and I would try to be a hero and move heaven & earth to get them what they wanted, even if that just meant helping them leave at 3pm so they could attend a family event. I may not be loved but was given wide berth and feel pretty secure in my position, which is now part time.

Gist is that 1) residency does suck and that’s not because radiology sucks or you lack some aptitude or genuine interest in it;  it’s the nature of residency training;  2)  things do get better, not overnight but gradually as you gain confidence in yourself, start enjoying some of the gratification that’s been delayed, and establish yourself in your practice and get to know people and there is give and take; 3)  when you start to invest in people / workflow / conditions in your work, you feel a greater stake (whether you actually own a greater $take or not) and a small but real sense of reward and even appreciation. Interdependence is better than independence. Even the Lone Ranger had Tonto.

[Unknown Member]

In short, residency sucks.   Fellowship will also likely suck.  This goes for all specialties.  You are cheap labor. 
 
Real question:
Why did you choose radiology???  There must have been reasons why you selected radiology instead of another specialty.  Have those reasons been debunked?  I wouldn’t base it on the boring/grinding day to day residency life or because you are the low man on the totem pole in radiology at this point.
 
I remember my transitional year was a big waste of time as well.   It was way more draining than radiology. 
 
I, honestly, got a little depressed in my R-2 year because you get started with call (its rough) and then you realize you have 3-4 years of training left.  I would advise you to hang in there if you have the right reasons for doing radiology.  I mean would another residency in a different specialty be better?   Probably not.  
 
I think its a myth some ppl propose that life should always be exciting and interesting at every turn.   As you get older, you realize there are good times and not so good times.  As I look back, residency and fellowship were some of the worst times in multiple ways.  Stay strong!

[btomba_77]

My depression was MS1-4

Residency worked for me …..

But I hated medical school … I hated the subject matter … I mostly hated the people … I hated the hours

Doesnt mean that it was the wrong choice

[Unknown Member]

Im with dergon. I loved residency. Med school sucked.

[Unknown Member]

Med school year 3rd and part of 4th year sucked for me, too. So much scrutiny and so much pressure to perform, yet so helpless on wards.  Years 1-2 I really enjoyed, now that I think about it. Great city, was single, enjoyed my time outside of studying, the world was my oyster. I had big dreams that have mostly come true. 

[clickpenguin_460]

Am I the only one that thought undergrad sucked?  :/

[leann2001nl]

R1 is a tough transition bc its such a different job than anything you do in medical school. You could go be an intern for most medical and surgical specialties and at least be somewhat useful after a little training but rads is a whole new language and world essentially .

Gets way more rewarding when you get to pgy2 and above and get to call stuff on your own, ie you told them the patient has appendicitis and needs an appy, or that there was this fracture etc. following up cases and seeing patient outcomes is very fulfilling personally.

[Unknown Member]

I have had lots of jobs. So I treated med school like one. If you put in a solid 8 hours during the first two years, no screwing around; good job, and you can do real well. Didn’t waste time on bad classes, just studied with alacrity. So for me, it was efficient, much better than tolerable; I enjoyed it. Clinical years always offered something to do if proactive, procedures etc. Better than any job I ever had before that. The most boring rotation as a student was actually radiology; so passive. But I saw the potential.
Residency was great. Learning exponentially, with nice colleagues and great staff. 
My first jobs were exciting; couldn’t wait to get out on my own.
So my journey has been fun. There were of course bad times, which I conveniently forget, but not too many. [OB/GYN in med school, that sucked.] But overall, the tales of suffering and woe don’t ring true for me.
It was all a lot more fun than the tedium of current radiology; which for me is mostly volume related. Also, the isolation of the specialty currently is disheartening. But I am near the end of the trail, a great ride.
 

[Unknown Member]

Wasting 1 year is nothing, now is a good time to switch if you like something better.  The average physician practices over 30 years, you want to make sure you’re doing something you love, if not love, you should at least like it. 

[ljohnson_509]

Radiology pays well, good time off, dont have to interact as much with others. But your early on and radiology has a big target on its back. Seems too risky if you dont love it.

[lzq667_242]

I think if you chose to pursue interventional subspecialty, it would feel more rewarding. I know people switched to surgery , for the same reasons you mentioned, then switched back again to interventional radiology. 

[lzq667_242]

I think if you chose to pursue interventional subspecialty, it would feel more rewarding. I know people switched to surgery , for the same reasons you mentioned, then switched back again to interventional radiology. 

[william.wang_997]

I would suggest that you change fields pronto if you know what you like. 
If as an R1 you are not enthused, find the field that enthuses you. The money you end up making won’t be satisfying.
Nothing wrong with it. The earlier you change course, the better it is.
I switched from IM to rads and was extremely bored in it.
 

[drvsandeep]

Thank you for all of the thoughtful responses.

I chose radiology because I believed it would be challenging and intellectually stimulating. I also thought that I would enjoy interacting with other clinicians more than patients. All of these things hold true – radiology has been very challenging and requires a vast fund of knowledge, and I still enjoy discussing cases with clinicians. However, I underestimated the sense of isolation and, at times, tedium that comes with the job.

I would be lying if I said that I loved my year of internal medicine, but I was seldom bored and never felt burned out, even after a three-month stint of wards during the peak of COVID. I enjoyed the camaraderie with my co-residents. I found patient care rewarding. I felt competent and confident, and toward the end of the year began to realize that being an internist might not be all that bad.

The dilemma I am facing is whether to return to internal medicine – a field that I enjoyed, at least in the short term – or stick it out in radiology to see if it becomes more rewarding as my skills and knowledge improve. The upper level residents seem more engaged in their work than I do. Is this a function of a deeper understanding of radiology or are they just cut from a different cloth?

Thanks again for all the insight.

[btomba_77]

I do not know a single internist who is happy doing internal medicine more than 5 years out from training.  
 
I know each choice is personal, but leaving radiology to be an internist? Kill me now.
 
 

[Unknown Member]

Quote from dergon

I do not know a single internist who is happy doing internal medicine more than 5 years out from training.  

I know each choice is personal, but leaving radiology to be an internist? Kill me now.

After 20 years of being a radiologist I still tap dance to work. I am a radiology aficionado.

[Unknown Member]

I know several internal medicine doctors who are very happy and they make more than radiologists.  They started their own practices, built them up and then sold them and started building practice again.   You can easily make more as an internist who owns their own practice vs a radiologist working for VRAD.  Knowing you are getting paid 1/3 of what your private practice collegues get vs knowing you are getting paid at the top % of what internal medicine docs make in itself is a big difference in mentality and how the job makes you feel.  A field/specialty is just the beginning, the actual job in that field varies and makes all the difference in the world.  Interest rates are really low now and will be low for a while, great time to start a business in the near future

[Unknown Member]

This is a personality issue to some extent. If you are kind of person who likes clinic or rounding on patients or standing in the OR, hopefully you know it by now after med school and internship.

I would hate to be a hospitalist or clinic doc. Surgical subspecialist… maybe. I dont think it gets easier diagnostic radiology and yeah the work is boring at times, thats why I listen to music and watch Netflix / Amazon Prime while working sometimes.

[nelevy920]

Stick it out in Rads. No better speciality.

Every specialty is getting gutted, cut and replaced. It will happen to us more so but we are so far pretty insulated. The mode for future is more work, less pay and more responsibility.

Diversify career and be able to bounce out of medicine.

[Unknown Member]

Sorry I would not want you to read my familys imaging, flounce. Watching Netflix while reading cases? Thats horrendous.

[Unknown Member]

Sorry I would not want you to read my familys imaging, flounce. Watching Netflix while reading cases? Thats horrendous.

[Unknown Member]

Many radiologists picked radiology because they could basically only do radiology or pathology and have anaphylactic reactions to other specialties dealing with patients like internal medicine.  A minority of radiologists however are more well rounded and could also enjoy many other specialties.  The advice you get will differ from the type of radiologist you ask, I suggest you stick to the more well rounded ones.  Interventional radiologists are a good source, they generally like procedures, patients, and diagnostic or sit on your arse radiology.  The beauty of medicine is that there is a field for every personality….even the psychopath, he can do pathology. 

[Unknown Member]

Quote from irfellowship2020

Sorry I would not want you to read my familys imaging, flounce. Watching Netflix while reading cases? Thats horrendous.

I get it. But you don’t know me. My colleagues in radiology and various clinicians ask me to look at their own imaging and family’s imaging.  I generally listen to the dialogue of what’s playing and will occasionally look away from the study I’m interpreting for a second if there is anything interesting happening in the show. If the study I’m reading is complicated or I see an unusual finding, I stop listening to what’s playing. Otherwise – for noncon heads, PE studies, CTAP for abd pain, RUQ ultrasound, MRI knee or IAC, screeners…. it’s like walking and chewing gum at the same time, autopilot.  I’m on swing shift now covering the ER and about halfway through Season 2, Episode 13 of The Americans, my second time watching this series. 

[Unknown Member]

Quote from striker79

I know several internal medicine doctors who are very happy and they make more than radiologists.  They started their own practices, built them up and then sold them and started building practice again.   You can easily make more as an internist who owns their own practice vs a radiologist working for VRAD.  Knowing you are getting paid 1/3 of what your private practice collegues get vs knowing you are getting paid at the top % of what internal medicine docs make in itself is a big difference in mentality and how the job makes you feel.  A field/specialty is just the beginning, the actual job in that field varies and makes all the difference in the world.  Interest rates are really low now and will be low for a while, great time to start a business in the near future

 
Internal Medicine- Yikes.
No way.
Work harder, make less, tortured by EMR.
95 year old patients every 15 minutes.
My IM friends are m i s e r a b l e.
I think all medicine is being gutted. Sad times.
Don’t think there is another specialty I would want outside of radiology; although I would think hard if I had to be a teleradiologist.
 
 

[sehyj1]

R1 year was pretty terrible, in retrospect

[ljohnson_509]

I cant imagine doing anything for a living other then radiology.

But now that I am near financial independence, I dont think I would miss it much. Too young to quit, thinking part time may be a compromise.

[sehyj1]

“I can’t imagine doing anything for a living other than radiology”

I have a gut feeling you hear that more in radiology than you do in other fields (swap radiology out with another field in the quote, of course)

[leann2001nl]

lol IM. Literally filling out paperwork for a living, fighting for dispo and managing chronic medical issues. What a life. Sounds like hell to me. 

[Unknown Member]

IR27, also don’t forget, having to get on the phone to fight insurance companies for your patients. Ridiculous.  Anyway, like Dergon, I thought pretty much all of med school sucked. Big time. Particularly MS3.  All that change, and your career depended on how quickly you could adapt to a new skill set, new patients, new EMR, new everything?  Goddamn stupid process  if you ask me.
 
For all the R1s out there, I would say study like hell.  I did, and we took a lot of call back then as an R1. That combo pushed me high on the learning curve quickly.  R2 and R3 weren’t bad, and honestly, much of R4 felt wasted.  Ideally would just start/finish fellowship that year. I know MGH had that system, not sure if they still use it. Makes sense to me.
 
Also I think the American system for Medical School is flawed. So worried about lawsuits that you aren’t allowed to really touch a patient.  My parents were doing appendectomies and hernia repairs as MS3s (abroad), with the resident in another OR doing a ‘real case’ for back up.  You really need to *do* things to know what they entail.  To the OP, hopefully you get to prelim a lot of cases and aren’t just passively watching.  That’s boring as hell. 
 
I see Boomer hated Ob/Gyn.  I thought I would too, but I ended up rotating in a naval hospital for that rotation. Instead of watching, I was delivering and doing a lot of the minor surgical procedures. Ended up loving it.  Libido disappeared by the end of the six weeks (lol) but hey, I moved on to the next rotation and my T must have boomeranged.
 

[Unknown Member]

Quote from striker79

I know several internal medicine doctors who are very happy and they make more than radiologists.  They started their own practices, built them up and then sold them and started building practice again.   You can easily make more as an internist who owns their own practice vs a radiologist working for VRAD.  Knowing you are getting paid 1/3 of what your private practice collegues get vs knowing you are getting paid at the top % of what internal medicine docs make in itself is a big difference in mentality and how the job makes you feel.  A field/specialty is just the beginning, the actual job in that field varies and makes all the difference in the world.  Interest rates are really low now and will be low for a while, great time to start a business in the near future

Internal medicine in any decent city is no longer a good job. Way too much competition from the NP PA hordes as well as other specialists. Big money is probably only available now in extremely rural and isolates areas. 

[aejunk1]

you should definitely go for IM.   A good IM practice with a few NP/PA can generate 3 comma per yr on income.

[Unknown Member]

I don’t think it is wise to think that one will go into primary care and make more than a radiologist. Some do but not most.

[Unknown Member]

Yes exactly, you hire a bunch of NP’s and PAs to see patients and rack up the dough.  Business owners are the ones that will always make all the money in this country. at the expense of NP’s, PA’s, and TELERADS.  I should have created my own VRAD.  There are so many suckers out there with no business acumen!  The brain power of academic radiologists should be directed towards a lot more towards business instead of radiology. IF you love internal medicine, I say go for it and find a mentor who has already made millions off his practice so he can show you how to do the business side.   

[leann2001nl]

3 comma is a billion . Must be a lot of RVU

[btomba_77]

Quote from IR27

3 comma is a billion . Must be a lot of RVU

OMG … “Tres commas” …. Did any of you guys watch [i]Silicon Valley[/i]?
 
[link]https://youtu.be/2XxwhMcUjYU[/link]

[Unknown Member]

Quote from dergon

Quote from IR27

3 comma is a billion . Must be a lot of RVU

OMG … “Tres commas” …. Did any of you guys watch [i]Silicon Valley[/i]?

[link=https://youtu.be/2XxwhMcUjYU]https://youtu.be/2XxwhMcUjYU[/link]

You know, you play your cards right, you could be in the three comma club, too. But probably not. But you could be. But probably not.
 
Same goes for making it big by creating a primary care empire.
 
LOL

[Unknown Member]

Quote from striker79

Yes exactly, you hire a bunch of NP’s and PAs to see patients and rack up the dough.  Business owners are the ones that will always make all the money in this country. at the expense of NP’s, PA’s, and TELERADS.  I should have created my own VRAD.  There are so many suckers out there with no business acumen!  The brain power of academic radiologists should be directed towards a lot more towards business instead of radiology. IF you love internal medicine, I say go for it and find a mentor who has already made millions off his practice so he can show you how to do the business side.   

If those NP’s and PA’s are supervised as intended, then there is a limit to the upside.
If they are let to run rapid, then we get into dubious quality issues, and medical liability issues. These practices are typically chaotic, and run their course due to some unintended consequence/complication. 
So it’s a way to make money for a while, I guess. I just see many of these types of deals crash and burn, because they spin out of control.
 

[Unknown Member]

I would not choose my speciality based on the possibility of being in the small percentage of that specialty who opens their own shop. 

Medicine is going to become socialized in this country on one hand and consolidated and centralized on the other hand, sooner or later. By the time the OP finishes his training, there is a high likelihood that at least in big and mid size cities nobody will be able to open their shop. Right now, most big markets are controlled by big hospital systems and they are expanding more and more. 

Although money should be a factor, the main reason to choose a speciality is the specialty itself. The OP should see whether he/she can tolerate the day to day work of a radiologist or an internist or a surgeon better. Some personalities can not become surgeons and some personalities can not become radiologists. 

[btomba_77]

Exactly. This feels like 2013 again where people like to compare the average salary of a radiologist in a crappy job to the upper echelon private practice/ entrepreneur positions in other sepcialties.

[Unknown Member]

I strongly agree with Hospital-Rads comment. The only thing you should feel entitled to after your residency training is to practice that type of medicine somewhere in the country, so you better like it.

Basing your future happiness on any expectation more than that, whether it is assurance that you will be able to practice in a certain city, that you will make a certain amount of money, have a certain amount of vacation, or have certain work hours, is asking for disappointment.

[Unknown Member]

Quote from Flounce

I strongly agree with Hospital-Rads comment. The only thing you should feel entitled to after your residency training is to practice that type of medicine somewhere in the country, so you better like it.

Basing your future happiness on any expectation more than that, whether it is assurance that you will be able to practice in a certain city, that you will make a certain amount of money, have a certain amount of vacation, or have certain work hours, is asking for disappointment.

 
In a nutshell, entitlement is a curse all around. 
Nothing good comes out of it.
 

[Unknown Member]

Do the specialty you love, the money will come.  If you dont love any, then just do the one that makes the most per least amount of effort/time…I don’t see how this could be radiology. 

[satyanar]

Quote from striker79

 If you dont love any, then just do the one that makes the most per least amount of effort/time…I don’t see how this could be radiology. 

Are you a radiologist?

[Unknown Member]

You cannot rule out I’m a radiologist at the time of this posting.  Findings above may be artifactual.  Correlate clinically.  Consider comparison with prior threads I have posted in.  
 
Findings discussed with Thread Enhancer at 1:30pm on 11/18/2020.  

[Unknown Member]

Haha!