[Unknown Member]

Don’t go to big telerad company – they may credential you all over the goddang place and that may create an obligation to work for them for X number of years plus you have all this excess baggage in the future when you join a new group or hospital and they credential you, it’ll be a pain. Find one group – preferably local , but if not, then distant – that is willing to let a new R4 who barely knows his bellybutton from his butthole to read their xrays and ultrasound or maybe even CTs and MRs to help clear backlog. There’s no long term obligation, and then when you get future jobs, you don’t have paper trail of gazillion hospitals where you’ve been credentialed at by working for a corporate telerad company. Hint – since you are doing it for the experience and not to get rich, offer to do it for significantly cheaper than a regular rad. It will help them come down from their Quality high horse and think, ‘should be fine to let him read xrays and ultrasounds, right? A monkey could do this stuff

[JohnnyFever]

You’re not experienced enough and need to finish residency.

[toumeray]

Final signing without completing a residency, even if by your assessment is at an adequate skill level, would be a big malpractice liability. Im not sure if an insurer will cover you.

[Barry M., M.D.]

i don’t disagree that it would be a liability. but for a discount, i wonder if a mutually beneficial agreement could be reached.
 
regarding my experience, on a practical level i don’t think me working right now would be that much different than an newly graduated IR that hasn’t read any diagnostics since the end of R3.

[amotter]

Not going to happen. Hospital credentialing and privileges requires completion of residency. Even in smaller towns. I tried this when I was an R4. Practices were interested but all fell apart during credentialing.

[farzadahmadimedrn710_43]

I could see it happening if you found a group that had you read outpatient scans at non-hospital imaging centers. Especially if they’re owned and operated centers where they pull all the strings.

[alex.nieto_484]

Not going to happen…thankfully. Sorry but you aren’t qualified to be signing off on cases after 3 years of radiology training.

[22002469]

But his/her skills are already atrophying!
 
In all seriousness, don’t think it’s going to happen for the reasons listed above. You could see if a PP wants to hire you as a scribe/prelim report generator maybe. If you are good and save them time maybe you can make some $, but might not be worth it for you or them short term.
 
Honestly I’d just focus on the mini-fellowships, not sure why those aren’t going to help your diagnostic radiology skills or you have peaked after R3. 

[alex.nieto_484]

Quote from Radsoxfan

But his/her skills are already atrophying!

Yea that made no sense to me. Unless you are doing 2 minifellowships and they are in IT and wellness and both are 6 months long I don’t see how you lose radiology skills as an R4.

[JohnnyFever]

Classic DunningKruger effect.  

[Barry M., M.D.]

Not sure why you’re confused. I’m doing a year long minifellowship where I don’t have a single Body, Neuro, Chest, or MSK rotation.

[farzadahmadimedrn710_43]

These guys are being assholes but R4s moonlighting and final signing shit was totally a common thing until the last decade or so. Another case of the older generation having great benefits and the younger generations getting crushed by boomer and gen x overregulation and nanny statism.

[abananarest]

Yea, where I trained many of our R4s were already at or above the community standard. Once you do a few years of overnight solo call at a level 1 trauma you are more than ready for a tele emergency position.

[radiologistkahraman_799]

We staffed a local small community hospital on the weekends at R4s.  It made you grow up really quick

[toumeray]

I am not sure I agree that doing non core radiology rotations means skills atrophy/training is over. You still look at radiology images constantly when you are rotating through any radiology rotation. Looking at priors, looking at things on multiple modalities, even in IR looking at lesions to biopsy and getting an idea of whats going on with the patient, it all helps. And honestly there really is some medical experience that is needed which translates into radiology in various ways, seeing where patients with different cancers tend to develop mets, etc. as the above mentioned unless this is an informatics mini fellowship I believe it will have some relevance

[ruszja]

Most larger hospitals require completion of residency or board certification. Getting credentials as a R4 is something that works in small hospitals where the CEO still has free reign to approve privileges. You may have an R4 sign radiology report and a 4th year urology resident staff the ER.

The next hurdle is medmal coverage.

[al.georgiev_193]

Dont do it. Im several years out of residency and am learning new things about radiology every day. I now look back at my practical knowledge (not book knowledge, but practical knowledge) as a fourth year resident and laugh. If youre not getting enough out of fourth year, thats something you can still correct.

You would also be too easy of a target when (not if) you have a miss. Lawyers would go after you to get to the deep pockets of the hospital. Doctor, do you think you would have more likely to make an accurate diagnosis if you had competed residency before practicing independently?. Itd be too hard to defend.

[Dvgit]

Just wait until you’re a fellow. Plenty of moonlighting then and you won’t be a prime target for lawyers when you miss something.

[skysdad]

Did you just get divorced or something? Just wait a year man.

[RT340067]

In my mostly rural state there was a small hospital where our R4s would go moonlight while the single rad was on vacation. So yes, it is possible, but this was a long term existing relationship.