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Time spent readingstudying as an attending
Does anyone as an attending systematically set aside x amount of time per day or week to study/read like you did as a resident (versus relying on a week of cme courses here and there)?
If so, how much time do you put aside each week and how do you organize that time? -
26 Replies
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In private practice? No.
Might be different in academic where you have to answer residents questions.
Basically, in private practice, it is all about volume. And the most negative chest CT you read the easier the search pattern becomes.
I feel like if you spent your training years actually learning the stuff they teach you. Thats all you really need.
As a radiologist all you can say is there is a spot on chest xray it could be 5 of these things. You can narrow it down to maybe 2, but it is still up to the clinical picture (which as a rad you dont have). Therefore no matter how much pathology and physiology you know it doesnt matter.
Same thing with all other parts of the body. Your job is to say there is something here on the scan, it looks like a malignancy recommend tissue sampleing to be sure.
You can try to be useful and spew out a list of tumor types and their case reports, but at the end it they will biopsy it no matter what you as a radiologist say.
So to answer your questions, no the cme I do is enough. Even that i feel like is rehashing the same differential, in a different set of images.
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Besides there are so many numbers and white paper etc on so many things, no one can remember them all. You have google and you have the internet in general. Use it. After while you end up saying the same things for a myriad of finding.
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Randomly do CME here and there. Nothing set on the schedule.
If theres a challenging case at work, I look up articles while interpreting the case. Sometimes I learn/re-learn something.
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OP, I think what you are describing is great, and admirable. Any craft or skill is only improved by consistent recurring formal study.
But the answer for most PP radiologists is going to be no, because the goal is to make money and getting better in the way you describe does not improve your reimbursement, even if your interpretations are better.
This speakers to the importance of CME: lets face it, if ABR didnt require it, we wouldnt do it on our own. Whether what they require us to do is the most efficient use of time is a separate matter.
On a separate note, most of us do our learning based on clinical cases. You see something weird; you set it aside and look it up on StatDx and ask colleagues for opinions, maybe even look in the EMR and talk to the clinician. That type of leaning is high yield and, IMO, the first step that everyone should be doing. Setting aside a time every week to read articles or textbooks would come after that.
My 2 cents.
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Quote from Flounce
On a separate note, most of us do our learning based on clinical cases. You see something weird; you set it aside and look it up on StatDx and ask colleagues for opinions, maybe even look in the EMR and talk to the clinician. That type of leaning is high yield and, IMO, the first step that everyone should be doing. Setting aside a time every week to read articles or textbooks would come after that.
I use google and uptodate and pubmed almost every day based on the cases I see. 30 min day or slightly less? I sometimes continue the learning at home if the issue is complex or I am too busy. I enjoy it. I do not set aside time for articles or textbook reading.
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This is your livelihood, reading and keeping up with the literature should be something you look forward to; musicians, athletes, etc. practice every day.
Learn new techniques and ideas; it’s part of the deal. It’s the fun part.
Subscribe to journals related to your specialty, and read them as they come in, of course paying attention to more relevant articles over others. You will develop a pattern.
Some basic suggestions; AJR, Radiographics, Clinics of North America, Radiology has seminal articles mixed in with minutiae; less productive though. ACR Case of the day, quality CME trips addressing weaknesses.
You can slip behind the times pretty quickly if you don’t develop a pattern. There will be of course skimming and looking at lots of pictures and captions. You will be drawn into some articles, and there will be AHA moments.
You should want to rip that journal open when you pull it from the mail box. [Showing my age, I guess.]
Having a regimented “study hour” for isn’t for me, it should be more fluid than that. It’s not about guilt or test taking; it’s about excellence in your profession. Develop a pattern that fits your life, so it won’t be work.
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I flip lightly through MSK journals … will dive in on an article that really catches my fancy.
But most of my new learning is diving down rabbit holes of interesting cases that I see that present some dilemma.
I don’t have any set schedule for regular study. Probably should … but I don’t-
When I first started in PP I did study every night for a few months about subjects I was now covering but had little or no experience with (fetal US and peds). Im not sure how much it actually changed my reads but it made me more confident. Thankfully those are two areas where misses tend to be discovered sooner rather than later and I havent had any complaints like a 3-headed baby or something.
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You might be surprised how many of my students are attendings. They may want to pick up a new study type, such as cardiac MR or Prostate MR. These attendings often will set up a study schedule.
Another instance is when an attending is changing a job and therefore changing areas of practice. I have seen this with academic to private practice and vice versa.
Sometimes attendings will want to maintain a skill set for marketability even if they are not using it in everyday practice, such as mammo.
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I had an attending that would read 1 book outside of his specialty per year. Yes you have to stay current beyond CME requirements, otherwise you will fall behind and no one will let you know.
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Quote from NotSoDirectDx
Does anyone as an attending systematically set aside x amount of time per day or week to study/read like you did as a resident (versus relying on a week of cme courses here and there)?
If so, how much time do you put aside each week and how do you organize that time?
Like others have already mentioned, you will learn during the day when you encounter a challenging case and have to look things up online or get a consult from a colleague….I also intermittently do CMEs from ARRS, primarily during staycations which have become more frequent given Covid. I learn a lot from top specialists, earn CMEs, and it I get reminded why I was drawn to radiology/medicine in the 1st place versus the mindless daily grind of getting through cases in PP.-
I do CME to check the boxes off, but Ive learned a lot while on the job during my first few years as an attending just by looking stuff up while working or reading about an interesting case after work.
But i dont have any set study hours like i did as a resident/fellow. I studied my ass off as a resident and fellow… so for the most part of private practice i dont feel not knowing enough to be a limiting factor. If i miss something, it usually because it was an eye-test and/or i was working too fast.
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A little off topic- but dont neglect financial learning as well. I know quite a few high earning rads that should be in a much better financial situation.
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Quote from wormhole
A little off topic- but dont neglect financial learning as well. I know quite a few high earning rads that should be in a much better financial situation.
I was interviewed for a podcast by a medical student a couple years ago. (“The Undifferentiated Medical Student”). The host was conducting interviews with >150 attending physicians representing *every* medical subspecialty.
When he asked what I thought every medical student should learn I focused on financial literacy. And for the one book every student should read, [i]The Bogleheads Guide to Investing[/i].
Out of dozens of interviews I was the first person to have spoken about investing, retirement planning etc.
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Im in private practice. I do 30-60 minutes of reading articles, watching arrs lectures, do cme, somethingmost days I have off (2020 pandemic excluded due to schooling situation)
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Quote from dergon
Quote from wormhole
A little off topic- but dont neglect financial learning as well. I know quite a few high earning rads that should be in a much better financial situation.
I was interviewed for a podcast by a medical student a couple years ago. (“The Undifferentiated Medical Student”). The host was conducting interviews with >150 attending physicians representing *every* medical subspecialty.
When he asked what I thought every medical student should learn I focused on financial literacy. And for the one book every student should read, [i]The Bogleheads Guide to Investing[/i].
Out of dozens of interviews I was the first person to have spoken about investing, retirement planning etc.
I agree with this wholeheartedly. Even more than investing, just some “business-sense” at all so medical students/residents can choose the right career path/type of job and be good advocates for our profession in the future. Too many admin-types out there taking advantage of physicians who have no business/investing/finance sense.
Should be a mandated thing at medical schools and within residency curricula IMO.-
Quote from Cubsfan10
Quote from dergon
Quote from wormhole
A little off topic- but dont neglect financial learning as well. I know quite a few high earning rads that should be in a much better financial situation.
I was interviewed for a podcast by a medical student a couple years ago. (“The Undifferentiated Medical Student”). The host was conducting interviews with >150 attending physicians representing *every* medical subspecialty.
When he asked what I thought every medical student should learn I focused on financial literacy. And for the one book every student should read, [i]The Bogleheads Guide to Investing[/i].
Out of dozens of interviews I was the first person to have spoken about investing, retirement planning etc.
I agree with this wholeheartedly. Even more than investing, just some “business-sense” at all so medical students/residents can choose the right career path/type of job and be good advocates for our profession in the future. Too many admin-types out there taking advantage of physicians who have no business/investing/finance sense.
Should be a mandated thing at medical schools and within residency curricula IMO.
There is a hunger for it too.
Of all the things I have done in my career…. the teaching at the alternator/PACS… the education awards … the committee service …. it is the financial literacy stuff (and that podcast interview) that has brought me the most positive feedback.
Years later I continue to have multiple past residents and fellows reach out to me giving me huge thanks for putting the basic ideas of living a smart financial life into the front of their minds early in their career.
(I’m sure I have posted about it here before, but …. I didn’t start really paying attention to my finances until age 40. I estimate that if I had taken my current saving/investing approach and used it starting on day 1 after fellowship I would have about 1,300,000 more dollars than I have now. )-
Could you create an online course specifically for rads? I know people have tried to do similar things but they always seem vague and generalized. I would love for an experienced rad (or rads) to create courses tailored to rads with lessons/topics like the following:
1. Taxes
2. Retirement accounts/equity investments
3. Insurance(s)
4. “Business” of rads – how we make money, provide value, etc. – aka prep for meeting with admin types to know our worth
5. Other – side hustles, real estate, etc. -
Quote from dergon
There is a hunger for it too.
Of all the things I have done in my career…. the teaching at the alternator/PACS… the education awards … the committee service …. it is the financial literacy stuff (and that podcast interview) that has brought me the most positive feedback.
Years later I continue to have multiple past residents and fellows reach out to me giving me huge thanks for putting the basic ideas of living a smart financial life into the front of their minds early in their career.
(I’m sure I have posted about it here before, but …. I didn’t start really paying attention to my finances until age 40. I estimate that if I had taken my current saving/investing approach and used it starting on day 1 after fellowship I would have about 1,300,000 more dollars than I have now. )
It’s called greed. LOL No shortage of this in medicine or in the USA. Those who want to become rich will.
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Quote from drad123
It’s called greed. LOL No shortage of this in medicine or in the USA. Those who want to become rich will.
I’m not nearly as cynical as that.
I think it stems from a desire for self-determination. Physicians now realize that fewer and fewer of us are fully in control of our own professional lives … so the desire to get to financial independence is strong.
F-U money and the option to walk away if things get bad later.-
Quote from dergon
Quote from drad123
It’s called greed. LOL No shortage of this in medicine or in the USA. Those who want to become rich will.
I’m not nearly as cynical as that.
I think it stems from a desire for self-determination. Physicians now realize that fewer and fewer of us are fully in control of our own professional lives … so the desire to get to financial independence is strong.
F-U money and the option to walk away if things get bad later.
Yes, exactly. I can’t believe how many people go through 15 years of training and then let others dictate their professional lives.-
Read during tough cases and follow up. Any suggestions on how to keep up with developing technology or standards?. Our group was all over Lungrads, but slow to use TIRADs. Still trying to figure out how to stay aware. And lead rather than follow.
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I’m in private practice and i have to say that I read more now than I did in residency because i have more free time. I read about radiology and other fields in medicine, business, finance, exercise physiology, sports, food and cooking, nature, ecology… you name it. Now i can follow my passions as i see fit. It took me about three years post residency to want to read anything about radiology because i was so burnt out but the passion comes back if you ever had it. I dont agree that the only way that anyone would study or do cme post training is if forced to by regulators. If this is you then you probably shouldnt be a doctor. Also if you are so focused on making money that you dont take time to explore and learn new things then you are a tool and your life will probably reflect that reality
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i try to do some cme every day
i like radiology a lot so it is easy to be motivated
also i have decent amount of downtime every day so i don’t need to do it at home – for instance
ive read a ton re financial stuff a lot over the years also-
Impressed and inspired by how much radiology reading people do, great job. I used to study a lot in my first few years out of training, then it dwindled down to just looking up differentials for clinical cases I come across and required CME.
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I do a lot of half ass reading as an IR. Basically just read abstracts from a variety of journals. I do that quite often. It’s pretty important because vascular landscape changes so quickly.
I never do any reading for DR. That being said, I don’t consider myself a good diagnostic radiologist.
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