Five Reasons Why The First Year Of Radiology Residency Can Be The Most Difficult
Second year radiology residents are overwhelmed and burdened by call. Third year radiology residents are exhausted from studying for their core radiology examination. And, the fourth year radiology residents are fretting about all the things they need to know prior to starting their fellowship and first attending job. But, what about the plight of the first year resident? Many non radiology physicians and some long-practicing radiologists think that the first year radiology resident has it easy since they are not given many responsibilities and can merely sit and watch the radiology attending in order to learn the practice of radiology. But in this post, I am going to dispel that notion. I am going to go through five reasons why I personally think the 1st year of radiology residency is usually the most difficult.
Little Medical School Background In Radiology
Unlike internal medicine, surgical, obstetrical/gynecological, and psychiatric residents, most beginning first radiology residents have had almost no experience in the mechanics of all things radiology. Sure, they take a few courses during medical school. But, the courses are usually surveys and do not provide the vast experiences needed to function as a full-fledged radiology resident. On the other hand, for example; internal medicine residents have worked up patients with histories during their medical school training; obstetrical/gynecological residents have usually delivered a few babies in medical school prior to beginning; surgical residents have assisted in multiple surgeries and have worked the floors prior to their first day of residency; and, psychiatrist residents have interacted with numerous patients prior to starting. These initiated residents can almost fully function from day one. New 1st year radiology residents, on the other hand, do not know how to dictate, review films to be read, or perform the procedures that we tend to do on a daily basis.
Since a first year radiology resident cannot perform many of the functions necessary to be “of use” to the senior radiologist, many first residents feel inadequate until they are able to begin call as a second year when they can function much more independently. It certainly can make for a difficult initial year.
Incredible Amounts of Reading
More so than other specialties, radiology requires a boatload of reading during the first year. You need an understanding of internal medicine, surgery, obstetrics/gynecology, orthopedics, neurology, and more in order to be a respectable radiologist. Unlike other specialties, you cannot get away with meager reading and learning only from your experience with others. If you do not read for hours every day, you will fall way behind and will never be able to pass the core examination. Many residents are unaware of the requirements before starting and take a long time to adjust to the nightly reading regimen, a difficult process.
Dictations- A Difficult Road
Imagine your frustration as you first start with never having held a Dictaphone, clicking the wrong buttons, and feeling really unsure of yourself as you talk into a stick!!! This is the routine for the typical first year that starts to dictate. Not only does the first year resident have to get the physical mechanics of learning to dictate, but they also have to create a report that makes sense. This process often occurs with little instruction or regimentation. It becomes hard to put us in the shoes of the first year resident. But, as an associate residency director, I routinely recognize how hard it is to start from scratch what we routinely do as radiologists on a daily basis.
Frustrated Attendings Who Don’t Want First Years Around
Radiologists typically have to take extra time out of their day to teach a first year radiology resident if they are on rotation, more so than with other years who can function more independently. Given the increasing workloads of radiologists, many attendings see this as a burden and would rather get home to their family on time in the evening. In addition, the attending is often not that familiar with the first year resident and cannot figure out how much responsibility to give. Other radiologists feel forced and have no desire to teach. These frustrations on the part of many attending radiologists reflect in the personal interactions with the first year resident who often times get the sense that he/she is not wanted around. Kind of depressing, huh…
Noon Conferences- A Foreign Language
Have you ever listened to a conversation in a language that you do not understand? That is the feeling that the first year radiology resident often gets when he/she goes to the first noon conference. Many times noon conferences are given on topics such as ultrasound or MRI that the resident has never seen with language that is not common vernacular and with findings that are unintelligible for the uninitiated. It is hard for many a radiologist to remember what it is was like to attend a conference such as this. But, these esoteric conferences are what the first year radiology resident often experiences.
The Final Upshot
It is very easy to dismiss or forget the challenges that a first year radiology resident faces either because you have never been through the situation or tincture of time degrades the memories of being a first year resident. But, don’t discount the frustrations, experiences, and anxieties of the first year radiology resident, as they are very real. It takes a long period of adjustment to acclimate to how we work on a daily basis as more experienced radiology residents and attendings. Give the lowly first year radiology resident a chance!!!