Year: 2016

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Away Rotation in Rads

away rotation

Question By: Nick

Hi there; first of all, great site and info!

So, I’m an MS4 and decided to do an away rotation in IR at a Midwest school which starts in a couple of weeks (I’m at an east coast med school). My wife will be starting vet school at this Midwest school, which is one of my main reasons for wanting to do the rotations. Otherwise, I have performed as an average applicant, and the school that interests me sits in the middle of the pack. My questions: how to approach 1) trying to make the best impression I can in the month (major do’s and don’ts; how to interact with residents/attendings/residency coordinator, etc.); 2) how to approach informing them that my wife will attend school there and that I obviously will want to stay near her for the next four years. I do not precisely know how to “play” this card. Yet, I don’t want to sound desperate even though I feel that way (who wants to live away from their wife!). Thoughts?

Thank You!

-Nick

Director’s Response:

Part 1

First of all, I would like to welcome you to our website. You are the first person to post a question on this page, and it is a great one!!

So, to begin… Let me tell you a story about two trainees that did an away rotation through the interventional radiology department. One did everything right, and the other our department never wanted back again. I will start with the desirable trainee first.

The Desirable Away Rotation Resident

On day one, he got along well with all our interventional attendings. Without fault or complaint, he would share the procedures with the other residents in our department. He would always do his fair share of consent work (even though considered scut). Through the month, he got to know each attending and let them gradually feel comfortable with his work. So by the end of the rotation, each radiologist felt excited to have him participate in almost all the procedures. And he arrived early and stayed late. He went above and beyond when it came to patient care. And, of course, he knew all the pertinent details about each patient. In addition, he befriended everyone and could make a great conversation. Our department wanted to hire him. Unfortunately, however, he would have to live too far away from his family to join our practice.

The Undesirable Away Rotation Resident

On the other hand, we recently had an away rotation trainee who was ultra-aggressive. He refused to do consents and still tried to get in all the cases. All too often, he made many requests from our residency coordinator, which prevented her from getting her residency work done. Finally, he also argued constantly with his fellow medical students and, unbelievably, the residents he worked with. Meanwhile, he had an impressive list of research papers and academic qualifications that dwarfed most other medical students and residents.

Finally, the time came for the medical student to apply to our residency program. And I have to say, I have never seen such an outpouring of violent no votes from attendings, residents, and even technologists! We could not take him into our program, regardless of his academic qualifications.

Part 2

So for the second part of the question, I will assume that your wife will attend veterinary school at the same site as your desired residency. In our residency program, we like our residents to have local family connections such as spouses, parents, or good friends in the area or hospital. Residents with significant ties to the site are happier and less likely to change programs. So, it is a net positive.

I would also tell the program director and attendings at your away rotation that your wife will live nearby. And that you are motivated to stay in their program. Of course, you must also show them that you like the program and the staff. On away rotation, make sure you perform like the resident we wanted to hire, not the student we despised!!!

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Clinton or Trump- How Will Each One Affect My Finances As A Radiologist?

The first debates between the two candidates just passed with much fanfare. Lots of yelling and screaming. But what does it really mean in a practical sense? Since radiology residents have a long career ahead of them, I started thinking about how each candidate’s policies will affect the financial status of radiology practices over the short and long term, if enacted. In a real sense, these policies are likely going to be altered due to the congressional makeup. If Hillary Clinton gets elected, it is likely that anything she tries to pass through congress will be blocked by a republican congress. On the other hand, Donald Trump is likely going to have difficulty pushing through his agenda with all of the political interests out there. Even so, I went to their websites: Hillary Clinton and Donald Trump. I then extracted the most salient health care policies and imagined what they would do to radiology if they had full control of their health care policy without the interference of Congress. So, here is a list of some of their most important health care policies. I will evaluate which policy would be more helpful over the short and long term for each candidate and assign a point to the winner of each. Whoever has the most points wins! Let’s get started…

Continue reading Clinton or Trump- How Will Each One Affect My Finances As A Radiologist?

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Radiology Resident- Get Up and Move It!!!

Sitting can be hazardous to your health. Just take a look at some of the article headlines and links from major news organizations- CNN, CBS, Huffington Post. And, the list goes on…

What do we picture radiologists doing all day? Unfortunately, the stereotype is that radiologists are sitters; we are on a comfy chair near a diagnostic workstation, powering through loads of studies. There’s some truth to that. In fact, I can almost guarantee that you will gain that freshman fifteen pounds during your first year of residency if you follow the typical work schedule without modifying your behavior. That’s the bad news.  The good news is that there are ways to circumvent the habit of sitting down for long periods of time, even as a radiologist.

And, since residents are early in their career, it is easier to start forming habits that will potentially last a lifetime. So, here are some suggestions to conquer the ills of long-term sitting, whether you are a radiology resident at work or at home.

1. Stand Up

Many desks these days allow you to complete your work while standing. In fact, we have several workstations dedicated to the standing radiologist in our own department, although unfortunately not enough.

But, let’s say that this option is not available. What can you do to remind yourself to get up? I recommend either a watch timer or an Apple Watch. Regularly, I get messages on my watch to tell me to stand up. It can be occasionally annoying, but it usually does the trick even though there are times I am unable to get out of my seat.

Additionally, little things help. Instead of texting your colleagues, consider getting up and having a conversation with someone. Instead of calling the technologist to complete a study, get up and tell them. These are ways you establish connections with people and lessen the amount of time you are sitting during the day.

2. Get the most calorie burn out of your workspace

Whenever I am at work, I always think about ways to maximize my body’s workload. Think about calorie-burning activities like banning the word elevator from your vocabulary. In fact, the only time I take the elevator is when there is a “wet paint” sign on the stairs. Using the stairs is a great way to burn those extra calories

Take a long way around to get to your next meeting or conference, whether it means going outside or visiting your colleagues. Just remember to leave your workstation a little bit earlier!

3. Get that heart rate up- find a new activity you can stick with!

Any activity that doesn’t interest or excite me, I find difficult to stick with. And, I think it is easy to extrapolate the same to others. So, find something that increases your heart rate, but most importantly find an exercise routine that you enjoy. And, it is crucial to do so. Remember, radiologists sit down more than most other professions and you certainly don’t want to add home sitting time to your total.

For instance, I started running several years ago and have continued diligently only because I look forward to the run. Why? It’s very simple. I have my iPad set up to watch Netflix and HBOGO shows that I find hard to watch without interruptions by just sitting down. Some of the series that I have gone through include Game of Thrones, The Sopranos, House of Cards, and Mad Men, among many others. So, I really look forward to my time on the treadmill.

Also, you may want to find activities that intrinsically interest you because you are learning something new, whether it be physical, mental, or practical. I have recently taken up Tae Kwon Do and have found it to be a great way to build up my stamina, flexibility, and coordination. Each lesson I take, I find that I am learning new things and want to come back for the next time. Some of that enjoyment certainly stems from the great instruction I receive locally from Ko’s Tae Kwon Do with Grand Master Ko.

Get Up And Move It!

Getting out there and moving is especially important as a radiologist because of the increased sedentary lifestyle and the years that you can potentially lose due it’s health consequences. So, make a concerted effort to get up and move!!!

 


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Paying back student loans vs increasing savings- a dilemma!

Congratulations!! You’ve finished medical school and you’ve collected your first few paychecks or perhaps you finally have a few extra dollars to spare. Feels good, huh.

But, you look at your monthly student loan statement, and you have debt ticking higher month after month. Perhaps it’s not much, less than 100,000 dollars, or maybe it is 200,000, or even up to 500,000 dollars. Scheduled repayments may range anywhere from a few hundred dollars per month to multiple thousands of dollars with interest, of course. You feel a little queasy all of a sudden as you realize your predicament. What do you do?

Well, I’ve hiked up this mountain of debt and have been fortunate enough to climb off of this mountain. The good news is that someday you will too. The question is how and what is the best way to do it.

So, you finally may have your first job as a radiology resident and maybe you have an extra 100 or 200 dollars after your expenses for the first time. What do you do with the money? Do you pay down student loan debt or put it into a savings account/investments? That’s an interesting question without a one size fits all answer. I will go through a rational method of making these decisions.

Paying Back Loans Or Increasing Savings?

First off, we are assuming you have no high-interest credit card debt or other high-interest debt. That needs to be paid off first because you can never catch up your debts with interest rates over 10 percent. So, let’s say that is the case, now some of what to do next depends upon the amount of student debt, your student loan interest rate, and your shorter term goals.

As a thought experiment, let’s begin with what you may get back when you begin to pay off your student loans when you have taken out a large amount of debt. At a resident salary level, you do get a student interest tax deduction at the end of the year of up to 2,500 dollars on the interest serviced on the debt. So, if you have the money to pay off the student debt of 2500 dollars and most or all of that goes back to interest (due to a large student loan), you will get back 15 percent assuming a salary of up to 65000-80000 dollars in 2016 for a single person (deduction phases out between 65000 and 80000 dollars) and assuming a salary of up to 130000-160000 dollars for a married couple (deduction phase out between 130000 and 160000). Where can you make 15 percent interest on your money as a guarantee? Not many investments in this world will guarantee you that sort of return.

On the other hand, let’s say you have a relatively low amount of student loans at a fairly low-interest rate. Most of the money that you pay back is going to go back to the principal and not the interest. Your return on investment is not going to be close to the 15 percent interest rate that you get back from the student interest tax deduction. It will be closer to the true interest rate of the loan.

If you are fortunate enough to have a low-interest rate of up to 2,3, or 4 percent either by consolidating or refinancing your debt and you have small amounts of student debt, it makes sense to concern yourself more with the savings part of the equation. However, anyone with interest rates of over 4 percent, in today’s low-interest rate environment, should really make loans their first priority. But in either case, low or high-interest student debt and small or large student loans, I always say diversify. What does that mean? Never put all your eggs in one basket. Put some towards savings and some toward student debt. Everybody needs some savings. Interest rates and amount of debt make it a matter of priority and amount dedicate to each bucket.

How To Figure Out How Much To Add To Savings And Student Loans

OK. Let’s say now you are interested in saving for a larger emergency fund or maybe you need a down payment on a car or house. These may be necessities for your situation. Well, then you would want to take a fixed percentage of what you have left over at the end of the month and divide the total left over into two buckets. If your student loan interest rate is low and you have low amounts of debt, it would make sense to put a higher percentage of your leftover funds into the savings bucket (say 80 percent). And, if your interest rate and debt are higher, then you should probably consider putting less into saving (say up to 20-30 percent). This will allow you to build up your savings and begin to tackle your student loan debt.

This method will allow you get control over your student loans over time while maximizing the amount of money saved for you and/or your family. And then, when the day comes that you get your first real job as an attending, you will appreciate the more manageable debt load and the savings that you have built up during your residency!