Second-year radiology residents become overwhelmed and burdened by call. Third-year radiology residents feel exhausted from studying for their core radiology examination. And, the fourth year radiology residents fret about all the things they need to know before starting their career. 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 he does not have many responsibilities. He can merely sit and watch the radiology attending to learn the practice of radiology, right? However, in this post, I am going to dispel that notion. I am going to go through five reasons why I 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. However, they are usually surveys. Also, they 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 before 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 before starting. These initiated residents can almost entirely function from day one.
Instead, new 1st-year radiology residents cannot dictate, review films to be read, or finish the procedures that we perform on a daily basis. Since a first-year radiology resident cannot complete most of the functions necessary to be “of use” to the senior radiologist, many first residents feel inadequate until they can begin call as a second year when they can function much more independently. It certainly can make for a problematic 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 to become a respectable radiologist. Unlike other specialties, you cannot get away with little reading and learn only from your experience with others. If you do not read for hours every day, you will fall way behind and will not pass the core examination. Many residents do not know the requirements before starting and take a long time to adjust to the nightly reading regimen, a painful process.
Dictations- A Difficult Road
Imagine your frustration as you first start with never having held a Dictaphone. You click the wrong buttons and feel unsure of yourself as you talk into a stick!!! This routine is typical for the first year that starts to dictate. Not only does the first year resident have to get the physical mechanics of learning dictation, 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 ourselves in the shoes of the first year resident. However, as an associate residency director, I regularly 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
Unlike more independent senior residents, radiologists typically have to take extra time out of their day to teach a first-year radiology resident. Given the increasing workloads of radiologists, many attendings see this as a burden. They would rather get home to their family on time in the evening. Additionally, the attending does not know the first year resident well. Therefore, he cannot figure out how much responsibility to give. Other radiologists feel forced and have no desire to teach. These frustrations of many attending radiologists reflect in the personal interactions with the first year resident. Often, the resident gets the sense that he/she is not wanted around. 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. Attendings give noon conferences on topics such as ultrasound or MRI. Yet, first-year radiology residents have never seen these images. On top of that, they use language that is not common vernacular.
Moreover, the findings are unintelligible to the uninitiated first-year resident. Many attending radiologists do not recall what it is was like to attend these conferences. However, these esoteric conferences are standard for the first-year resident.
The Final Upshot For The First Year Resident
Senior radiologists can easily dismiss and forget the challenges that first-year radiology residents face. However, don’t discount the frustrations, experiences, and anxieties of the first year radiology resident, as they are genuine. It takes an extended period of adjustment to acclimate to the work that experienced radiology residents and attendings perform on a daily basis. Give the lowly first-year radiology resident a chance!!!