What do the following jobs have in common? Garbage Workers, Oil Cleanup Crews, Sewage Treatment Workers, and Doggy Pickup Services. No, it’s not just that they all clean the environment and serve essential functions in our society. These are jobs that very few people want to perform. And therefore, those that do can charge high rates to complete the services. And, you know what? It is harder to find employees for these professions. I call these sorts of jobs: golden niches.
How is this relevant to radiology? It’s simple. Find an area (or even better, more than one!) that no one else in practice wants to do, and make it your life’s work. Then, you have a job for life (assuming that the business is not bought out or downsized!)
So, this brings me to the topic for today, the golden niches. What radiology specialties are ripe for a new radiologist to practice that can lead to this extraordinary situation and why? Well, we will go through several radiology procedures and modalities that can potentially qualify for one of the golden niches. However, not all practices are the same. And therefore, I must put in this qualifier, golden niches in one hospital or imaging center may not be so in another. You may find that you may have many MRI MSK readers in your practice, and in another, you may have a few. Or, some centers have little need for some of these golden niches. I will point you toward some modalities and procedures that you should think about reading and performing when you interview for your next job!
MRI Cardiac/Cardiac CTA
In our practice, we have limited numbers of radiologists that read these modalities. It is also costly and time-consuming to learn if you did not complete a fellowship. So, if you come aboard and have lots of cardiac work, you can be the hero!
Cardiac Nuclear Medicine
During residency, many residents do not get a chance to dictate these cases since the cardiologists perform them. And, at some centers, they require their radiologists to be nuclear trained. Therefore, fewer radiologists tend to read these studies, allowing you to take over!
MSK Musculoskeletal MRI and Ultrasound
Still, many radiology residencies throughout the country provide limited MSK MRI experience and even fewer MSK ultrasound. So, you may be one of a few in the practice that feels comfortable with these modalities!
Facet Injection For Pain Management
In some centers, practices farm out these cases to the anesthesiologists or the pain medicine physicians. However, in some hospitals, radiologists do the work. And you know what? Only a few MSK radiologists feel comfortable with this procedure.
How many of you know the latest about pdfs, HLA, and more? I thought so. And, some practices need these radiologists to run the show!
Most residents are not trained well in this modality during residency. And, even fewer take courses when they finish up. So, you want to run a virtual colonoscopy program in an institution that has the demand. Here’s your niche!
Nuclear Medicine Therapies
Drug companies have developed loads of new nuclear medicine therapies like Xofigo. Moreover, many radiologists do not feel comfortable treating even the old standby of I-131. So, here is an opportunity for you to take charge!
MR Spectroscopy/Perfusion Studies/Neck CTAs
MR spectroscopy/perfusion/neck CTA studies tend to be more esoteric modalities reserved for the neuroradiologists. So, if you have trained as a neuroradiologist, make sure not to skip out on instruction in these areas. You can become instrumental!
Complicated Neck/Temporal Bone Work
Have you ever noticed the remaining cases at most imaging centers and hospitals? It tends not to be the head and body CTs. Instead, no one wants to pick up the CT soft tissue neck and temporal bone studies. So, don’t forget to learn about these topics during residency and fellowship!
To feel comfortable performing neurointerventional procedures, you generally need one year of diagnostic neuroradiology and two years of interventional radiology training. That limits the playing field for this work. Need I say more?
Almost universally, non-breast imagers want nothing to do with these procedures. You have liability issues and inexperience that prevent many from wanting to read these cases. Time to step in!
The Golden Niches
Well, there you have it. Here were some undesirable (and therefore most desirable!) jobs you should consider performing when you start. And, I’m sure there are a few more that I forgot. In any case, it’s not about love. Instead, it’s about job security, my friends. So, go forward and find your golden niches. You won’t regret it!