Question
Dr. Julius, I read the article you wrote last year on how to choose a fellowship. I was wondering if you had any new insights since then, and also if you could help me narrow down on a specialty.
What I am looking for: a very high salary, independent, being able to work from home would be a luxury, minimal patient contact, be a specialist.
My background: I finished two years of general surgery, and switched to radiology. R1.
Thanks for starting this website,
Unsure Resident
Answer:
Hi,
I’m glad that you have come up with specific criteria for what you require in a fellowship. Often, that can be the hardest part. Of course, I wouldn’t tell the folks that interview you that you would want minimal patient contact unless you know the interviewers well. Radiology 3.0 has become part of the verbiage of most academic departments. And, that implies some patient care — just a word of warning. But, between you and me (and the wall), we both know that not all subspecialties carry the same amount of patient interaction! So, which specialties have less contact? Most of the pure imaging subspecialties without procedures. MSK or Neuro would be specialties more likely to have less patient contact.
High Salary Issue
Getting back to the main question at hand, which fellowship should you choose? Let’s start with the first criteria, very high salary. Unfortunately, compensation is more tied to the number of reads and the location that you work than the type of fellowship that you do And, on a yearly basis, the benefits for any given modality can change. For example, interventional radiology at one point was the highest paying specialty per procedure. Now, it generally pays less than most others. Currently, MRI probably reimburses better than most other studies. However, you would be chasing a moving target if I were to tell you that it will remain the same.
Independence Issue
Regarding independence, you are ultimately reliant on your referrers and your patients, so you are never truly independent. But, if you mean that you want to become a group of 1, something like teleradiology would enable you to have your own business getting paid with a 1099 form instead of a W -2. Also, teleradiology would give you the option to interpret films as much or as little as you want. So, theoretically, you can “create” your own desired high salary if you wanted to read like crazy! Additionally, teleradiology would naturally allow you to work from home.
Summary
So, there you have it. Based on your criteria, a possibility would be a teleradiologist that specializes in MRI such as either MSK, body MRI, or neuro MRI. However, the two things that you failed to tell me was whether you wanted to work late hours or what procedures you enjoyed the most. I would think you should probably take that into account in this “equation” as well. Let me know what you think!
Regards,
