Question About Confidence About Reading Outside Subspecialty
I will be completing a neuro fellowship in one year. Still, my potential job opportunities require that I read everything, including MSK and Body MRI, which I don’t have the confidence about for one reason or the other. I need to learn to read these studies; how do I do this? Would I have to do a second fellowship?
Not quite sure how to proceed!
Answer
Yes, many of the great radiology opportunities indeed involve generalist work with the ability to do your subspecialty (in your case, neuro). And, from my experience, most general radiology practices expect that their neuroradiologists cross over to all sorts of other subspecialties within MRI in addition to the sophisticated neuro cases. So, the big question here is how you get the confidence to read other complex subspecialty cases outside your wheelhouse. And, I believe in your situation, a second fellowship is most likely not the answer. How do I know that? Well, I have already been there.
So, what did I do to ensure that I would feel confident enough to read MSK MRI on the job even though my primary specialty was nucs? During my residency training, I made sure to read extra cases in the modality when I was on site. I accomplished some of this just before my fellowship in nuclear medicine. And, this was in the days just before PACs started. So, it was much harder to do back then.
Nowadays, it’s much more manageable. Start picking up cases from the PACS, read them, and then look at the dictations afterward. This method is a simple way to gain confidence and familiarity with other specialty areas you usually don’t read. You can even do this at your up-and-coming neuro fellowship since most are affiliated with a hospital or outpatient center that does MSK MRI. So, I would try this first. How do I know this will work? Well, it certainly worked for me. I feel reasonably comfortable with reading MRI MSK to this date.
Of course, your confidence will continue to build even after you start working. However, at least you will give yourself a head start if you begin the process. I hate to say it (because I’m not too fond of the ABR jargon), but this skill is what the ABR calls practice-based improvement in a nutshell!
That’s some advice that has worked for me!
Barry Julius, MD
