Month: October 2022

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Why Rapid Speech Can Destroy An Interview!

rapid speech

Rapid speech is prevalent when people are in unfamiliar situations. I, myself, tend to talk a bit quickly at times. But an excellent radiology residency interview can turn into something else if you don’t remember to take down the speed of speech a notch or two. We have seen it all too many times. Here are some reasons you should listen to yourself, pace your speaking, and prevent yourself from rapid speech with your interviewer at the speed of light.

Flight Of Ideas Suggests Lack Of Focus

Whether it may or may not be accurate, when you sputter, it implies that you may have difficulty concentrating on one topic at a time. Or, otherwise, this mental state we call a flight of ideas. Residency directors do not want residents that cannot focus on studying, reading films, and performing procedures. All these parts of radiology residency take tons of mental energy and focus. All this ability is cast into doubt when you are speaking rather quickly.

It Might Be Very Difficult To Understand

When you speak quickly and do not enunciate your words well, your speech can become very difficult to understand. Sometimes older folks have an even more challenging time comprehending what you are saying because their hearing is not as good. Regardless, if you are hard to understand because you are speaking so rapidly, imagine what might happen when you have a team of surgeons expecting a verbal wet read. Will you keep on talking incomprehensibly? These thoughts are, first and foremost, among the faculty interviewing you!

Rapid Speech Can Give Your Interviewer An Unsettling Feeling

Have you ever tried to interview a patient with hyperthyroidism? Many times you can’t get a word in edgewise. Why? Because all that thyroid hormone circulating in their system causes elevated metabolism, a rapid heart rate, and pressured speech. Moreover, a conversation usually involves a bit of give and take. In this situation, it is very unsettling to have a conversation with someone that barely lets you respond. The interviewer will most likely be trying to imagine what it would be like to have someone next to them for hours that didn’t ever stop yammering! This trait is not favorable for a radiology resident!

Trying To Hide Something?

In our culture, we perceive those that speak fast to be hiding something. It could be a personality flaw, an issue, or a problem with the application. Regardless, rapid speech could portend deeper issues with the interviewer at hand. We want our candidates to be open book and easy to approach. So, jabbering can destroy the impression that you are trying to make.

Rapid Speech While Interviewing

Talking too quickly is something that you can easily correct, but you will need to think about it and be deliberate. Listen to yourself by taping a mock interview with your colleagues or family on your smartphone or computer. And play it back and see how fast you are talking. If you find yourself hard to understand or with a bit of pressured speech, dial back your speed at the following conversation/interview. And be aware of the pace of your speaking. Although not harmful in and of itself, talking quickly can leave an impression of a lack of focus, incomprehensibility, unsettling feelings, and ideas that you may not be forthcoming. And this is an issue that you can quickly repair. So, fix this issue before you get to your following radiology interview. It can make the difference between achieving a spot in your desired program or not!

 

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Overcoming Radiology Research Writer’s Block

writer's block

For some residents, coming up with great ideas for radiology projects may seem next to impossible, especially when starting. Maybe you are less than a year out in training and don’t know where to begin. Or, perhaps, you are just unsure how to come up with excellent ideas that the journals will accept. Regardless, given that I have written extensively on this blog and written multiple papers, let me tell you how I find ideas that will work and interest your audience. Here’re some of the basic techniques I use to overcome writer’s block!

Have A Writer’s Mentality

If you are not hunting for ideas during the daytime when you are working, you will not find the next great project. Whenever I look at an interesting case or have a great discussion, I will think about whether there is some way to make it into an article or a great project. My philosophy is that the best projects are those that fascinate me or cause me significant irritation during the daytime. Maybe, you are very interested in a particular procedure or topic that will often spark your interest in a project. Or, if you notice a problem with the institution- that could be a safety project. Constantly keep an open mind, and you will easily find many potential ideas for your following excellent paper!

Keep A Record Of What You See

Nowadays, almost everyone walks around with some form of a cellphone. You can quickly turn that device into a mini-journal. Whenever I talk to residents or am sitting down looking at images, in the back of my mind, I will write down ideas and cases that I think might work for the following article. It could be an interesting comment, thought, or case study. Regardless, write it down. Often, you can convert that thought into something more substantive later on. But keeping a record is always an excellent starting point. If you don’t write it down somewhere, you will forget about it later.

Contact Your Mentors To Avoid Writer’s Block

Whether it is your fellow chief resident, faculty, or chair, let them know that you might have an idea that will work for a journal article or book. Bounce the idea off your colleagues. Many have been through the process numerous times and can guide you to take an angle you might have thought about before. Or, they may say that others have already pursued that idea. Your mentors will know best because they have been through the process many times before.

Also, your mentors can guide you toward other folks that may be able to help you with the process. Perhaps, your institution has a statistician that everyone uses. Or they may have some research coordinators. All these individuals can help you along the way to hone your ideas.

Find An Angle

Maybe you have already come up with a great idea but are not sure how you will put pen to paper. In this situation, I usually like to think about how the topic would not only interest me but would catch the attention of others as well. You could twist or reverse the idea by taking a fresh approach. Many ideas die, not because someone else has already pursued them but because they have not taken a new direction. Perhaps you can look at it from a different population standpoint, more significant numbers, or even by adding other possible associations. All these add-ons can lead to something fresh and new from what researchers have already done.

Overcoming Radiology Writer’s Block!

Maintaining the proper mindset and creating a system is the key to overcoming writer’s block. Simple processes such as keeping projects in mind, writing ideas down when you have them, contacting others who can help, and thinking about a different angle are simple ways to prevent writer’s block from creeping up on you. These are the systems I practice every week when I write this blog (approaching 500 articles!) and they also work for creating research studies. So keep this advice in mind, and you will become a prolific writer too! 

 

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Don’t Let Significant Life Events Interrupt Residency!

significant life events

Many of you are guaranteed to have significant life events during your four years. Marriage, family crises, car accidents, and sickness are all part of life. And a four-year period of time is a large enough amount for something huge to change in your life. But, with the daily grind of residency, all these life events can become significantly more complicated. Who has time to be able to leave work at a moment while you are dealing with of myriad of possible life issues? So, what are some of the primary steps you can take to prevent your life from interfering with your work? How can you make sure to preserve your integrity within a radiology residency while these events happen during your radiology residency? Some of these obligations seem like common sense, but this is an excellent checklist for radiology residents. These steps can be easy to forget when life throws you a curveball.

Notify Relevant Faculty

You may be in an uproar because of a challenging event. However, most of your faculty will be understanding. If you are not going to be around because you need to go to court or a funeral, most faculty and attendings will understand. Additionally, you won’t be leaving them in the dust when you don’t show up for work at that time.

Get Coverage

By that same token as above, if you are not going to be around, try to find someone that can take your place if you need coverage for whatever rotation you are on. Now that you are a resident, you need to take responsibility for your actions, and getting coverage shows that you can handle the job.

Find Times That Don’t Interfere With Patient Care

OK. It is certainly not possible to change the time of a funeral. However, you can usually make many critical phone calls, heated conversations, and necessary appointments at times that don’t interfere with patient care. It is merely polite and appropriate to do so. Imagine you were the patient on the other end listening to a personal phone call from your doctor. That whole situation could be a bit embarrassing.

Try To Plan Events With Significant Notice

You can plan some significant life events with notice. Marriages, engagement parties, and meetings to discuss a will don’t have to occur in the middle of a typical workday. Try to plan these events well in advance, so they don’t have to interfere with your training and patient care.

Don’t Assume Everyone Knows Your Significant Life Events

When you are stressed out, not everyone may appreciate your situation. If you feel comfortable telling your colleagues and staff what is appropriate to divulge, let them know what is happening. Most folks will have some empathy for what you are going through at the time. It may even bring you closer to your residency. Most residencies are kind of like a family. Conflicts can arise when people in the family don’t know the issues.

Stay At Home If It Is Needed

Especially nowadays, since the beginning of the COVID pandemic, most faculty have become more sensitive to the issue of staying home if sick or can’t function appropriately at work. And, every once in a while, there is nothing wrong with taking a mental health day. If it makes you able to come back to work soon with renewed strength and attention, it may be worth the day or two that you need for yourself.

Dealing With Significant Life Events During Residency

Four years is a relatively long time to be anywhere, let alone a residency. And personal disasters and happy life occasions/milestones are destined to occur. Some of these events will distract you from the focus of your training. Nevertheless, try to mitigate the effects by following some of these guidelines. Simply telling folks the issues, getting coverage, and finding times to take care of business can make a difference. Following these guidelines allow you to look responsible. And they are ways to ensure that your residency will run more smoothly and without bogging you down with miscommunications and problems during radiology residency. Life interruptions don’t have to ruin your residency experience!

 

 

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The Art Of The Last Minute Radiology Deal

last minute

Ever notice how most big financial deals are settled, not years or months before the deadline, but only a few days, hours, or minutes until the final click of the clock? Whether it’s the federal government’s budget, car purchases, or buying a house/investment property, the definitive signature and finalized contract only takes place at the 59th second of the last minute, right before the deal has to be done. Settling for a new radiology position or a contract with the hospital as a radiologist is no different. Many radiologists expect they will not have to play this game because they are physicians and not subject to the vicissitudes of the business world. Nothing is further from the truth. This dance is merely how businesses, including imaging practices, complete large financial packages. And, as we are part of the business world in the imaging world’s eyes, you should expect the same.

So, what are some last-minute items you should negotiate when you sit down at the table to create your final package? When and how should you walk away from the table to whet the appetite of the other party and enhance your party’s circumstances? We will divide the conversation about negotiating into two separate parts, the individual and the hospital. Let’s talk about the art of the last-minute radiology deal!

Nailing The Best Last Minute Radiology Package

Generally, the contract is partially negotiable when you finally go through the interview process and receive your offer in the radiology world. At this point, there is a bit of give-and-take with your future employers. Typically, the first parts to settle are the salary structure, years to partner, vacation time, and some of the oversized line items within the contract. Some of these items may be immutable, but what can you leave to the end so that you can harness the best deal possible?

Moving Expenses

Most practices will flip the bill for this service for two reasons:

  1. It is a tax-deductible expense for the business.
  2. It ties the applicant to the imaging company because they will need a residence close to the job. In all my positions after fellowship, moving expenses were available as an option paid for by the practice.
  3. You can request it at the last moment.

Malpractice Tail Coverage

Typically, most malpractice insurance companies do claims-made coverage. And, if a plaintiff sues after you leave the practice, you will still need malpractice coverage. This detail is where malpractice tail coverage comes into play. If an imaging business wants you as an employee, they may very well tack this bonus onto your contract at the last moment.

Percent Working At Specific Roles

Nowadays, there are fewer and fewer generalist radiologists. So, you may not want to practice mammography if you had little experience of comfort in the modality during residency. So, practices will often accept additional clauses securing the percentage of time that you want to work in a specific modality, especially if they need this service anyway. You can often easily tack this stipulation onto the contract at the final moments.

Getting The Most Out Of Your Hospital Deal Last Minute

Similar to negotiating as an individual for a position, often, you may play the role of negotiating a contract with a hospital. The extensive line items usually come first, like contracts, the functions that the practice will need to fulfill, etc. But what are some other critical parameters you can negotiate at the end?

Separation Clauses

Sometimes the deal does not work out the way that both parties expect. Therefore, you may want to find a way for the hospital and practice to part without too much hardship. This separation clause is a stipulation that may not seem important at the time of the deal signing. But, it is critical to have an out when things go south. So, it may not be the priority, but it is something that you can negotiate later on.

Support For Other Services (Chairman, etc.)

Some radiology services can be very costly but not considered at first glance. Here is where you can negotiate for extra support. Line items such as residency management, chairmanship, or other ancillary roles are some examples of fees that the institution should pay because they don’t come for free. These are great add-ons at the end of the deal.

The Art Of The Last Minute Radiology Deal!

Consider these line items to add to the contracts you might negotiate. Of course, they may not be the first items you would consider when starting a negotiation. But, they can be critical add-ons once at the end of the talks that can make a significant difference in your final contract. Every little bit counts when you are about to strike a deal in your favor!

 

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What Was Radiology Life Like Without PACS?

without pacs

I may be dating myself, but I am the last generation that did a radiology residency without PACS. Yes. I lived and breathed the pre PACs era. Some of it was pretty good. And, other parts of it, not so much.

Nevertheless, radiology was very different before hospitals started to add these systems to their networks. So, what are some of the most significant changes I have seen throughout my career when I compare the two eras? What was life like before the advent of PACS? Let’s go through some of the most critical differences in radiology.

Many More Films Got Lost Without PACS

On any given night, you would expect a good percentage of cases to remain in absentia without a dictation. Unsurprisingly, the orthopedic surgery residents would stealthily slip into the reading room when the radiology resident stepped out. And this person would steal the films so that the surgeons could use them for orthopedic surgeries at nighttime. Or, the alternators (the old defunct machines that you might see in the back of a reading room somewhere nowadays) would suck up several films, and they would get lost in the device or even shredded to pieces. Many cases would simply no longer be available for dication either for a delayed period or never. Film loss was just a fact of life. Nowadays, it is only the rare irretrievable case that you will need some help with from the IT folks.

Saw A Lot More Clinicians

Today, our reading rooms fill up with primarily residents and a smattering/skeleton crew of a couple of attendings. Back in the day, the reading room was hustling and bustling. Surgeons, Ob-Gyns, and more would regularly show up to look at their cases with you because they couldn’t look at them themselves on a PACS system. You got to know each clinician by name and personality. It was more than just a tryst in the reading room. Of course, that came with the upside of meeting great physicians and the downside of discovering a few jerks here and there. Nevertheless, the reading was much less of a lonely place. And, you would learn about the final disposition of cases more often because we kept in close contact with our physician brethren.

Had To Produce Your Films For Case Conferences

Have any of you ever encountered a dark room? Back in the day, it was a regular event for radiologists. We would have to develop our copies to present for case conferences. It was a big deal and somewhat time-consuming. But, we all got to know this haven of darkness every so often. It was much more intricate than just downloading a case on PACS or snapping a picture on an iPhone for a presentation on a Powerpoint. These technologies were available but still uncommonly used at the end of the pre-PACS era. It was a pain in the-you-know-what!

Priors Were Less Common

Getting priors was a real pain in the neck back then. We would somehow have to go down to the file room and retrieve them. Therefore, we would dictate many more cases without them because they could be hard to come by. So, you could imagine we lost some specificity and sensitivity in these dictations. And, then, when you did retrieve the priors, you would receive these enormous folders where you had to find suitable films. You would be lucky if you didn’t get a paper cut in the process. (They were much more prevalent back then and hurt like hell!)

Less Windows Available Without PACS

Nowadays, we click a button and re-window a case. Back then, you couldn’t look at the bones if you didn’t have the bone windows on film. So, the techs would print fewer windows to save on film. Often, if the reason for the study had nothing to do with the window, you would not have them available to read. I’m sure we missed tons of osseous lesions!

Keep Lists Of Results On Overnight Cases

Instead of having a PACS system to look cases up, we would have to keep a running tab of the patient studies we read, especially on CT rotation. Clinicians would come down and check out the results on the list and chat with the resident. Every room would have a list of cases from the previous night. Eventually, they would make their way onto the Radiology Information System. But until then, the responsibility was ours to keep tabs on everything in the reading room.

Working From Home, Ha!

And finally, working from home was a figment of one’s imagination. We needed to perform all reads and procedures in-house. Imagine being unable to take off to let the Verizon folks fix something in the house. That was our world. We lived and breathed the hospital in those days!

Radiology Life Without PACS

We lived in a different world back then. Radiology lifestyle and culture have changed dramatically over the years since hospitals have installed PACS. Yes, we had more contact with other physicians, but it came at the expense of many problems. Nevertheless, although mostly better today, some good did happen before hospitals introduced PACS to our world. Would I want to go back to those times? Probably not. But they were a great experience that new radiologists cannot imagine today!