Year: 2022

Posted on by

Losing A Radiology Partnership Track Midstream

radiology partnership track

Imagine this. You have been working hard coming in day after day at the crack of dawn before anyone else starts dictating for years while on the radiology partnership track. And, you leave last. The techs and nurses love you. You answer all their questions with enthusiasm. You are nice to all your colleagues, partners, and non-partners alike. And, you have a family that relies on you to bring home a salary to pay for the house and the kid’s school. Then, one day, suddenly, one of the senior partners enters the workroom and says they need to speak to you. OK. No problem

The senior partner tells you that you are off the radiology partnership track. Unbeknownst to you, a quirky primary referrer is angry about some of the reads you have made over the past year. He threatens to send patients elsewhere if you stay on as a partner. And, the senior partner says as much as the rest of the practice likes your work, your employer has no choice but to discontinue your partnership track. You protest that your work ethic and your dictations are second to none. It doesn’t even move the needle.

This situation or something like it plays out every year at some practice in the country. The reasons for the termination of a partnership can vary widely. Anything from insubordination to malpractice, personality conflicts, or financial reasons can all cause the end. Once you lose partnership tract, you lose several years of your life to a place you have dedicated your time to a job that does not love you back. No matter how you slice it, it is a heart-wrenching situation for the employee. So, if this situation happens to you, what are your options? Which ones can work, and which ones can you avoid? Here are some of my thoughts.

Continue Working At The Practice As A Non-Partner

Usually, this is a short-term solution if at all possible. But, sometimes, you have to continue to work at the site for a bit. You may have a family where you cannot just take up and leave. And, many practices have non-compete clauses that can make it very difficult to pick up and move to another local employer. So, as painful as it may be, it can still be reasonable to work at the site for a while until you are ready to move on and start another job.

Quitting And Moving To Another Place

You will most likely still have loads of opportunities available in this market (as it stands today!). But, you will have to explain what happened at the previous practice to throw you off the partnership track. Many places will continue to allow you to work if you have a reasonable explanation. Most employers know that getting thrown off a partnership track can happen for many reasons, some nonsensical. In many cases, they may be willing to give you another chance.

However, starting another partnership track may not be feasible in certain situations. For instance, if you have one of many red flags, such as losing a partnership track for the fourth time. Or if you have a horrible reputation with poor recommendations from another site. You may need to opt for a nonpartnership job, work in teleradiology, or some corporate gigs in these situations.

Suing The Practice For Damages For Loss Of Radiology Partnership Track

Sometimes, your anger can get the best of you. And, you may not understand why the employer had to let you off the partnership track. Furthermore, all the time and money you put into the partnership track can seem wasted. However, unless egregious, this path does not usually work very well. For one, the contract laws favor the practice. A business can typically hire and fire an employee for multiple reasons. And, it will be tough to prove that not making you a partner has been illegal. Also, the practice will have deeper pockets to protect itself than you will have as a solitary employee. And finally, this pathway can establish you as a non-hirable radiologist because all this can go on the public record. Most practices will think twice about hiring someone who will sue them if they don’t get what they want.

It’s Tough To Lose A Radiology Partnership Track Midstream

Hands down, it is one of the most challenging experiences for radiologists when a practice throws them off of a partnership track. Losing out on time and the energy you put into a job can drain you professionally, emotionally, and physically. 

A partnership is subject to the whim and fancy of multiple factors. So, make sure not to establish roots before you make a partner. And, choose the best option for you and your family when and if the time arises that you don’t make the final cut. A partnership is rarely guaranteed. But, making the right choices afterward can help you move on in the best way possible.

 

 

 

 

Posted on by

How To Maintain Focus In Radiology While Armageddon Begins

armageddon

We are witnessing a sea change in the world order as hostilities brew between Russia and Ukraine. Additionally, for the first time in over 30 years, we are experiencing a new cold war with the possibility of triggering a nuclear catastrophe. One small wrong move from the NATO allies or Russia can cause Armageddon. It can be as simple as cyber hackers shutting the lights off in Ukraine that accidentally do the same in Poland. Or, perhaps, a rogue pilot can cross into the wrong territory. We have more to worry about in the world than ever before. To top that off, the news and social media constantly bombard us with images and updates. These pictures of desperation can make what we do seem insignificant, especially with news tweets and updates all the time.

Yet, regardless of the catastrophes brewing abroad and the frustrations we experience, what we do as a profession still has meaning to the patients we diagnose and treat and the referrers that order the studies. So how can we keep our cool and concentrate on what we do as a profession without losing focus from the nightmares happening abroad? Here is some essential advice to remember to maintain our focus while the world changes.

We Cannot Control Armageddon In Ukraine But We Can Control What We Do At Home

In Ukraine, Russia, and abroad, what’s going on are events in an ongoing Armageddon that we can’t stop. Elected and unelected politicians on both sides control the reigns. We can make our feelings known about these disasters. But, we can’t do much to stop the flow of these events.

On the other hand, we can control what we do at work to help patients using the tools we have learned in radiology. Regardless of what is happening in the world can continue to provide excellent patient care. And, we make all the findings and diagnoses so that patients are treated well and get better. So, we should continue to do so.

Remember What We Do Helps People

We still provide a valuable service that helps physicians and their patients regardless of the suffering abroad. It can be easy to forget that since some of us provide indirect patient care sitting at a computer and reading films. But, ask almost any one of our clinical friends, and they will tell you that what we do is not insignificant. We diagnose appendicitis and aortic ruptures, potentially saving lives and complications. We should never forget that.

Appreciate Your Situation

We, outside of Ukraine, are fortunate not to be refugees. We are not running away from bombardment and have a job always to return. Sure, the information age connects us to everything in the world. But, it is not on our doorstep right now. And fortunately, we can continue to perform our daily rituals and lives. We need to appreciate how lucky we are.

Donate/Charity

It is still possible to do something about the situation for all the badness happening in Ukraine. If we cannot be there, you can at least support your favorite charities to ensure that you are helping out the victims. Donating can help alleviate some of those feelings of helplessness for the folks in Ukraine.

Maintaining Our Focus While There Is Armageddon In Ukraine

Listening to the horrible stories of millions of people leaving their country under the threat of Armageddon can be difficult. But, if we recognize that we can’t control external factors, realize what we do is essential, and at least donate to the cause, these are some ways to allow us to continue to focus on the critical roles that we serve for the community. Although the situation abroad does not look promising in the short term, let’s hope that our democratic ideals will win out in the end. Time will tell.

Posted on by

Coping With The Disruptive Study

disruptive study

Ever notice how one or two studies can become the focal point of any night?. Hordes of surgeons, medical specialists, and more come down every fifteen minutes to look at or discuss the case with the radiologist. And, you become the “most popular physician in town.” Sure, it can feel good to be so popular. But, you will find many costs to the disruptive study. On a busy night, you cannot get to the next case. And, the tick-tock of the clock becomes more ominous as the weight of an ungodly list of additional studies piles up. Most critically, you become unable to read everything else. So, how do you prevent a disastrous outcome with unread studies, unhappy doctors, and a nightmarishly long shift? Here are some tips for decreasing the suffering that a disruptive study can cause.

Make Preemptive Phonecalls!

If you know that a case will be “interestingly” positive, make sure to call all the relevant parties beforehand. Although not a guarantee, this polite maneuver will often prevent a group of surgeons or ob/gynecologists from asking you about the case while you are in the middle of dictating something entirely different and complex. Plus, it will make it seem like you are on top of everything.

Don’t Be Ambiguous

Sometimes cases are like magnets to the clinicians because your dictation or what you tell them is not clear. It could be a nodule that you measured as 2 cm in the body of the report, but you stated it was 2 mm in the impression. Or, perhaps, you were not straightforward with your differential diagnosis. Ambiguous reports lead clinicians to find out what is going on by searching for you, especially while dictating something else!

Dictate The Disruptive Study As Quickly As Possible

Cases have a shelf life. If you don’t dictate them on time, the shelf life will end, and you will have a clinician coming down to review the case before you know it, interrupting the workflow for your day. So, as a rule, I try to dictate the “interesting: report as soon as possible. You significantly decrease your colleagues’ chances of stopping you in your tracks.

Tell Your Junior Resident About The Case

Sometimes you are on buddy call or have another radiologist help you out. This opportunity is perfect for teaching your junior resident and then having them go over the case with everyone else! Firstly, this will prepare the resident to learn about a radiological finding or a disease entity. But, it will also teach your junior resident how to go over cases. And the fringe benefit is that you can get the rest of your work done!

Worst Case Scenario- Batten Down The Hatches!

Sometimes the night can get extremely busy. And, you have no time to beat around the bush. As a last resort, sometimes you have to tell the doctors that you are in the middle of doing something else. And that you don’t have the time to go over the study. If you don’t have the time, it’s not cruel to delay a third interpretation of the same case. You do have other cases to read!

The Disruptive Study- Not The End Of The World!

The disruptive study is simply part of our job. Bizarre and challenging cases spark the interest of our colleagues, and they will want to address the issues with you. Nevertheless, we can mitigate the interruptions that it will cause by calling clinicians, increasing clarity, reading cases efficiently, or telling other junior radiologists about them. And worst-case scenario, you can ask them to come back when you are ready. The disruptive study can be painful. But, at least, you have some ways to decrease the potential for it to ruin your whole day!

 

 

 

Posted on by

Inheriting Other Program’s Problems – The Lateral Residency Transfer

lateral residency transfer

Every once in a while, a program will lose a resident for various reasons. It could be to move closer to family, poor performance, or a gazillion other reasons. When this unfortunate event occurs, a program is stuck trying to fill a spot. And, you would think at first glance that it would be pretty straightforward. I mean, radiology is pretty competitive nowadays. Instead, only a fixed small number of residents can transfer from one PGY3, PGY4, or PGY5 spot to another. And, programs need to be very careful when they recruit these positions. A lateral residency transfer from another residency program can become more problematic than having one less resident in the program.

So, what are the issues that residency programs face when recruiting residents from other programs? And, what kind of transfers are programs looking for? Here are some of my thoughts on these situations.

Lateral Residency Transfer: A Minefield Of Problems

Professionalism Issues

Many applicants from other institutions leave because their former residency program does not want to renew their contracts. Out of those reasons, one of the most common is the professionalism violation. It could be any one of thousands of professionalism infractions, including ethical, moral, and legal issues. Moreover, programs suffer from a lack of information about the resident’s former residency. Frequently, the former site of the applicant doesn’t release “all the information.” So, poor professionalism behaviors can quickly arise again when the resident enters your program.

Academic Issues

In addition to the professionalism issue, many lateral transfer residents cannot academically make it through their current program. Perhaps, it is related to test-taking skills, dictations, or inability to make the findings. If you hire them without knowing the real issues, these same issues will eventually surface when they transfer to your program.

Medical/Mental Health Issues That Can Interfere With Training

We also have to worry about medical and mental health problems interfering with resident training. Notably, this information can be complicated to retrieve because it is a HIPAA violation for a program to give this information out to another freely. And although programs make every attempt to overcome these issues, it can lead to all sorts of problems for both the incoming resident and their colleagues who need to cover them.

The Fickle Resident

Finally, some residents leave because they spontaneously want to abandon their former program for various unstable reasons. These include dating scenes, being in a warmer climate, or myriad other miscellaneous reasons. This sort of resident can decide to do the same when entering your program. Not a great situation!

What Programs Want From A Lateral Residency Transfer

Residents That Need To Leave To Be Closer To Family

Sometimes residents will have a sick relative, and they need to care for them. Or, they have a wife and children who live in a different country than their current residency program. These reasons are legitimate. And, they make for a happier resident that will be more likely to complete the radiology residency.

Particular Interests That The Former Residency Cannot Satisfy

Other times residents discover they have different interests that one residency cannot meet. Perhaps, they are interested in participating in bench research not available to them at their current site. Or, maybe the new site has a PET-MRI, which is the resident’s area of interest. Regardless, these reasons can be valid as to why the resident may want to come to your program.

Legitimate Medical Issues That Will Not Interfere With Training

Some residents need to be closer to certain cities/hospitals to get their treatment. And, perhaps, it is not available at the current institution/town. Or they need the care of family members to help them with health issues. These residents can potentially become a great asset to a new program if they meet its demands.

A Real Change Of Heart For The Lateral Residency Transfer

In medicine, it is effortless to make a mistake. We don’t necessarily know what we want to do when we get out of medical school. Medical schools do not give the best sampling of what life is like post-medical school in all specialties. And, many residents realize they made a mistake early on. Sometimes nuclear medicine residents or emergency medicine residents who have completed imaging rotations can qualify for these more advanced positions. Well, these sorts of residents can become the best trainees because of their dedication to doing something they want to do instead.

The Lateral Residency Transfer Can Be A Tough Situation!

Due to all the pitfalls and possibilities that a lateral transfer can offer, it can be challenging to cull residents that will fit the new program’s culture and meet the demands and rigorous tests of residency. Selecting residents with professional/academic violations, medical issues, or the fickle resident can throw a wrench in the new residency program when similar problems arise in the new program. And this situation can be worse than not recruiting any radiology resident. But, many residents have valid reasons for changing programs as well. So, residency programs, just like the residents, need to do their due diligence. The consequences of picking the wrong resident can be dire!

Posted on by

Calcium Scoring CT Scans- Are They Worth The Risk?

calcium scoring

I am not a cardiovascular radiologist by any stretch of the imagination. However, I read lots of cardiac calcium scoring studies. And, a good chunk of the time, when I read these studies, I find all sorts of other issues. It may be a pulmonary nodule, a liver or renal lesion, or an adrenal nodule. Regardless, I see too many of these ancillary findings.

Why do all these incidental findings matter? Well, I have a sneaking suspicion that most of us don’t have a handle on the actual risks to this study. So, my question for today is, do these ancillary issues supersede the potential benefits of getting a cardiac calcium study. What are the complications of receiving this scan? And, what does the current literature say about how these “incidental” findings alter the actual risks of receiving this examination.

Calcium Scoring And Incidental Findings

If you want to read an excellent paper on the topic, look at the AJR article called Incidental Extracardiac Findings at Coronary CT: Clinical and Economic Impact. To summarize, around 43 percent of patients receiving this study had some form of incidental findings. And in 52 percent of these patients, the author deemed these findings significant. So, if we do the math, 22% (0.42 x 0.52= 0.22) of the time we read these studies, we will find a significant incidental finding.

Now, in my experience, this number sounds about right. I find pulmonary nodules and hepatic cysts all the time with an occasional smattering of all other sorts of problems. And, I hate recommending the Fleishner criteria and ultrasounds to follow up these studies. Why? Because I know that they will lead to undue additional radiation, procedures, and other complications that we have not even thought about most of the time. And these issues don’t even include the untold psychological tax for each patient with an incidental finding.

Moreover, other patients may even have higher numbers of incidental findings. Check out this paper on diabetics and incidental findings, and you’ll see what I mean. How do we deal with these subsets of the population getting these studies?

And, then, of course, the number of incidental findings depends on the field of view. Some scans use a wider field of view than others which logically should pick up more incidental findings. I always think that if I had to have this test, I would want to receive one with a smaller field of view to decrease the possibility of the incidental finding!

What Is The Real Complication Rate Of Incidental Findings?

At this point, my research on this topic gets a little bit dicey. Unfortunately, I have not found quality information that reports on the actual complications of incidental findings of a relatively healthy person that receives a Cardiac Calcium Scoring CT scan.

Instead, I find myself having to turn to personal stories of relatively healthy patients that had issues with some of these incidental findings. I know one relatively young patient with a remote history of non-metastatic superficial melanoma who had multiple pulmonary nodules. The interpreting radiologist read them as significant enough to be suspicious for malignancy. The patient felt fine, but the surgeon wanted a VATS. Fortunately, the patient’s doctor canceled the surgery and allowed the patient to follow up with serial short-term chest CT scans. The nodules turned out benign!

Or, I think about a breast nodule that a radiologist found that turned out to be a small benign fibroadenoma. The patient had a significant workup with a slightly complicated course of bleeding. It may have gone unnoticed if not for the calcium scoring CT scan.

I am sure these individual cases are just the tip of the proverbial iceberg. Now, you may point out that we do find all sorts of lung cancers, metastatic disease, cirrhosis, and other diseases that may have some benefit of making findings early on a calcium-scoring CT scan. And, I can give you a few of those stories as well. However, these tend to be in a sicker population. Moreover, from my experience, these are a significant minority of cases compared to the world of the benign incidental findings on a Calcium scoring CT scan.

What Do You Say To Colleagues And Patients That Want To Get A Calcium Scoring Study?

Because the hardcore truth about complications and Calcium scoring is not out there yet, here is what I tend to tell relatively healthy patients. First, make sure that you have the risk factors to support receiving this test. As I described above, the complications are not benign. Second, if you think it is worthwhile and will change medical management, make sure to find an institution that uses a small field of view that encompasses less adjacent anatomy. There are many different protocols so that they can make a difference. And, then finally, if the radiologist discovers an incidental finding unless it is glaringly problematic, make sure to take a conservative approach if reasonably possible.

If you receive the test, we can’t undo the incidental finding. But, at least, you are aware of some of its risks and can mitigate some of the problems you may encounter!

 

 

Posted on by

DO Or Foreign MD- Which One Is Better For Radiology?

foreign md

Each specialty looks for different skill sets and activities when selecting candidates for residency. As part of an admissions committee, institutions scour dean’s letters, recommendations, board scores, volunteer activities, and more to ensure that the candidate makes it through rigorous residencies. However, one of the most “in-your-face” factors that most residencies cannot overlook is the degree applicants have completed. Yes, it is a soft criterion because a suitable candidate can graduate from most foreign MD programs or DO institutions in the United States. Nevertheless, it can become an issue, especially when the committee is not sure of the quality of the medical school.

So, for radiology residency specifically, which degree stands out as the best for applicants? And, which one gives them the best chance of getting into a radiology residency program? I will break down the different degrees into Caribbean MD, Other Foreign MD, and DO schools to accomplish this feat. For each, I will give you the insider advantages and disadvantages. Then, I will provide you with my opinion of the rank order based on the objective facts of each degree.

Top Tier Caribbean MD Schools

Within the Caribbean MD schools, there are undoubtedly several tiers. First of all, we know the quality of St George’s institution since we have had a relationship with them in the past. And, we know that a top student from this school performs at the level of most United States medical schools as we see in our program. Moreover, many other program directors feel the same way from what I have heard. Unfortunately, many medical schools nowadays are biased against Caribbean graduates, even St. George. Many large prestigious academic institutions won’t even touch one of these applications unless the applicant is an exception to the rule.

Furthermore, with the AOA (American Osteopathic Association) combination with the ACGME (Accreditation College For Graduate Medical Education), having a DO degree is no longer a disadvantage for getting a residency. DO residents no longer have to complete separate osteopathic internships and osteopathic accredited residencies. So, Caribbean residents have more competition than ever before to get into ACGME accredited residencies. But, at least, the Caribbean schools with a known reputation can help these applicants secure a spot.

And then finally, the new Step I board pass/fail non-scoring criteria will prevent radiology residency programs from assessing incoming students’ test-taking acumen, which correlates with passing the radiology boards. Therefore, residencies will be more wary of accepting a Caribbean student, even from a top-tier program, especially without knowing if they are a good test taker.

Other Foreign MD Schools

For other foreign MD programs, residencies have the same problems. It’s a problem of familiarity. What does a degree from a Taiwanese, Indian, or Iranian institution mean? This problem is even more complicated than the top-tier Caribbean schools (where we are more familiar). How do we know how students compare to United States schools that graduate? Perhaps, a few institutions do break this mold. But for the most part, we cannot figure out where a candidate stands. Nor do we have the time and energy to tease that out. Primarily, we don’t need to when programs have so many excellent United States candidates to choose from nowadays.

Additionally, the ACGME combining the AOA and the new Step I board pass-fail criteria will make it much more difficult for these students to secure a radiology residency slot due to the increased competition.

DO Schools

Today, many MD radiology residency programs still have a bias against DO candidates, especially at larger academic institutions. Nevertheless, all DO schools must meet the same criteria as MD schools since the AOA and the ACGME have combined into one organization. Therefore, even at the most questionable United States DO institution, theoretically, we should know the baseline training of the medical student applicant. We cannot receive this same assurance from a foreign graduate school.

Moreover, getting rid of the Step I board scores will have a negligible effect on these applicants. Why? Because we have an idea of the baseline quality of these US accredited schools.

So, What’s The Final Ranking Of DO AND Foreign MD Degrees For 2022?

From best to worst chance of securing a radiology residency spot:

  1. DO Schools
  2. Top Tier Caribbean MD Schools
  3. Other Foreign MD Schools

 Just a few words of advice, because you may have graduated from a lesser-known foreign medical school does not mean you have no shot of acquiring a radiology residency. And, if you are coming from a top-tier United States medical school, it does not mean you are guaranteed a spot. But, the type of program you are coming from influences the chances of getting in. You were wondering about probabilities, right?

 

 

 

 

 

Posted on by

Should Radiology Residents Have Workstations At Home?

workstations

One of the most significant changes in radiology in the post-Covid age is the ability for radiologists to “telecommute” to work. The pandemic has hastened the adoption of these technologies, not just for teleradiologists but for almost every practicing radiologist. Nevertheless, most radiology residents still cannot read from home workstations (although I have heard of a few).

So, is it a good idea for residents to have workstations at home? Well, I will go through some of the pros and cons of home workstations for residents. And, then I will give you my conclusion for which if any residents should have workstations from home.

Reasons For Residents To Not Have Workstations

Need Real-Time Consultations To Learn

My best teaching situations are routine phone calls and visits from our physician colleagues at the workstation. And when a resident takes these consults, they are most likely to learn how to practice and communicate in radiology. Working from home decreases these potential connections to the daily consultations that radiology residents will receive.

“No Real Time Teaching”

Especially for first-year residents, there is no substitute for sitting with an attending at a workstation for a bit to learn radiology. Yes, it is possible to make phone calls to your faculty to go over the images. But, usually, only after you have seen the case and without a faculty member by your side. So, you lose out on many teachable moments to learn about normal findings or ask miscellaneous questions on all the cases you see. These questions can be the most thought-provoking.

Reading In A Bubble

Yes. You need to make independent decisions and read by yourself eventually. But, when you are at the institution reading, you can more easily recruit the help of nurses, technologists, faculty, and more. It is much easier to talk to the ultrasound technologists about patients’ histories in person who just completed a case than to catch staff on the phone somewhere. Ancillary staff and fellow physicians add critical information to your findings and interpretations.

Expense

It is a significant additional expense for institutions to allow residents to read from home. Workstations can run in price from thousands to tens of thousands of dollars. And Medicare only indirectly reimburses for resident dictations, so it has low perceived value for the institutions. Therefore, resident workstations can theoretically increase the cost of healthcare.

Reasons To Have Workstations

Sick Residents

Residents get sick just like everyone else. And, sometimes, it’s a mild bug (or even Covid!). Most residents don’t want to infect everyone else. Yet, they still may have the ability and desire to work. Well, with a home workstation, that is still possible. Having a workstation from home opens the possibility of continuing to learn and read without having to take a day off!

Looking Up And Reading Cases Off-Hours

Sometimes, you just want to look at actual cases at any hour. Maybe, it was an interesting case from the day. Or, you just want to learn more about a particular subspecialty, say MR MSK. For that matter, residents (and faculty) are much more likely to learn about these cases and subjects on off hours if they can look them up quickly at home. That power can undoubtedly add to resident education.

More Accessible To Prepare Interdisciplinary Presentations

We often see residents scrambling to get all the cases they need for the next tumor board during the day. This process can often interfere with daily work. If you have a workstation at home, there is no excuse for doing these activities off-hours when you are home. It’s much easier to complete when you don’t have to go to the hospital.

Is It Worth It For Radiology Residents To Get Workstations?

I am certainly one of the biggest proponents for onsite learning as a faculty member. Based on the many reasons above, such as real-time teaching, I tend to learn more when sitting at the hospital surrounded by colleagues instead of reading cases from home. Something about being present with others enhances the learning process. And that is one of the main reasons residents do a radiology residency, to learn.

Nevertheless, there is no denying that the flexibility of home workstations can also help when a “traditional” learning environment is unavailable, whether due to sickness or after-hours work. So, I am not against residents having home workstations if the institution can afford to pay for it. But, home workstations should not replace the residency experience. Instead, workstations can supplement the learning environment for the resident. As an add-on tool, it’s not a bad idea!

Posted on by

Inflation And Residency- Not A Winning Combination!

inflation

Many of you have probably noticed the headlines about high inflation rates. Over the past year, inflation has risen by over 7 percent. It may only seem like a number that the talking heads on TV and youtube espouse. And, maybe, you have noticed some increased dollar costs at the end of the trip at the supermarket. Or, perhaps take-out from the restaurants that you like the most are a bit more expensive. Then, of course, your gas tank is a lot more costly to fill. 

Taken individually, it may not seem like much. But it is probably more than you think when you add it all up. So, let’s discuss why folks with fixed, regular incomes like you tend to get battered the most. And then let’s talk about how you can potentially prevent the year from eating up your entire salary.

Why Inflation Significantly Impacts Residents

Annual Incomes Are Already Set For The Year

Often, hospitals create residency salaries before calculating the following year’s cost of living. Therefore, you may notice that your income does not meet the increase in the cost of living for this year. This relative decrease in salary can undoubtedly give you far less room to squeak by.

Most Residents Are Not Asset Owners

People who own assets such as houses don’t have to worry about rent increases because their mortgages don’t change. But unfortunately, most residents are not in that boat. Additionally, trainees do not have as many stocks, cryptocurrency, or other hard assets that rise with inflation. So, you are at a distinct disadvantage.

Increase In Prices Eat Into A Regular Salary Without Much Room For Discretionary Income

First of all, your salary is typical for the United States workforce. But, the ordinary person in the United States lives paycheck to paycheck. So, this increase in prices will take a significant bite out of your annual budget, especially when you have very little room for discretionary income, to begin with.

What To Do To Prevent More Pain!

Moonlighting

Not everyone has this opportunity available. But, if your residency has this option, you may want to think about participating. In-house moonlighting can help defray the additional costs of a high inflation rate, perhaps at the current inflation rate or even more. Plus, it will also allow you to sharpen your independent radiological skills. 

Sharing Apartments/House Hacks

Did you not want to share an apartment with colleagues when we had a more normal inflation rate of two percent? Well, maybe it may make more sense now. Overall, rentals will sharply increase in price this year for much of this year. And so, sharing the entire bill may make a lot of sense.

Or if you are fortunate to already own a property in the area. Maybe, you would want to rent part of it out this year to decrease your costs. This move can also significantly reduce the cost of inflation in your regular salary!

Strict Budgeting For Times Of Inflation

Lastly, if you are a prodigious spender, you may want to rethink this lifestyle, especially this year. Budgeting and tracking expenses closely can help decrease your annual costs and prevent the paycheck-to-paycheck lifestyle with high credit card debt. Use a spreadsheet or an application. Either way, this method may help to avoid overspending related to inflation!

Inflation And Residency

More than any other time in your career, inflation can eat away at a higher percentage of your annual income since your residency salary is relatively lower than what you will make eventually. Also, most residents don’t have the assets to decrease the influence of an inflationary world. Therefore, it can be tougher to make ends meet than a typical year.

Nevertheless, you can use some of these tools to prevent inflation from impacting too much. And hopefully, we will see some improvement in the following years and get back to a baseline lower inflation status!

 

 

 

 

Posted on by

A Last-Minute Decision To Go Into Radiology Is OK!

last-minute decision

So, you’ve put all this time into beefing up your application for radiation oncology, urology, neurosurgery, or medicine. You have researched and toiled in these or other subspecialty electives for countless hours to make a good impression. And, it’s about time to make that ultimate decision to pursue your final goal. But, something doesn’t feel quite right. Your gut tells you that you will probably not want to spend the rest of your life in this field. What do you do? For those of you that have to make soon that heart-wrenching decision of which specialty to choose, it is OK to make a last-minute decision. Trust me. Don’t worry about disappointing others or not pursuing your original goal. Here are the reasons why.

A Subspecialty Career Lasts A Lifetime

We are not talking about just a few years. Whatever specialty you decide to choose can last the remainder of your career. So, don’t worry about disappointing your colleagues, research cohorts, and mentors. Don’t do it if you are sure that you are pursuing the wrong path!

Physicians Are Miserable When They Don’t Pick The Specialty Their Heart Desired

I know that too many physicians are miserable and burnt out in their career path. Many of them regret the day that they chose the wrong specialty. And, many decide upon the incorrect medical field because the one they want is time-consuming or “tough.” Most of us can live with a few challenging years, but not for difficult years for the remainder of our careers!

Friends, Colleagues, Mentors, Will Understand Your Last-Minute Decision

You may receive some disappointed looks at first. But, in the end, your true friends will understand that you need to make this decision for yourself, not for someone else, and certainly not for a superficial reason. Real friends will eventually understand the choice you made

Last-Minute Decisions Happen All The Time

I don’t know about you. But, I know many physicians, specifically radiologists, who decided to join the fold at the last minute on their fourth-year radiology rotation. No, they may not have all the credentials of someone preparing to do this pathway all along. But, they can make excellent radiologists (sometimes even better than ones that already knew their destiny!)

Hard to Back Out Once In A Pathway

The easiest time to make a decision is now. Once you have already started a new residency, it is much harder to reverse course. You need to get permission from program directors, colleagues, and the federal government! And you may not have the funds to change paths so easily. So, make this decision to go into radiology before you start another residency if you can!

You Don’t Need Tons Of Research To Get Into A Decent Radiology Program

Yes, completing research is excellent. But do you need tons of research to get into a radiology program? No! We have selected many candidates who did not have a laundry list of radiology-relevant projects. So, if you decide to avoid radiology because you don’t have the research to do so, don’t!

Better Off Getting Into A Mediocre Radiology Program Than None At All (It’s A Self Taught Discipline Anyway!)

Think again if you are interested in radiology and are not applying because you can only get into mediocre programs. Many great radiologists have not gone to man’s best institution. Fortunately for you, much of radiology is a self-taught discipline regardless. Any program in your desired field of choice is better than no program!

Look At Me! I Made A Last-Minute Decision

Lastly, and more importantly, please consider that I am one of those radiologists who made their decision after being on the internal medicine track all along. I only made my final decision at the beginning of the fourth year. And, it all worked out very well for me. You can make a last-minute decision to go into radiology as well!

The Last-Minute Decision!

Society puts too many negative connotations on the last-minute decision. In truth, though, last-minute choices are not always bad. What is terrible is refraining from pursuing what you want because you believe you have a fixed path. So, make that last-minute decision to join the radiology fold if that is what you want. Your last-minute decision can be the best one!

 

 

 

 

Posted on by

What Hobbies Correlate With Becoming A Successful Radiologist?

successful radiologist

After reading a gazillion personal statements and participating in another bazillion interviews, I would be a kazillionaire if I had a dollar for every time I read that a medical student will make a successful radiologist because of one of their hobbies. And, if you gave me a small rock for every time a medical student claims that they are great at one of these hobbies and how that applies to radiology, I would be sitting on top of Mount Everest! So, do hobbies have any correlation whatsoever with becoming a high-quality radiologist? The answer to that question is yes. But, not the way you might think at first. And indeed, not in the way most folks add their hobbies to their personal statement.

So, let’s go through some of the more common hobbies applicants think will make them great radiologists. Next, I will disclose why applicants believe these hobbies make them higher-quality radiologists. But, of course, I will debunk this perceived correlation. Finally, I will reveal how hobbies help the average radiologist!

Photographers

One of the most popular themes in personal statements is the correlation between becoming an excellent radiologist and one’s love for photography. I often hear how they can see subtleties and make those same findings on a film. Well, I can think of several resident photographers, and their radiology abilities are all over the map. Some are excellent radiologists, and others are more average. So, I am not sure if this skill makes a significant difference in your findings skills. 

Video Gamers

Like photography, I have seen tons of applicants talking about video games as one of their hobbies. A more rarified few will claim that they are extraordinary competitive video gamers and have won prizes or cash for their endeavors. On this point, I have seen several articles talking about improved hand-eye coordination. But, it can also lead to distractions and decreased reading during residency. So, I feel that in terms of becoming a better radiologist, playing video games is kind of a wash.

Art Connoisseurs

Like the photographer, these folks talk about their love for paintings and museums. Others will even paint pictures themselves, some that have even made it to a gallery or two. And then folks tend to claim that they have a “good eye.” It is also a typical statement that I hear about in recommendations that usually tell me nothing. Why? Anyone can make this claim, and it is hard to back it up with facts as a medical student. Nevertheless, this hobby is a popular radiology applicant pursuit. In and of itself, I am not sure if it correlates that well with quality!

Cooking

Here is a hobby that I also love. I prefer to eat my food than the food I purchase at restaurants. And, it does involve some hand-eye coordination, creativity, and knowledge. However, when I look at the applications of incoming medical students, I find nearly every other one has the same hobby. Because it is so prevalent in society, it doesn’t add much except for an excellent conversation between myself and the interviewee!

Music And The Successful Radiologist

We have all sorts of “radiologists-to-be” that either listen to, play, or dance to all kinds of music. For those that play different instruments (like myself), it undoubtedly is a great outlet to have fun and mix with other like-minded bandmates and friends. And, for the dancers and players among us, these folks may have slightly better hand-eye coordination. (plus or minus) Some may DJ on the weekends, and others may perform gigs. The extra time can detract from residency studying or improve hand-eye coordination. Nevertheless, I don’t see a strong correlation between the love for music and becoming a better radiologist in the way you might think!

So, How Do Hobbies Correlate With Becoming A Successful Radiologist?

Well, here is the kicker! None of these hobbies have much to do with the quality of radiologist that you will become. (as much as you might think!) However, having a hobby is more important than the hobby itself. You have something else to discuss and fall back upon when things may not go your way during residency. So, don’t worry about your hobby per se and how it will turn you into a great radiologist. It will not transform you into the “radiologist Excalibur.” In that respect, it is not so important. But add your hobbies to your application because it adds to your persona and character. We do like real people in our specialty of radiology!