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Top Ten Signs It’s Time For A Radiologist To Retire!

retire

I’m sure many of you have encountered radiologists who should have retired years ago but are still hanging around. Maybe they are burnt out. Or, perhaps, life has thrown them a few curveballs. Here are some of the top ten reasons why you know it’s time for your fellow radiologist to retire!

One Extra Case Sets Them Off

You probably know one or two radiologists like this. If anyone asks them to help with another case, they will lay it thick on you. Perhaps, they will yell and kick, or they will say they need to get home and can’t afford the time it takes to complete it!

They Can Only See Films From One Eye In A Certain Position

Some radiologists will do almost anything not to go to the doctor. They hang around longer than necessary in practice. I have known a few that would practice with ailments for which I am not sure they can compensate. For many of these radiologists, it may be time to pack your bags!

Spend More Time Napping During The Day Than Reading Cases

In the past, I used to know a radiologist or two who would spend a few hours in their office while everyone else was working hard. Some residents saw them getting shut-eye while everyone else struggled to keep up with the work. If you get to this point, maybe you should be getting up late every day at home without having to read films!

New Ailment Every Day

I’m sure you have heard of a radiologist who always seems to get sick. One day a heart condition, the next day, a limp, and the next day a raging cough. Some folks are too frail to make it to work. If that is you, it may be time for you to nurse yourself back to health and take some time off. It will do you some good.

Yells At The Medical Students Upon Arrival

Poor students. The wrath of some attendings manifests itself on the underlings that come in to visit. They are angry at the world and take it out on the learner. No, it isn’t right. But, it does happen. These folks need some time off to think about their behavior!

They Are Reading 400 Cases Per Day

Most practices have one radiologist that reads too much to be safe. If you are reading four hundred or more cases per day, I feel you are missing a lot of critical findings. Think again if that is what you want or if it’s simply time to slow down.

Flagged Cases So That A Particular Radiologist Will Not Read!

If you have your name tagged on one too many cases, it may be that another one of the radiologists is not allowed to read this referrer’s studies. Or, some physicians whisper about another radiologist and don’t want this person reading the cases. Either way, it’s not a good sign. It likely means that this radiologist is not doing his job well. This radiologist may want to give up and stay home.

Their Cases Always Seem To Make To Morbidity And Mortality Conference

Ever notice that the same radiologist’s cases make it to morbidity and mortality conferences? Well, perhaps, it is for a good reason. All their misses contribute to the holistic lousy patient care. Be on the lookout if this radiologist is in your department!

No One Can Speak To Them Anymore Or Ask Questions

Some radiologists stay away from this one colleague. Unlike most colleagues you can bounce ideas off of, they can’t ask any questions of this person for fear of yelling and negativity. You probably have someone like this in your practice. There is a good chance that it is time for this radiologist to retire!

Always Complaining That They Should Retire

Everyone knows of a radiologist that constantly talks about retiring. They say it in myriad ways, and it becomes a real bear to hear. “I can’t stand work it’s time to retire,” “I can’t take it any more and it is time to go” are the statements they make all the time. Well, do it already!

Reasons It’s Time For Radiologist To Retire

No one can work forever. But, I think that these reasons to retire soon do justice to those folks that should pack it in sooner rather than later!

 

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Should Teaching Programs Hire Non-Teaching Faculty?

non-teaching faculty

At almost any hospital residency program, you will have a mix of faculty with all different interests. Some like to teach and spend concerted time with the residents. In some more academic hospitals with residencies, other faculty want to pursue research areas. And then there is the final group that wants to put their energies into completing the day as quickly as possible and returning home to family without wasting time on other endeavors. So, today’s question is: should hospitals and practices with residency programs hire these non-teaching faculty if they have a residency program dedicated to teaching? To answer this question, let’s talk a little about the current hiring environment in radiology. And, then let’s discuss the advantages and disadvantages practices and hospitals face when hiring non-teaching radiologists in the current climate. And finally, we will come up with a feasible conclusion.

The Current Hiring Background For Radiologists

We are in the midst of one of the most acute shortages for radiologists in 2022 as it stands right now. Even residents that have not completed their training receive solicitations for work. It is not uncommon for practice owners to cover unwanted shifts to ensure their practices run smoothly due to a lack of personnel. And, starting offers for new radiologists are robust. A “warm body” that can read and catch up on all studies is a treat for many sites. So, many practices can prevent a practice crisis if they hire radiologists to do the work but do not want to teach, but at what price?

Disadvantages To Hiring Non-Teaching Faculty At A Teaching Site

If They Don’t Have To Teach, Why Should I?

The biggest fear for a practice of mixed radiologists is the impression of inequity. When radiologists see that they can get away with less responsibility, you may hear the phrase “it’s not fair” bandied about. This unfairness leads to decreasing morale and radiologists thinking about leaving practice for greener fields elsewhere. This environment can be toxic even if you compensate faculty members for teaching.

Does Not Foster A Culture Of Inquiry

To create an excellent residency program, I like to say you need a culture of “why.” I love when my residents ask why about the reports, procedures, or protocols they see. It forces me to rethink my training and beliefs to analyze what we do “by rote’. And, it’s a great way to reinforce and learn new knowledge for attendings and residents. Disinterested attendings who do not participate can spoil this excellent learning environment.

 Advantages To Hiring Non-Teaching Faculty At A Teaching Site

Free Up Teaching Faculty Who Want To Teach

If you can isolate the non-teaching faculty to rotations that do not involve teaching, you can allow the teaching radiologists to teach without the hindrance of backed-up work. Freeing faculty members who want to teach can theoretically improve the teaching faculty’s morale. However, the practice would need to decide on a protocol for which it will not degrade residency training.

Can Get More Work Done

You may have heard the adage, “a resident will slow you down.” Yes. There is some truth to that. It takes time to explain and go over dictations and give lectures. If you do not have these responsibilities, it is possible to plow through extra work throughout the day (perhaps with a headache!). Practices with some attendings that work without residents can theoretically accomplish more RVUs during the day.

Should Your Teaching Practice/Residency Program Hire Non-Teaching Faculty?

There is always more to a decision that might be easy at face value in a typical environment. New radiologists that do not teach can cause inequities and do not foster a teaching culture. Nevertheless, freeing up teaching faculty and getting the practice work completed is critical. So, if you see a new grumpy radiology hire that does not want to teach residents and is plowing through the cases, there is a good reason for that. Many practices are under duress to hire a body to fulfill the work of the business, not just to teach residents. However, programs that employ these radiologists must ensure they are not on teaching rotations to minimize conflicts. Instead, programs should make a concerted effort to plug in those attendings that want to teach to the divisions with the most exposure to residents. It may take a bit of adjustment on the part of the resident and the faculty until the radiology shortage resolves!

 

 

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The Last Case Bolus Phenomenon!

bolus phenomenon

Ever notice that the end of a shift tends to have a bolus of cases? Just as you are allowed to leave the building, you find yourself with multiple studies that you need to read emergently. Usually, they are more complicated, and you don’t leave your station near when you are “supposed to be” finished. Well, this bolus phenomenon is not by any means random. Based on logic and my experiences, there is much more to this phenomenon. So, let’s go through some of the causes why you suddenly experience more cases that can often be the most difficult ones right at the end of your shift. You may be surprised at the reasons!

Transitions Are Not Smooth

Down in the emergency department, just like in radiology, no one wants to leave over work for the next ER attending shift. So, they will often order a bolus of cases so that the next physician does not have to write for them. This process causes a sudden cluster of studies in the radiology department. And, at this point, toward the end of your shift, you also feel the heat.

The ER Doctor Likes Your Work

Here is some good news/bad news for you. Guess what. Sure it’s great that the ER physician downstairs likes your dictations and diagnostic acumen. You have made a friend for life! However, that same phenomenon can lead to a bit of pain; right before your shift ends, they will try to get in as many patients as possible so that the physician downstairs will get all your dictations before the subsequent radiologist arrives. Sometimes, it does not pay to be the best!

ER Shifts End The Same Time As The Radiologist

Unfortunately, we like to begin and end shifts at typical times. Ten o’clock can be a standard time for physicians to leave. So, as the radiologist, you are not alone at that time. Therefore, you will receive the bolus of cases that need a disposition at the same time that you will leave. In this case, you can resolve this issue by changing the timing of shift changes so that they don’t coincide.

Transport Logjam

Ever take a gander outside the reading room, only to see ten patients in beds in line in the waiting area, waiting for their study. A lack of transporters can often cause this logjam. And, the same lineup often happens in reverse when they need to leave. These logistical issues often occur when your hospital does not pay enough to get these transporters to do their jobs. A hospital is only as good as its weakest link!

Pressure For Disposition, a Definite Cause For The Bolus Phenomenon

Finally, some emergency medicine physicians can become fickle. These emergency medicine physicians delay and protract until they finally decide what to do. And they must make this final decision before the end of their shift. To do so, they will probably need that definitive imaging study to confirm or refute their suspicions. So, these examinations culminate their thought processes right before they leave. You are there reading CT scans for them to reap the benefits!

The Last Case Bolus Phenomenon Is Not Random!

It feels painful to experience a large cluster of cases at the very end of your day, right before the end of your evening. However, contrary to what you might think, it is not a random process. Poor transitions, ER physician fans, problematic timing, transporters, and pressure for disposition, are all factors that often cause this bolus phenomenon. Some of these factors you can change and others not so much. It’s one of those hazards we experience when a shift is about to end. It’s just part of the job!

 

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What Milestones Will You Achieve At The Age Of 50?

milestones

Now that I am on the cusp of hitting the big 50 and I have been practicing radiology for nearly twenty years post-residency let me give you some thoughts about where I have gone in my radiology career after residency and fellowship. Life does not end after residency. By showing you my career path and milestones, I hope to give you a bit of perspective on the twists and turns you can expect in your career. Also, you might find it enlightening to see the critical junctures I had and apply them to what you may want to do as you go along in your practice. I will start when I just finished my fellowship in 2004, summarize what happened in approximately five-year intervals from 2009 to 2019, and finish with the present. 

2004- My First Job

As I had just started my first practice, my first goal was to get as much experience as possible to become the best radiologist I could be. Also, paying off my student debts and saving for the eventual purchase of a house was first and foremost on my mind. At this point, I would work extra shifts and read as many cases as possible; it was a considerable adjustment after six years of postgraduate training and medical school. I made sure to attend loads of courses to keep up with radiology. And I was excited to start on a path to a partnership tract. (Turns out that happened during my second job!)

2009 – Partnership Begins

After this point, we had paid down our student loans (one of the significant milestones) and lived in our house for a bit. After years of medical school, residency, fellowship, and partnership track, I felt what it was like to settle down in a stable career; I became ensconced in the radiology residency and began to take on new roles once I started as a partner in a partnership. And, I began to learn a bit more about the intricacies of the business of radiology, not just the day-to-day practice. Work and routines became more familiar and seemed like a family.

2015-2016- Expansion And New Roles- Many New Milestones

Our practice began to grow incrementally with the acquisition of new hospital contracts and outpatient sites. Learning about how mergers and acquisitions work was fascinating as part of this expansion. And I became the medical director of one of our outpatient sites. To this day, I continue to run this private office. During this period, I learned about all the organizations and issues with new sites, ensured appropriate staffing, and began covering all the different areas at this site. The outpatient office has become a second home within the practice for me.

Then, in 2016, I decided to start up radsresident.com on a whim due to my interest in teaching and the internet. Still, it has been an incredible experience that merges all the aspects of radiology, technology, and writing that I enjoy. And it’s been going strong ever since!

2022- The Fun Continues

To this day, I still enjoy the complex cases and people that I have met in radiology since I started. Although I am no longer gung-ho about working extra shifts like at the beginning of 2004, the residency program, this website, and my day-to-day work continue to challenge me. And I look forward to going in to work every week. Moreover, extra-curricular activities play a more significant role in my life. Yes, they have changed over the past twenty years, but they are critical for having a fulfilling life and career.

What Are The Milestones You Expect Over Your Career?

Indeed, I could not have exactly predicted what would happen to my radiology career since my fellowship ended. If you had told me after finishing my training in 2004 that I would be running a blog, a residency program, and an outpatient office while being a partner in practice at 50 years old, I am not sure if I would have believed you. Changes along my career path have made the past twenty years enjoyable. So, I advise you to embrace the milestones you will experience in your career. It will make for a much more rich and exciting path. For me, I expect the next twenty years to be no different!

 

 

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How To Keep Tabs On Incomplete Radiology Studies

incomplete radiology studies

At least once or twice a week, there are some incomplete radiology studies that you can’t read at the moment. Perhaps, the referring physician is not available to go over the results. Or, maybe the study has a technical issue before you dictate it. Other times, it’s a challenging study you want to share with your colleagues to get another opinion. 

You must complete these cases in any of these situations, but an issue or two prevents you from getting to them. Dropping the ball on any of these cases can lead to problems in the future. So, what is the best way to remind yourself to complete these tasks and finalize them? Should you use electronic or written materials for this task? Let’s go through some options some radiologists deal with some of these issues. Hopefully, this piece will help you to come up with a system as well.

Using Your Memory

For most of you, this technique would be the one I would avoid using alone. It’s a recipe for disaster unless you have a photographic memory you can turn to at any moment. You will most likely forget the critical information you need to look up the patient information and forget about the case itself.

Keeping Cases On Paper

Some real old timers I know kept a list of these critical cases in a tiny notebook they used to whip out at times. I know a few that would swear by this technique. They would typically write the name of the patient, the MR number, the date of birth, the phone number and name of the clinician, and the issue with the case itself. One of the most significant advantages of using a system like this is that you don’t have to worry about HIPAA violations if you keep the book safe. No one can access the patient data except for you. However, if you lose that book, you are SOL. And, it is easy to forget to come back to these patients.

Keeping Incomplete Radiology Studies On A Phone In Notes/Reminders

This method is the primary way I remember to take cases needing further involvement. I will put the patient information in a locked notes folder on my iPhone. And, I typically write down the information I will need to return to complete the case. By doing this, I know that I have all the information for the patient, safe and sound. Additionally, I check these data lists daily to ensure that I do not forget their further workup. If there is something that I need to take care of more urgently, I will typically serve myself a reminder as well to complete the task at a specified time/date.

Using The PACS System To Help You Out

Finally, some PACS systems have features that can help you with these errant cases. Some have instant messages for tech recall issues. And others have automatic messaging of critical findings. At our institution, I will typically tag my name to a study so that I will continue to see it on the worklist until I do the task. This method is another fail-proof way so that cases do not slip through the cracks. But, I recommend you look into some extra features on your PACS system that can help you a bit!

How To Keep Tabs On Incomplete Radiology Studies

We need practical tools to remember to complete delayed cases. Dropping the ball and forgetting about them is a recipe for disaster. So, find a way to recall these cases that work for you. Whether it is paper, notes/reminders on an iPhone, the PACs system, relying on your memory, or any combination of the above, make sure you have a plan in place. Some cases need the extra love!

 

 

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How To Learn Buttonology As A Radiologist

buttonology

When starting in radiology, the trickiest items to learn are often not the images, procedures, or concepts. Instead, figuring out what buttons to push to find what you want can be the most challenging. Electronic health records, PACs (picture and archiving systems), dictation software, and internet access and use can vary widely from institution to institution in quality and useability. And you may find that figuring it out can take a very long time, especially learning it efficiently. So, how do you set yourself up to learn the ropes when you need to figure this all out? Let me give you tips on how to go about learning all this technological buttonology.

Set Some Extra Time To Play Around With Buttonology

Time is your friend. Spending time practicing with the dictation or the PACs system is the best way to gain familiarity. Anyone can show you the buttons to press, but the chances of remembering how you did it can be close to zero. Only after manipulating the controls can you get used to how the software functions. And, it’s even better when looking at real-world cases. For me, software like Tera Recon has only become relatively easy to use after the tenth time I have processed a cardiac CTA. Also, I remember spending extra time trying to create templates on Powerscribe for dictation so that it was easy to do and could serve me well later on with numerous dictation templates. Time spent now will save oodles of time in the future.

Get To Know Your IT Specialists

Most institutions have dedicated staff to maintain and support PACs, RIS, and the internet. Suppose you want to get to know a function or filter better. Sometimes you have to ask them. I have found that I will sometimes spend three times the duration compared to an IT specialist to figure out how to overcome or improve an issue with the PACs station. So, be nice to these blokes!

Ask Your Fellow Residents And Faculty

When learning the buttonology of your systems, this point is not the time to be shy. I have always said that if we put the heads together of all the faculty, we would have the most comprehensive knowledge of how our electronics and software work. We all seem to know bits and pieces of these systems that can increase our efficiency. But, not everyone knows the same things. So, please, also ask your colleagues if you are unsure what to press or when. It can make all the difference.

Don’t Miss The Training Sessions.

Most of us don’t enjoy these training sessions. They usually interfere with our day (and even prevent us from eating lunch!) Nevertheless, take these sessions very seriously. They can enhance your daily efficiency in spades. I still remember when our hospital acquired the new PACs system; I spent a ton of the time making sure the hanging protocol for plain films and priors was suitable. Fast forward to today, and the couple of days I spent with a personal PACs trainer years ago have magnified my daily efficiency by a significant multiple compared to those who didn’t attend. It pays to stick around for the additional attention even though you may experience pain!

The Magic Of Buttonology!

The quality and efficiency of every day depend on much more than just reading films. We need to be aware of how we can slog through the technical work of each day most efficiently by clicking the least amount of buttons and technological obstructions. But, it would help if you spent the time to learn the buttonology. So, give yourself some extra time to get to know each of the systems, ask your colleagues and staff if unsure, and do not miss any additional training sessions. Missing out on any of these extra steps will divert you from your ultimate target of maximizing your efficiency!

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Don’t Skimp On Sensitivity!

sensitivity

In radiology, almost anything can change our sensitivity to detecting disease. Problems with electronics and hardware such as PACS, the RIS, imaging software, or even dictation software can cause us to miss out on information. Phone calls and texts can interrupt our train of thought. Many of these problems can be beyond our control. But, there are also ways that we are directly responsible for our daily reads that can affect our sensitivity. So, what are some main ways radiologists can knowingly skimp on sensitivity to negatively affect patient care?

Not Getting Priors- A Template For Decreasing Sensitivity

Out of all the ways we can negatively affect patient care, this one likely has the most bang for the buck. Whether we need to search for changes that can affect chemotherapeutic regimens or determine if a pulmonary embolus is acute or chronic, we can severely decrease pathology detection and change patient management when we neglect priors. It is certainly worth the extra time to look at the prior studies!

Not Reading The Prior Reports

Just as critically, it is not just about searching the priors but also about reading the previous reports. I can’t tell you how often I have discovered items in the information that are the reason for performing the following study that may not be so obvious if you don’t read the prior dictation in addition to looking at it. It could be an incidental tiny pancreatic cyst or a subtle rib sclerotic rib lesion that you might not realize by just skimming the previous images . In either case, you must also make sure to peruse the prior reports to maximize sensitivity.

Using The Correct Software For Imaging

It is effortless to skimp on interpreting images when the programs are slow or unwieldy. However, we are obligated to look at studies in a way that will maximize sensitivity. That may involve looking at a PET scan on the appropriate interpretation platform or using the reconstruction software for coronary artery CTAs. If you skimp on this step, you are much more likely to miss disease that can negatively affect patient management.

Windowing/Protocols

It is much easier to go through a study if you don’t take the time to go through bone and liver windows on a CT scan or neglect the diffusion-weighted sequences on an MRI of the abdomen. However, by forgoing these steps, you are also sacrificing sensitivity. Sure, it’s nice to get home a bit earlier. But is it worth the outcome of missing a liver lesion or a hidden enlarged abdominal mesenteric lymph node?

Not Waiting For All The Images To Arrive

I get impatient when the computer sends the studies over slowly. That happens to almost everyone once in a while. And, it is very tempting to interpret the images based on the images that you have alone. But, for instance, axial CT scans images without the coronals, and sagittal can cause you to miss compression fractures, renal masses, and more. Don’t skimp on the waiting for these last images to cross over.

Skimping on Sensitivity!

We, radiologists, have taken a Hippocratic oath. This oath obliges us to do no harm. Although we are under pressure to complete all our cases, we must best answer the clinical question appropriately without sacrificing sensitivity. Or else the study can become worthless or, even worse, harmful to the patient. So, make sure to cross all your t’s and dot all your i’s by checking for priors, using the correct software, looking at all the windows/sequences, and not being impatient before interpretation. These are simple ways to increase our sensitivity and ultimately improve patient care!

 

 

 

 

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Great Expectations For The Radiology Resident

great expectations

The wait has finally arrived. After years of biding your time in medical school and residency, you are finally en route to what you want to do: begin training as a radiologist. And radiology residency begins. But, is it all that you had expected after all these years? Are you getting unadulterated teaching from your faculty as you had hoped? Is the learning at noon conferences with enthusiastic and engaging staff? Do the fellow residents live up to the great expectations that you had in the first place?

Well, there is a good chance that any residency program that you choose will not entirely live up to your great expectations. So, coming from an associate program director, what are reasonable expectations for your residency program when you start? And what are some unreasonable expectations for your newfound position? Let’s discuss these expectations by expounding on what is reasonable and limited. Then we will summarize the best way to treat these expectations overall.

Reasonable Anticipation

Reading Alongside Attendings

Any program worth its salt needs to have some time dedicated to having residents listening and reading along with attendings. At the beginning of the residency, the only way to know radiology is to listen to how your mentors interpret films and dictate. And this means some dedicated time to watch, listen, and learn the ropes in real-time with a radiology faculty member. A residency cannot survive for long without this factor.

Ability To Ask Questions

If your faculty shuts you down or insults you whenever you ask a question, you cannot thrive in residency. We learn by asking questions. And in the beginning, there is no such thing as a stupid question. Heck, you don’t even know what to ask! But, if your faculty scolds you for asking questions from your mentors, this would be an example of a malicious program to residents and learning!

Monitoring Your Dictations

Any residency should ensure that its residents are dictating and interpreting films appropriately. It is the currency of radiology. The only way to do that is to assess the outcome of the radiology process. And that is the final report or dictation. All residencies should have a system for attendings to review resident dictations. This process is an essential factor for learning.

Feeling Safe

If you feel like faculty members threaten you or fear for your sanity (or life!), you have a real problem. No person can go through such a stressful learning situation in addition to the stresses of radiology residency (and yes, radiology training is considered stressful!). Nor should any resident have to encounter a problem such as this.

Unreasonable Expectations

Unadulterated Attention From Attendings At All Times

Whether you are in a research institution, University program, University-affiliated program, or community/private practice residency, you will not be the priority of most faculty. Most have research to publish, work to complete, and families to come home to. So, if you are too idealistic that you will receive the attention of all the faculty all the time, you will never feel satisfied.

Expectations That Everything Will Be Taught

Yes. For some concepts, it does help to have a teacher. But, no matter what anyone says, most radiology is self-taught. We need to see 100 cases of appendicitis, thousands of routine chest x-rays, and perform hundreds of paracenteses before we get it all right. No one but yourself can do that for you. And, that does not include all the concepts you need to reinforce and remember by reading in every area that radiology covers.

All Teachers And Colleagues WIll Be Your Friend

Just because we are all radiologists does not mean everyone will be your buddy. Similar to the “real” world, we all have different personalities and desires. And, not all people mesh well together, no matter how much we want that to happen. On the other hand, we all can learn from one another. If you apply every person in your program to this concept, regardless of how they feel about you, you will begin to appreciate them for who they are.

Great Expectations

We all come into new situations with great expectations. But, check for yourself. Are these expectations realistic or not? Any program should fulfill the basic requirements, such as working directly with attendings in a safe environment. But, you can’t expect any program to pull all the challenging weights for you. There is just some work you need to do for yourself. It’s the only way to become an excellent radiologist!

 

 

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Why Mission Statements Are Mission Critical

mission statements

Ever thought about what kind of radiologist you wanted to be? Many of you, you were probably thinking about private practice. Others have thought about writing papers and becoming the academic type. Maybe you are a hands-on radiologist and like to have your fingers on everything. And, a distinct minority of you may have opted for the business route. But have you ever noticed the website of the residency you attended or are interested in joining? Many of you have not thought twice about it. But, at the beginning of your residency website, mission statements describe what the residency program strives to be. Does that match what you have ultimately wanted to become? You may not realize it, but it is probably a pretty good match in most cases. And that is for a good reason. It is what the program that you attended trained you to become.

For those applying to residencies, this message about your residency should play a significant role in your decision to interview and rank the programs you attend. But, it usually is barely a thought within the application process. Getting into a residency program itself can be daunting enough. Nevertheless, I wouldn’t blow this message aside. It could make the difference between a career you desire and one you will regret. And here are the critical reasons why.

Mentorship

If you attend a program with a mission statement that contradicts what you strive to achieve, it can make it a bit more challenging to obtain the desired outcome. For instance, if you are going to a program without a research emphasis and want to learn to write papers, you will have a more challenging time finding a mentor who can teach you the ropes. It’s not impossible. But, you will not find it as easy to learn the tricks of the trade. To get high-quality papers published, you need certain ingredients. And, you are more likely to find the know-how in a program that does say research in its mission statement.

Or, if you are interested in global radiology and the program does not state anything about it, you are less likely to find a radiologist that works outside the country to emulate. You will have a harder time finding the connections you need to make a similar jump in your career.

Location/Reputation

Some programs mention that they are well known regionally, nationally, or internationally. Depending on where you want to stake your reputation, this factor can influence the location of your practice when you finally set up shop. A regionally known residency is excellent if you want to stay in the area. Likewise, if you wish to have connections throughout the country, consider a program with a national reputation. And, if you want international referrals and work, a residency with this reputation may be the right one for you. These choices can impact where you decide to work in the end.

Procedural

You will notice the words hands-on in some residency mission statements. This verbiage symbolizes that the staff has the procedural know-how to train its residents to feel comfortable with many radiology procedures. Not all programs emphasize these skills. So, it is critical to figure out if you want a residency with a procedure-heavy emphasis. It’s not necessarily for everyone!

Cultural Factors

Other mission statements will claim to have to maintain a diverse class. These residencies may utilize culture/race/sex in addition to interests and competencies to decide which residents to rank in their program. So, expect a more racially/ethnically diverse mix in these programs than another one that does not mention this factor. 

Connections and Mission Statements

If you cull through mission statements with a fine-tooth comb, you will notice that they may talk about connections within the community, global resources, businesses/industry, or other departments. Take these connections seriously because they may influence your residency and where you ultimately decide to practice. They may allow you to branch out to other areas that may jibe with your interests. It’s something else to mull.

Mission Statements Are More Critical Than What You Might Initially Think!

When you decide on a residency, that little phrase at the beginning of the residency website holds much power over your future career. Generally, it is a theme that the residency program follows seriously and can impact where you want to practice and what you will eventually do. So, before deciding where you want to go, take a second look at this clause. And determine if the values and ideals derived from these mission statements mesh with yours!

 

 

 

 

 

 

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Do “Fancy” Residency Websites Mean Better Programs?

residency websites

Sure, some residency websites blow others out of the water. They have more fancy videos, smiling attendings, and satisfied residents. Their FAQs are thorough, and the mission statement is clear. But does this fluff and bluster mean you are in for a better ride during your residency? Or, does the word of your colleagues and faculty take precedence over anything you might see or hear on a residency application website? Let’s come to our conclusions. 

The History

Once upon a time, years ago, believe it not, there were no residency websites. And even after that, when I applied in 1997-1998, they were more of a mere afterthought. Anyone worth their salt would do their digging into the ins and outs of residency programs. Programs barely updated their information because the number of eyeballs hitting the web was far from what it is today. It simply was not the primary way to assess a program.

Fast forward to our time, and that is no longer the case. The currency of the world as we know it is the internet. And, if you don’t play that game, you lose.

Does A “Fancy Pants” Website Equal Better?

Let’s talk about some of the positives of well-curated residency websites. First, it shows that the residency program or hospital put some forethought into their online presence. So, it signifies hospital organization and a desire for the entity running the video to recruit residents. Remember. Creating a decent website is not required, so that is all well and good. Therefore, there is a tendency for residencies with high-quality websites to have more resources.

However, websites only show you the best of what the residency program and institution want to show. They will not let you know that they have not met their annual requirements to publish articles. Or, it will not tell you that they barely passed the last site visit due to a lack of faculty motivation. So, be very careful to believe everything the website wants you to see.

How Should You Evaluate Residency Websites In Your Calculus For Making A Decision?

Websites are helpful for a superficial survey of what the program may have to offer. Suppose the mission statement on the website declares that they aim to produce community radiologists. Then, it is probably true that you are looking at a program that deemphasizes research to make residents into good quality overall radiologists. So, if you are gung-ho about radiology research, it may be a way to exclude that residency program.

However, suppose you like the residency because the faces all looked happy, and the culture seemed benign. In that case, you will never know from watching a few videos from the institution and mulling the rhetoric on the website. It is a facade. I recommend checking the institution for yourself to know more about a program’s reputation.

Residency Websites: A Serious Business

Given the competition for the best residents among institutions, residency websites have become more of a significant business than years ago. But, it is a means of promotion. It may not demonstrate all the facts you need to hear before making your final decisions. So, regardless of whether a website is glorious or lousy, look under the cover and dig a little bit deeper if you are still interested in the program. Interview and check out the facilities if you still like them. And, of course, talk to the residents in the program if possible to get the real scoop. Don’t ever rely on a residency website and your primary/only source of information to make your final decisions!