Category: Applicant Advice

Posted on by

Do Board Review Companies Help With The USMLE?

board review

Not all students learn the same way. And, each method of studying has different pitfalls and benefits. For a distractible student, you need an isolated organized environment to study. And, a large group may not benefit this individual. As a kinetic learner, the action of performing a lab or dancing while reciting study material may allow you to absorb the material better. But, sitting in one place staring at a book may not work as well. My point is that board review is not a “one size fits all” activity. And I recognize that.

Moreover, in my experience, I have seen board review companies giving an unqualified boost to some test-takers in question. And, others who have not taken a board review course do just fine So, to answer the question posed on this post, do board review companies help medical students and residents with the USMLE, I will have to be a little wishy-washy and give you an unqualified maybe!

But if you are reading this post, what you are asking is will a board review company help me. And, perhaps, even more importantly, is the course a waste of money and time? So, another way to word the question would be, what types of medical professionals would and would not benefit from using a board review company? And, those are just the questions that I will answer!

Students That Benefit From Using Board Review

Residents Without Organizational Skills

What board review companies do best is to provide you with a routine and a defined way to study for the examination. They give you the material that you will need to make sure that you will pass the exam. For some students and residents, the course leaders’ material and the demands provide a bit more structure. Of course, a system and a routine can allow these test-takers to focus on studying for the exam.

Poor Test Takers

Some residents and ‘medical school students either develop anxiety or think too deeply about a question and perseverate for a half hour. Board review companies are good at making sure you understand the how’s and why’s of taking tests to improve your test-taking skills. What’s interesting about many poor test-takers is that they don’t necessarily translate into bad radiologists. In this situation, a board review company can provide a bit of a boost to your scores. It is most likely worth your time and money for that extra help if you consider how much more you will make in your lifetime.

Previous USMLE Low Board Scores Failures

They say that the definition of crazy is expecting a different outcome after doing the same thing again. Well, anyone that has not done well on a board exam beforehand should utilize the extra help to get you over the hump to increase your chances of acceptance into the radiology fold! Board review companies can help to change the way you study the next time around.

Students/Residents With Borderline Credentials For Acceptance

If you are a resident toward the middle or bottom of your medical school class, a higher score on Step I (Or now Step II USMLE with the new changes) can make all the difference between acceptance to residency/fellowship and rejection. Many residencies (and to a lesser extent fellowships) will use cutoffs in Radiology to ensure that the accepted class will pass the core exam. Why? Because there is a correlation between doing well on the USMLE exams and passing the core exam. And, a boost of only 5 points on your exam can make all the difference between capturing that interview and total rejection. It’s probably worth it to shell out that extra dough.

Foreign Applicants

Finally, if you are coming from another country, the programs will scrutinize your application more. Any advantage can help your case. If you have reached this far, you are better off taking a course even if it only increases your score by a few points. It may make all the difference!

Students That Don’t Need The Extra Help

Natural Born Test Takers

Yes. Some students and residents can take almost any test and pass it with flying colors. (Aren’t you jealous?) They have just mastered the art of examination to a tee. Based on the question itself, regardless of the information at hand, they can almost sniff the right answer. If that is you, then forget about board review. Save your money!

Honors in Every Course With Twenty Papers Already Completed

Check. Some folks have had an incredible academic record, and no matter what will get into the residency of their choice with or without excellent board scores. If this person is you, why bother to pay up for another exam?

You Get The Point!

I think you see what I am getting at here. Some folks don’t need to pay for that extra boost of a few points. It may not be worth the extra outlay of cash for those folks.

Board Review Companies Work Well For The Right Fit!

I know how painful it can be to shell out a bit more money when you already have umpteen gazillions of dollars of debt. But, sometimes, it is worth it to pay up for the additional help, especially if it may mean the difference between having a long career in the specialty you want. Having a guide that can get you through the pitfalls of studying for these tests is invaluable for the right sort of test-taker. So, consider where you stand and decide if it is right for you. Here are some of the more frequently used board review companies below that my residents have used to help you along with your decision. You can click on them if you are interested. I am an affiliate of both! (Princeton Review currently has a discount that expires on September 3!)

 

 

 

 

 

 

 

 

 

 

 

Academic Tutor LOL (24 hrs) – $180 Off!

Posted on by

How To Do Remote Learning The Right Way

remote learning

Not all programs are alike. Some have advanced IT departments that will create whatever materials the faculty wants. Others have barely entered the digital era. Regardless of how far along the curve your program or hospital sits, we’ve all been thrust into this brave new world, now that residency programs and radiologists demand social distancing.   So, let’s look at the requirements that remote learning tools should satisfy to be successful.

If you are looking to apply to programs, ask whether the residency has these tools. Or, if you are a resident or faculty member in a residency program, try to push the residency to get them. Residencies that do not have most of these remote learning tools are way behind the times!

What Do Programs Need  For A Successful Remote Environment?

HIPAA Compliant Online Meeting Places

As much as I am a fan of Zoom, it  does not allow for safe discussions about sensitive subjects. Just take a look at this Forbes article from the end of April 2020. We certainly cannot entrust private conversations about patient cases in this environment. Residents and attendings alike need to discuss patients in a setting where they don’t have to worry about hackers entering a meeting. If your hospital or imaging center insists on your radiologists using Zoom or other insecure remote viewing tools to look at patient images and information, it can put the patients and radiologists at risk.

Remote Application With Ease Of Use

What good is a remote tool if it takes you 2 hours to get on the network? We need to be able to reach our intended colleagues and fellow residents rapidly. Sitting in front of a computer and waiting a half hour to get past the initial page is not acceptable. All the remote tools must be quick  use for anyone to logon.

Also, remote access tools need to be turnkey. We should be able to rapidly learn how to use them and have our colleagues respond accordingly. Moreover, hospitals should have networks to enable easy access to these resources.

Attendings and residents alike should use these online tools to go over cases and procedures together. Any faculty member or resident should contact each other with them at any time during the workday for learning.

Online Radiology Library

We are no longer in an era where we should need to have one resident wait for someone else to finish reading a radiology text from the library. All residents should have immediate access to both standard textbooks and relevant radiological periodicals online. Any hospital that does not allow for this needs to get with the times. A well-read resident should have all the reading materials that she needs.

Remote Noon Conferences/Scheduling

In addition to HIPAA compliant meeting places, all residencies should have their attendings ready to give noon conferences on the remote access tools. And, that implies all faculty members that provide lectures. It is no longer acceptable to have lecturers unable to give a noon conference because they do not know how to access or utilize the remote meeting applications.

Remote Attendance/Check-ins

Many programs have their residents digitally check-in in the morning or at the start of a noon conference to document that they have attended. Additionally, programs should have the online logs of cases that residents have performed or watched, not just for the six-month resident evaluations, but also for the program itself. This documentation helps with compliance to show that the residents have completed the appropriate requirements of residency. If public schools throughout the country can utilize remote attendance, radiology programs can undoubtedly do the same!

Acceptance Of The Remote Learning Environment

Finally, and probably most critically, all programs need to create a culture where we embed these tools into the fabric of the daily work. All attendings and residents alike should feel comfortable using these remote learning tools. And, they should make use of them whenever possible. There should be no excuses as to why the players within a residency program can’t work with the remote learning tools!

Remote Learning: The Way Of The World

Remote learning is no longer just a fancy accoutrement or add-on to a residency program. It has become a requirement that all residencies should  satisfy to maintain the health and welfare of the residents and faculty alike. These factors should be the bare minimum for a successful residency experience. My advice: make sure your program takes remote learning seriously. It is a necessity for radiology learning today!

 

 

 

Posted on by

Online Interviews: A Waste Of Time Or An Effective Screening Tool?

online interviews

We are not the first. Many industries have been using online interviews for candidate screening for a while now. Yet, we, in the medical field, have shunned using these technologies for resident interviews for years. As physicians, we have felt the interpersonal connection of a live in-person interview was critical for candidate selection. Now, for the first time this year, the pandemic will force radiology residencies, like all other medical subspecialty training programs, to follow suit.

But, what do we gain and what do we lose by ending the in-person interview process? Are residencies going to recruit a higher percentage of unprofessional or incompetent residents? Or, are we going to discover that the format of the interview matters less than we ever thought in the first place? Lots of questions remain up in the air for this year. So, let’s talk about some of these issues by discussing some of the benefits and disadvantages of the online interview process. Then, we will end off by coming up with some hints for prospective interviewers and predictions for this interview season.

Advantages Of Online Interviews

Saves Tons of Cash

Fourth-year medical students are some of the most debt-laden medical professionals out there. By this time, many have accrued hundreds of thousands of dollars in debt. In the past, programs expected them to shell out umpteen more dollars to attend an interview. No longer. Save on your travel and interview expenses, rapidly adding up to thousands of dollars.

Time Savings

All that time that went into travel before, now you can use it for other purposes. Whether you desire to catch up on Netflix  or study a bit more for exams, additional “me” time is always useful.

“Decreased Pressure” For The Interview Candidates

Indeed, in previous years, live in-person interview situations were a bit more nerve-racking. Of course, with the new online changes, lack of this direct pressure can lead to false comfort levels in the online setting. However, there will be no more sitting and chatting with colleagues in the seats next to you, drumming up your anxieties before your interview!

Disadvantages Of Online Interviews

More Difficult To Get A Feel For The Program

Residency directors and chief residents will now have a tighter grip on the interview process. They will be able to show you more what they want you to see- no more wandering around the premises to figure out what happens in the hospital. You will only get online tours, carefully curated to ignore all the negatives. Moreover, you won’t get a chance to talk to that disgruntled resident in the corner. It will make it that much more challenging to make a final choice!

Also, you will miss meeting anyone in the program, not on the Zoom meeting. These include other physicians, residents, program coordinators, technologists, and more. From my experience, critical staff such as these can also make your residency a delight or a misery.

Harder For Programs To Get At The Real Candidate

The longer you stay in an interview situation, the more likely your real personality will shine. If you get bored quickly and are at the live program director’s lecture, you are much more likely to start using your cellphone. Now, with only a few online interviews for 15 minutes apiece, it will be easier to maintain your cool without lapsing. And, you can have the program director only see what you want! But on the other end for the interviewers, it will be harder to catch the nuances of both candidate and program director personalities alike. That sidewards glance or frown can be much more difficult to detect in a Zoom meeting. Or, we can no longer detect an unkempt smell. It is just not the same. Programs may not get what they bargained for when they match prospective candidates for the following year.

So What Should You Do To Make Online Interviews Worthwhile? (Hints For Online Interviewers)

You need to treat the interview as you would if you were going to an on-site interview. Maintain the same dignity and decorum as you have otherwise. A lapse in judgment or the wrong statement can throw a wrench in the process just as it would have done in years past. By that same token, I would recommend you take a look at some of my previous blogs on this subject, such as Ten Ways To Sabotage Your Radiology Interview and How Important Is My Radiology Interview, Really?  And don’t wear a fancy top or suit and forget to wear pants even though you are online. You never know. You may accidentally stand up and show your briefs!

Predictions For This Interview Season. Will These New Radiology Residents Be Better Or Worse?

In general, interviews are sometimes helpful to weed out candidates that don’t fit the mold of a particular residency. For the most part, I believe that these online interviews will mostly give the same information about candidates as in years past. Candidates will usually put on their best airs regardless of the interview forum.

However, this year, we may see a candidate or two slip through the cracks that would not have made it past the interview process in the past. We may miss some subtle hints, more evident in an in-person forum. But, I believe this to be a very, very small percentage of the total candidate pool. Most likely, this will be hearsay and conjecture anyway, because it is complicated to measure the quality of the candidates in any given year to the previous ones. Nevertheless, I will wait and see this year’s results. The truth will eventually come out!

Radsresident.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to amazon.com.

 

Posted on by

USMLE Step 1 New Pass/Fail Grading-Winners and Losers From A Program Director’s Perspective!

grading

Every year, program directors spend large amounts of time and effort in the application process to select qualified radiology residents. Currently, we rely upon sparse information to ensure we get capable residents. And, one of those pieces of data includes one of a few items that discriminate all applicants equally regardless of institution, nationality, or sort of medical school degree: the USMLE Step 1 examination. But, that stream of information will become even more meager. As some of you may have heard, as of 2022, this USMLE Step 1 examination will become a pass/fail examination. As a result, we lose out on a discriminator that can assess a resident’s ability to pass exams and correlates to passing our radiology core examination. Unfortunately, these changes render the test useless for our purposes.

So, we will need to rely upon other methods to select residents that can pass a radiology board examination. In this case, let’s take this issue on step further. How is the new grading system going to affect applicants? And, who will be the winners and losers? Let me guide you through what I predict will happen once the new grading system for this exam begins.

Winners

Ivy League Medical Graduates/Medical Schools

Since we are losing out on one of the few means of equalizing all applicants, we will have to rely more upon the “name” of the school rather than the individual data points. Therefore, known medical schools will take on higher importance in the application process. Regardless of quality, the system is forcing us to use the institution’s reputation over the quality of the individual’s data.

Poor Test Takers

For those folks with problems passing an examination, this change will help somewhat. You will have one less exam to obsess about your score, now that you only have to pass the test. Of course, you will now need to do well on the Step II examination. And, this test will probably replace the Step I exam as a screening tool for the ERAS application to our specialty. But, it is one less hoop for the average poor exam taker to jump through.

Step II USMLE Examination Review Courses

Now that acing the Step I examination no longer becomes significant, program directors will need to rely on another indicator for test-taking abilities. And, the only one left during the residency will be the Step II examination. So, this will force applicants to take this examination m0re seriously. So, you will probably see more Step II courses sprouting up to help applicants score well on this test.

Losers

Foreign Applicants

As program directors, we like to compare apples to apples when assessing resident applications. And, many times, it is harder to determine the quality of a medical school when it does not adopt the standards of the ACGME. So, we need to rely on other means to assess the residents. Now, we lose out on another data point to do so. Therefore, foreign residents will be the first to lose out in the selection process at the expense of other standardized medical institutions.

Radiology Program Directors

For several reasons, this will hamper our radiology residency selection process. First of all, we are losing out on one of the only examinations that correlate with passing the core exam. Therefore, theoretically, we will be accepting more residents that will not be able to pass a standardized test, the core examination. Second, we will have a smaller pool of applicants from which to choose, now that many of us will require applicants to take the USMLE Step II as our “test-ability discriminator.” Third, we will be more delayed in waiting for Step II exams to come in for the ERAS application. And, finally, we will have one less data point to use in our assessment arsenal.

Step I Pass-Fail Grading: Changing The Playing Field!

Tweaking the testing process always changes the outcomes for those applicants that take them. And, the new grading system for the USMLE Step I is no exception. In the radiology application process, there will be clear winners and losers. Foreign applicants and radiology program directors will get the short end of the stick. Meanwhile, Ivy League applicants and poor test-takers will benefit a bit more. And, to assess applicants, we will become more reliant on Step II USMLE examination. So, these are the main changes that lurk over the horizon. Get ready to change accordingly!

 

 

 

 

 

Posted on by

Things To Not To Do When Ranking A Program Number One

number one

For those of you involved in an NRMP matching process (radiology residency or fellowship), you only have a few more weeks to finalize the rank list. But, the most significant decision is to rank number one. Why? Well, you have around a fifty-fifty chance of getting that spot if you are thinking about putting it down on your rank list, better than any other place. So, how do you make sure that you are clicking the right program when you finalize it all? Well, to sure ensure your sanity and make sure you have the best likelihood of getting this spot, here are some things that you should not do with your number one ranked program.

Don’t Play Mind Games

It’s not worth thinking about whether or not the program wants you badly. That should play no part in the assessment to rank a position as number one. Only, and I mean only, should you list a program first if you want to go there. It would be best if you only took your assessment of the program into the equation. If the program selected you and you didn’t want the program, where does that leave you? In a matching spot that you don’t like, of course!

Don’t Lie

It is unethical to let a program know that you are going to be ranking a program first unless you mean it. Some programs will use this information to rank you higher if they liked you in the first place. (a residency will not change their rankings if they don’t!) Regardless, if for whatever reason, you decide on a different program than the program that you said was your first choice, and then match with another site, forever hold your peace! Radiology is a small world. And, the ramifications of doing this are myriad. Not to say the least, unbeknownst to you, programs may blackball you in the future if you decide you want a job with one of their faculty. You never know!

Don’t Get Too Invested In Your Number One Choice Before You Match There

There is one guarantee in life: that there is no guarantee! Just because you are confident that a program is going to choose you, don’t buy a condo next door. Until it is official, you never know. I know of several students that had bought all the T-shirts of the presumed institution that they will attend, only to find out that they had not matched at the program. Please. Wait until you have the residency has accepted you before telling your colleagues. You don’t want to look like a fool!

Don’t Psyche Yourself Out Of Your Number One Rank

Your number one choice selected you for an interview for a reason. Regardless of how you may feel now, you do have a chance of getting a spot at your first choice. That chance is probably better than you think!

Don’t Forget To Double Check You Number One Choice

Computers and people’s hands are finicky. You can easily click the wrong button and not realize what you have selected. Or, maybe you changed your mind about your first choice and forgot to choose the program on the match list. In either case, check and recheck that list multiple times before you click submit!

Ranking A Program Number One- Don’t Take It Lightly

The matching process is a headache. But, you’ve already made it through seven-eighths of the ordeal. Don’t screw it all up at the last minute. Make sure to dot your i’s and cross your t’s. Ranking your first choice is a big deal. So be careful and remember: many applicants get their first pick!

 

Posted on by

Are You Getting the Outpatient Experience You Need In Your Residency Program?

outpatient experience

Some radiology residency programs throughout the country often claim a great outpatient experience. And others, if you ask, they won’t mention it at all. As an interviewee, you may not think about this segment of radiology. But, as a practicing radiologist, this is where you will spend a good chunk of your time.

So, what are the different sorts of outpatient experiences? And, is this outpatient experience even critical to your training? Or, is it something that you can forego because the hospital covers it? The bottom line, are you getting the outpatient time that you need?

Let’s investigate the world of outpatient radiology and what it all means for the typical radiology resident. To do so, I am going to discuss why it is critical to your training. Then, I will split the categories out outpatient imaging into those that you might encounter. And finally, I will talk about what you genuinely need in radiology residency to make your outpatient experience complete.

Why Is Outpatient Imaging So Important?

They say that about 90 percent of radiologists go into private practice (me included!), and the other 10 percent become hospital academics. And, a large swath of those 90 percent practices some form of outpatient imaging. Moreover, the imaging mix differs in outpatient imaging compared to the standard hospital menu of cases. So, if you want to simulate the real practice of radiology, you need some form of outpatient experience.

Three Different Types Of Outpatient Environments

Hospital Outpatient

Almost all hospitals have nonemergent patients that will show up to receive their imaging. The extent can vary from hospital to hospital depending on the location, patient mix, etc. However, the sort of patient that shows up for nonemergent imaging at a hospital tends to differ from the standard clinic patient that wants imaging. These studies often are more complex. And, they show up to the hospital either because they have some complicating issue that prevents them from getting outpatient center imaging (asthma, contrast reaction, etc.) Or, they may have an appointment at the hospital and may as well get their studies. Finally, less likely, a patient will show up here because he wants to go to a hospital rather than an imaging center.

Regardless, these outpatients will less likely have complaints like osteoarthritis or a superficial lump on the back. Instead, the patients will overall have more complex and involved issues. So, your mix of patients will not be the same.

Hospital Owned Outpatient Center

This experience is a hybrid between private practice imaging and the outpatient hospital experience. Here, you will get complex referrals from a hospital center. But, you will also receive the more typical outpatient type of studies. When you sit down and read, you will find a mix of patients with widely varying difficulty levels of cases.

Private Practice Outpatient

And most likely, private practice is what you think of as the “pure” outpatient experience. Here you get referrals almost exclusively from local doctors. Or, you will get patients who come in independently to receive screening tests like mammograms. Cases tend to be more one complaint sort of issues with more “normals.”

How You Might Experience Outpatient Radiology

Sampling

Depending on how the residency arranges your outpatient experience, you may be an occasional observer. Perhaps, the attendings dictate the outpatient cases because they get paid for them. And, you get to watch them interpret the studies. Or, it may be a random sampling as you are reading hospital outpatients. In either case, this is not the immersive type of outpatient experience.

Immersive

Here, you will be primarily interpreting outpatient cases and having your attendings sign off on them. It is much more similar to the daily workflow you might encounter in any given private practice. You will have a more similar experience as an outpatient private practice radiologist.

What Is The Best Outpatient Experience?

Well, as usual, the answer depends. Though, the key to becoming an excellent radiologist, in general, is to have varied experiences across the board. It is possible to have too much outpatient radiology at the expense of inpatient imaging, especially if you want to become a hardcore academic. So, you need to ask yourself, am I getting a broad enough experience concerning all the other segments of radiology training for my interests?

Nevertheless, I would recommend searching for a program that gives you the capability of reading and interpreting all sorts of “simple” and complex outpatient cases. And, I also believe that immersive experience is better. Why? Well, it allows you to get a feel for private outpatient practice. And, it will enable you to make a more informed choice of practice situations when you ultimately decide to settle on a final path.

Are You Getting What You Need To Become An Excellent Radiologist?

Having all the ingredients available for you to get the training you need to become a radiologist, well, that is the main point of residency. So, if you are in a situation that does not give you the right mix outpatients, look into ways that you can get the appropriate outpatient experience. Take some time and effort on your part to create a custom rotation. Or, push your faculty to allow you to get the proper exposure. In any case, make sure not to skip out on this subsegment of radiology. Without this experience, you will not be the consummate well-trained radiologist you want to be!

 

Posted on by

What Do Radiology Program Directors Really Want From Their Residents? The Perfect Resident Triad!

perfect resident triad

This year, applicants have asked the following question more than ever before, “What do I look for in a radiology resident?” And I will answer this question with what I like to call “the perfect resident triad.” But first, I thought it would be interesting to discuss why I believe this question has become more common coming from medical students.

The Psychology Behind The Question, “What Do Radiology Program Directors Really Want From Their Residents?”

On the surface, some folks may say I am putting too much thought into why applicants may be asking this question. But, I believe this question says something about medical students applying to radiology. There is more to it than meets the eye.

First, I believe this question reflects current medical student cultural differences. Distinct from generations past, this question requires applicants to worry more about goals and expectations than any class before. And I think this difference is a function of what today’s educational system has demanded of all these students.

Moreover, I believe that schools have gone “ga-ga” with grading. From my own experience with kids, students today are continually bombarded with grades and tests, more so than I had ever experienced. In essence, the increased frequency of this question with the implied inherent message of “how do you evaluate me?” makes a lot of sense given today’s student culture environment.

Regardless of all the hidden meanings behind the question (that could be a whole psychological blog in itself!), I figured this would be a great forum to provide you an associate program director’s perspective and answer to this common question. And, maybe it will help you to figure out how to become a better radiology applicant and resident. So, here’s a summary of the perfect resident triad, the three characteristics that I want from incoming residents!

The Perfect Resident Triad

Academic Abilities

First and foremost, we need to know that a resident can make it through the radiology residency program. And, nowadays, unfortunately, the best piece of evidence that allows us to assess if a resident can pass the boards is the USMLE Step I. Studies have correlated excellent performance on this examination with the core examination, So, we need to take this data point seriously. To do so, we have made a cutoff score that will lessen the chance of having residents fail the exam.

Second, we need to see that you have done well in medical school. Our best assessment of this comes from the Dean’s letter. This document tends to be the only one that will say anything negative about the applicant. Therefore, we need to use it as a means of distinguishing resident academic qualifications. Also, from our experience, this measure correlates well with how much a resident will study during residency. And, radiology residents need to read a lot!

Personality

Although you might not think personality should matter much in a radiology resident, nothing could be further from the truth. Faculty members can sit with a radiology resident for hours at a time. The ultimate burden that a faculty member needs would be to dread that a particular resident is going to be there on any given day. Additionally, program directors do not want a “rabble-rouser” that will create problems every other day for her fellow residents.

The bottom line is, personality counts. And, to assess personality, there are only a few bits of information that we can use, interviews, and the Dean’s Letter. We rely on our interviews to make sure that the applicant responds reasonably to a conversation with questions. And, we utilize the Dean’s Letter to look for patterns of behavior that may cause our lives to be miserable!

Independence

Finally, we do not want to have to tell our residents what to do at every given moment. Sometimes, you have to take the bull by the horns. So, we expect not to have to tell them to get involved with as many procedures and cases as possible. And, we don’t want to be on top of them all the time to make sure that they find a research project. And so on. Residents are adults, and we expect them to act like mature learners that can take charge of their education.

We assess this characteristic based on the interview, previous research, and academic performance. Although not perfect assessment tools for this trait, they do provide us with some quality information.

What Do Program Directors Want?

So, that’s what I want from my residents and what I believe most program directors would wish: the “perfect resident triad”: To summarize, we want the following: 1. A team member that does well academically. 2. A resident with a personality with which we can work. 3. And, someone who maintains a bit of an independent streak. If you are that sort of medical student or resident now, you will be an invaluable member of any radiology residency team. Come aboard!

 

 

 

 

 

Posted on by

Radiology Resident Myths Versus Reality

One of my mission statements is to be an excellent forum to dispel the myths and false expectations about radiology and radiology residency. So, I’ve done a post on the top myths about personal statements (Radiology Personal Statement Mythbusters: Five Common Misconceptions About Radiologists). And, I’ve written about the unexpected traits of great radiologists (Top Traits Of Great Radiologists (They Might Not Be What You Expect) ).  But, I have not yet written about what is real versus myth for radiologist residents. And, yes, there are lots of false information out there!

So, one by one, I will take each bit of rumor and conjecture you might have heard bandied about the internet below. Then, I will dismiss the fake truth about radiology residency that you may listen to from your classmates and colleagues. Beware the false information that you may see posted on forums, social media, and other websites. Here are some of the more common statements you may hear from your fellow students, and medical colleagues about radiology residency that are not the truth!

You Don’t Need Good Communication Skills To Become A Radiology Resident!

Have you ever heard of a successful radiology resident that cannot communicate with her colleagues? Among all the reports, conferences, and all physician interactions, the only successful residents are those that can speak and write in a manner that others can understand. Moreover, I have never seen a halfway decent radiology resident that can’t give an interdisciplinary conference or handle a team of ornery surgeons at nighttime. You cannot just pump out ill-conceived reports in the dark sitting at a computer. It just doesn’t work that way!

It’s A Cush Residency Compared To Others

Talk to most any resident at nighttime. And, she will tell you the hardest working resident in the hospital is the radiology resident. Regularly, they are bombarded with orders, phone calls, demands for reports, and diagnoses at any moment without a refrain. Do they get a wink of sleep? You have a much better shot at some rest as a surgeon or internal medicine resident between cases!

You Can Get Away With Reading Like You Did In Your Subinternship And Internship

Total BS! I don’t care what they might say about on that radiology forum that you have read. Never, and I mean NEVER,  have I seen a resident that can perform well without putting in the time to read. It’s just not possible. We are covering almost every single specialty of radiology. And, yes, that even includes psychiatry and dermatology (on occasion)!

All The Residents Will Be Nerd Techies

Radiology attracts all types. I’ve seen men and women come through who have been “fashionistas.” I have also seen the more techie/nerdish sorts. And I have seen all kinds in between. A stereotype like this does not do justice to the wide variety of personalities that enter our fold. Just stop by most any residency program and see for yourself!

We Hedge More Than Everyone Else

Medicine is not physics. There are so many variables in medicine that no one in any particular specialty can be one hundred percent sure of the future. Radiologists, like any other specialist, operate in this same environment. And, if you talk to almost any excellent physician in any specialty, they are aware of this fact. And, they hedge just as much. Check it out for yourself. Go into the medical records and charts, and look at all the notes from all sorts of specialists. You will see the same!

It’s The Best Way To Get Away From People

Well, it depends on which people!. Indeed, you will have less patient contact if you are working on some outpatient imaging rotations. But, you will not get away without speaking to other nurses, technologists, and other physicians.  That is part of our job description! We talk to these folks every day.

It’s Impossible To Get In If You Are A Foreign Resident

Yes, it is a bit more challenging to get into radiology if you are coming from outside the United States. But, certainly not impossible. About a little less than a third of radiology residents graduate from outside the country. (From the NRMP) That’s a decent number of residents!

Radiology Resident Myths Versus Reality

We exist in an environment where it is effortless to propagate untruths and fake data. In a world of inaccurate information, I aim to provide you a bit of the truth in the world of radiology residency from a reliable inside source. So, don’t just take the information about radiology residents at face value. At radsresident.com, you can discover facts about radiology residency like these, which is the reality rather than myths!

 

Posted on by

How Do I Choose My Prelim Year? So Many Options!

prelim year

In 1997, I applied for radiology. At the time, I was not quite sure about my future radiology residency career. So, I decided on the best back up plan if I was to bail on radiology. Logically, therefore, I decided to complete a one-year internship at Beth Israel Medical Center in Manhattan in Preliminary Medicine. I considered that at least if I decided to forego the radiology residency, I still had the opportunity to utilize that year as a time that would count toward an internal medicine residency program. In hindsight, it may not have been the best decision for a future radiologist such as myself (although it was an excellent program!). But, it worked for me at the time based on my circumstances back then. Hell, most critically, I got to spend a year in Manhattan!

So, how should you decide on which internship to complete?  Even though I had made a decision one way, and perhaps not the best way, I will give you a few basic concepts that you can use to make that decision. Some of the factors should depend on your goals and desired location. As usual, I will slice and dice the categories to help you, in particular, make the correct decision for your situation.  I will divide it up as follows:

1. Rules for the budding radiologist who is not sure of their future specialty,

2. Guidelines for the future interventional radiologist

3. Advice for the subspecialist radiology.

Additionally, click on this ACGME link for the list of approved PGY-1 years for radiology. (You can’t use pathology to satisfy the requirements anymore!)

What Type Of Internship Should I Chose?

General Radiology (Not Sure What You Want To Do!)

Contrary to what everyone says when they want to start radiology during the interview season, everyone does not want to do interventional radiology. Instead, most folks have no idea what they want to pursue. And that is more “normal” than anything else. So, what is usually the best internship in this situation for the budding radiologist?

Typically, the majority of these folks would benefit the most from a transitional year. Why? It allows you to survey multiple areas within all of medicine. And as most of you already know, radiology also encompasses a good chunk of most medical specialties. So, to see lots of clinical scenarios in different specialties makes the most sense for the average new resident. Plus, these residencies tend not to be as intensive as others (but not always!) Remember, your goal is not to become a practicing internal medicine physician. Instead, you want an excellent overview of the world of medicine.

Interventional Radiology

For those of you that have their heart set on interventional radiology or you think that you will eventually pursue this avenue, I would recommend you to consider a preliminary surgical internship. This internship tends to be the most hours (but not always!). But, it is also the most procedural. And guess what? So is interventional radiology. Therefore, I believe that a surgical internship does prepare you the best for this eventuality. Consider it even though you may need to power through this internship!

Subspecialty Radiology

OK. For the rarer medical student, some of you may have your heart set on pediatric radiology, women’s imaging, or neuroradiology. Well, I can still make a case for the transitional year because of the variety of specialties that will reinforce your radiological education. However, for many of these folks, I believe you could consider a specific prelim year that will support your radiology practice later on in life. For instance, a neurology internship could help with neuroradiology later on. And, ob-gyn could provide a boost to your clinical knowledge if you decide to go into women’s imaging. That’s something to think about if you choose to take this route, and you are sure which subspecialty that you will practice.

Which Location?

As an intern, I will categorize the different sorts of interns into two types — the young and the restless and those that already have a family. And I will advise both.

Young And Restless

For this sort of individual, you should think about not just the type of internship. But also, consider a place where you have can pursue an active lifestyle. Do you want a good dating scene or do you like to go ice climbing in the winter? Try to pick a place where you will have things to do outside the realm of an internship. The prelim year is a nidus for burnout with long hours and occasional irrelevance to a future career in radiology. So, make sure to choose a location where you have a convenient choice of activities to do when you leave work!

Family Oriented

Then, some already have an established family. For these sorts, think about picking a location that would cause you and your significant others to be the happiest during the tough year of internship. Whether it’s excellent schools or finding a place to reduce your chances of repeatedly moving from prelim year to radiology residency, these considerations tend to be different from the “young and the restless”!

Which Should Win Out For Internship- Type Versus Location?

Well, this is the million-dollar question. Often, you can’t have it all. Perhaps, where you want to be where there is no transitional year? Or, the neurology internship is only in specific locales? So, in these more unusual situations, you will make the best of it. You need to make that final decision about what is most important to you in your own life. For me, being in Manhattan was a critical decision for that internship year. But, I can see how the sort of residency could sometimes trump location. It all depends on your life stage and situation.

What Happens If You Make The Wrong Choice?

I have some good news. If you do make the wrong choice, it’s not the end. Remember, it’s only one year (although it can seem like an eternity at the time!). So, if you decide to complete a prelim surgical internship and you choose to work as a diagnostic radiologist instead of an interventionalist, the world will not explode. You will still learn things that you will take into whatever specialty you decide to pursue.

The Prelim Year- All The Options!

So, there you have it, my take on the choices that you should consider for your prelim year. Regardless of what path you select, you will begin anew when you first start radiology. And, eventually, that internship year will become a distant memory. But, at least, you now have the basic guidelines to make the best-informed choice!

 

 

 

 

 

Posted on by

Do You Really Want To Go To A “University” Program?

university program

During medical school, commonly, students talk about their goals to get into a “University” program. Moreover, faculty often recommend that residents should receive “University” based training.

But, what does being a “University” program mean? And, how does that compare to a University affiliate or a residency with no University affiliation at all? You may be surprised to learn that there is significant variability in the definition of a “University” program. Also, the “University” training you receive or the residency where you want to enroll may have more features in common with a “Community” program than any other “University” program out there.

So, to figure out what all this nomenclature means, I have lined up some of the features of what you would expect University programs to contain. And, you can decide for yourself if your program of interest is more “Community,” “University,” or somewhere in between.

Resources

You would expect University programs to have large endowments, kind of like what you always hear about Harvard. But in reality, many “University” programs have very few grants or any extra money to spare at all. So, resources can vary widely among institutions. What does your residency receive from the University serving your residency?

Number Of Faculty

Once again, you would expect most University programs to have more faculty, right? Well, that number can vary widely between University and Community programs. Contrary to popular belief, many non-University institutions can have more faculty than their University brethren. Though, they may not have the University reputation that precedes them.

Offhand on my mental radar, I can think of one enormous non-University system in California called Kaiser Permanente, the largest health care employer in the state. And, until 2020, it will not have had an affiliated medical school to go along with it. It has more radiologists than any other system in the state.

More Subspecialists

Along with the faculty numbers, more subspecialists in a given area does not reflect whether an institution is community or University. It is more of a reflection of the size of the program. Go figure!

Support For Research/ Statisticians

As an overall trend, residencies home based in a University tend to have more support for research. However, you will find that some large scale Community programs also may excellent support for research at their institution. Don’t assume just because you attend a University program; you have more chances to participate in studies.

More Stringent Curriculum Requirements

Every institution has program curriculum requirements as mandated by the ACGME. However, you would think that a University program would hold to these standards more stringently than a Community program. Well, that is not so. It all depends on who manages the program and the teaching faculty.

Medical Students/Opportunities To Teach

Some University residencies are so extensive that radiology residents may seldom come across a medical student anywhere. On the other hand, many community hospitals have contracts with non-affiliated medical schools to house residents in their institution. Once again, being a University program does not necessarily afford any additional special

Let The Buyer Beware

Tread carefully when you assume that a University-based residency will meet all your expectations for your residency training. Not all University-based programs are the same. Some will have unlimited resources, enormous numbers of subspecialists and faculty, tons of funds for research, a well-formed curriculum, and lots of medical students to teach. But, others may not have one or more of these features. In a world of numerous residency choices, make your checklists to confirm that the “University” or “Community” program that you want meets your specific needs. Don’t rely on a name!