Tag: career

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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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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.

 

 

 

 

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Top Ten Reasons To Be An Urban Radiologist! (From A Suburbanite!)

urban radiologist

Last week I gave you all a top ten list for becoming a rural radiologist. But, I have received a few complaints from my urban colleagues that believe they have been shortchanged. Despite all the advantages of rural radiology, there are still some significant advantages for urban radiologists. Today, to be evenhanded and in honor of the city life, here are the top ten reasons to migrate to the city as an urban radiologist!

Concentration Of Specialized Radiologists In One Place

Where else can you find a subspecialist that specializes in neuro intervention of vascular malformations as well as a Xofigo center of excellence? Unlikely that you will find this in the middle of rural Nebraska. But, in a big city, you can find a subspecialist in almost anything. And, you can become that specialist because of the high concentration of patients in one place!

High Quality Of The Urban Radiologist

That is not to say that rural radiologists are bad, but it does take a lot to survive in the city. And finding that job usually requires some high falootin’ credentials. It would help if you had the right hybrid of certificates and connections. So, you do find a large proportion of overachieving physicians in the city. It even goes the same for radiologists!

More Cross-Pollination With The Urban Radiologist

What happens when you gather a bevy of doctors in one place? Well, you get to hear the war stories in other departments. And you are more likely to discuss other physician areas of interest. Of course, this discussion will often lead to distinct outcomes, whether creating research or treating patients differently. For instance, you have an all-star thyroid pathologist on the premises, so you are more likely going to do lots of thyroid biopsies, more so than other institutions. Cross-pollenation changes the dynamic.

Convenience

Where else can you walk a few hundred feet away from your site of work or residence and go to a supermarket, drug store, and dog training facility? I certainly can’t think of any. There’s no need to maintain a car or means of transportation. It’s all at your fingertips by walking or public transit.

Easier For The Urban Radiologist To Get A Date

Maybe you are single and looking? When you out in the middle of rural Idaho, you might have a more challenging time finding a significant other. And many young radiologists are still single. So, think about that urban job. You are more likely to find like-minded folks and, of course, get hitched!

Larger Diversity Of Patients

Are you looking to become more culturally aware? Well, look no further than the city. You will see all types of folks and have the opportunity to communicate and learn from them. It just doesn’t happen to the same extent out in the hinterlands. It’s only one of those advantages of city life.

Greater Swath Of Pathology

Along with the more significant cultural diversity comes an increased variety of pathology unique to every culture and country worldwide. You will find all sorts of weird and bizarre diseases in the middle of a city you won’t find elsewhere. These can include all kinds of genetic and environmental pathology. Want to swing for fences with differential diagnoses with zebras? Go practice in the city!

Cultural Opportunities

Do you like the opera or want to see a heavy metal rock concert? Maybe you want to check out the local happenings at the new dinosaur exhibit? There is no better place for this than a large city. You will never get the same opportunities out in the country.

Lots Of Shopping

Folks come all over the world to shop at select stores in large cities. And, you can find goods and services that you would seldom find anywhere else. It may be a market for ancient lamps or a store for hand-hewn mannequins. You can find it all, and it may only be a few footsteps from your urban job!

Restaurants/Food

For the eclectic culinary lover of a radiologist, there is no better place to try out the flavors of the world. Olive Gardens and Chili’s (as much as I like them) don’t always do the trick. Sometimes you want to eat out or pick up food from a culinary king. And, even better, when you step out of your imaging center to go to pick it up next door!

Being An Urban Radiologist- Not So Bad!

Yes, rural radiology does have its advantage when it comes to the cost of living and pay. But life is not all about money. You miss out on a whole world of opportunities when you live outside the city in rural America. So, if you like culture, entertainment, and convenience, consider a life in the city as an urban radiologist. You won’t regret it!

 

 

 

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Should Residencies Ever Rehire A Resident That Previously Left?

rehire

What is so special about the radiology resident when it comes to rehiring? Moreover, if a resident finds himself in a situation where he leaves and subsequently wants to go back, is it ever appropriate for a residency to rehire this individual? To answer these questions, let’s first discuss why residencies are so different from a regular job when rehiring.  

Why Rehiring Is So Different For Residencies?

Rehiring at a typical job and residency is not the same. For residencies, each post-graduate year has a distinct service role and responsibility that the program needs to fill, different from most jobs. Additionally, since residency is not just service (unlike a typical job), the resident also needs to meet educational qualifications in any given year. For some programs, that might mean passing specific procedural and cognitive activities. Finally, residents may need to fulfill designated milestones of differing responsibilities at each institution. So, residents are not easily interchangeable, and rehiring during residency can be challenging.

Additionally, when one leaves and wants to come back later, your program may not have the educational or financial resources to compensate the resident. For example, if you complete a different residency year and then return to radiology residency, Medicare may no longer fund your position. Or educationally speaking, a first-year most often cannot substitute for a third-year resident spot that might be open and vice versa. All these issues can also stand in the way of a rehire.

When Can A Residency Program Rehire A Former Resident?

Now that you can understand why rehiring might be so tricky, let’s discuss some of the situations that residencies might encounter that would enable the residency program to rehire a former resident. Three of these circumstances are a coincidental fortune, grants and opportunities, and institutional policies. We will go through each one of these in particular.

Coincidental Fortune

Sometimes all the stars align that allow a program to rehire a resident. Let’s take the example of a resident that was let go because of failing the Step III USMLE. At some institutions, residents need to pass the test before they reach their PGY-3 year. So, hospitals are not obligated to rehire individuals who do not pass their Step III boards after starting their PGY 3 year. 

But, let’s say the resident who failed initially was in good standing up until the boards and then passed their boards well into their PGY-3 year. Then, suppose the residency program has not filled that spot, and the former resident applied to it again after passing. In that case, the resident could be fortunate enough to retake their place (albeit possibly graduate later.) The story could have also ended without the resident able to retake their spot if it was no longer available. It was luck that enables the resident to get their job back again.

Grants And Opportunities

Other times, different programs have opportunities built into them to rehire residents after a specified amount of time. Perhaps, it is a year of international volunteering as a radiologist. Or, a resident may take off a year to complete a permissible research project in the institution. In these specific situations, programs can rehire their residents after they fulfill their time.

Institutional Policies

Finally, some institutions may have specific policies that forbid a resident from being fired. Perhaps, a residency suspends a resident but has done so without the appropriate documentation to do so. Other by-laws may force due process before termination (as long as it does not jeopardize patient care!) Specific policies in place at the hospital such as these can cause the rehiring of a resident.

To Rehire Former Residents: Not So Simple!

Residencies are much more than a typical job because of their education as well as service requirements. Therefore, rehiring former residents can present multiple obstacles due to the nuances of radiology residencies. Given these obstacles, don’t expect to regain your former position unless you do your due diligence to ensure that you still have a spot. Rehiring at a residency program is not the norm!

 

 

 

 

 

 

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Teaching In Radiology: How Can Residencies Help To Prepare?

teaching in radiology

Question About Teaching In Radiology

Hi Dr. Julius,

I am an MS3 who is planning on going into radiology, have always loved teaching, and want to make it a large part of my career. I was hoping to hear your take on how radiologists can teach and any tips to shape my career with this goal in mind.

 

Answer

“What kind of teaching opportunities do you have?” is a common question that I get from my interview candidates for residency every year. Teaching is a large part of learning in most radiology programs. Almost all programs have some form of teaching opportunities. These may manifest as teaching medical students, junior residents from different specialties rotating through your department, or interdepartmental tumor boards. Regardless, you will find many opportunities to teach.

Community Vs. Academic Teaching In Radiology

So what is the difference between programs and the different teaching opportunities? Well, it comes down to the sort of teaching. More community programs tend to give you less opportunity to teach students because they may not be affiliated with a medical school. Instead, you will have more opportunities to teach technologists, nurses, and fellow physicians. And, the options tend to be less formal. 

On the other hand, academic programs give you more formal opportunities to teach and mentor research projects and other academic members within your residency, such as students, observers, fellows, and more that you would not get at a community program. And, teaching can be in larger forums. The bottom line is that teaching opportunities are not unique to one type of program or another. The styles just depend on your inclinations and your choice of program. 

Stop And Smell The Roses (And Teach!)

I believe that each resident that comes through a program should stop and take the opportunity to teach others. Teaching others reinforces what you know and helps your fellow man or woman. Plus, you wind up hearing or asking questions that you may never have thought about in the first place. These questions make for promising research projects or take you to places that will make you understand ideas more deeply than you ever thought possible. The rewards are invaluable, and the time it takes to do so is relatively negligible. 

Then, when you finish your residency, you can decide for yourself if you want to take more opportunities to teach either in academic or private practice. They are all around you. It’s a matter of what you want to pursue in your career. 

 

My forty-three cents on teaching,

Barry Julius, MD

 

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Benefits Of A Career At Your Home Residency Institution

home residency

If there were not enough reasons to take your home residency seriously, here is another big one: faculty members running residency programs usually look for great candidates to fill their practices. And that person that they are looking for might be you!

But why would programs want their residents to stick around? Doesn’t that decrease the diversity of experience of the faculty training? Well, yes and no. First, not everyone you recruit will be from the residency program. Newly hired residents mostly go to fellowship programs outside of the residency institution.

Yes, the resident does miss out on the nuances of working at different sites when you never leave your home residency program. However, let’s be honest. There are numerous benefits to holding on to your residents and not just recruiting outside the institution. Let’s go through the distinct advantages of the residency program and the residents becoming faculty at the same site as their residency.

The Resident’s Perspective

You Know What You Are Getting Into

Familiarity is the number one reason to stick around at your home base. You are much less likely to be surprised by the business if you know them beforehand. I can’t tell you how often I have heard of practices withdrawing partnership positions at the last second, a month or two before the scheduled start time. Or, some imaging businesses may be less savory than you think. These disasters are much less likely to occur when you learn about your future job as you train during residency.

It Feels Like Home

It is comforting to work for a practice you know. You wake up and go to work with colleagues that you already respect. And, by now, you probably have many connections and friends in the same place you went to your residency program. You can’t find that as quickly if you move to a new radiology practice in a new locale!

You Know Your Location Beforehand

Sometimes, folks move to a new job to find out they want to live in a different environment. Perhaps you thought you might like to live in a rural community and then discovered that you enjoyed the suburbs better. Or, you decide to live farther away from your family, only to realize that you should have been living closer. You answered all these questions while living near your home residency program beforehand. Your surroundings are already familiar.

The Program’s Perspective

You Know What You Are Getting Into

Just like for the resident, I believe this one is the biggie. One of my favorite phrases is, “Better off with the devil you do know than the devil you don’t!” And that phrase doubly applies when recruiting from inside the system. If you are hiring from within, you already know all the quirks of the applying candidates. On the other hand, an unknown outside entity can throw your practice into disarray if you find out that the person you are hiring is not as it seems. I can’t tell you how many radiology businesses hire an “unknown” candidate only to find out once they start that they do not do mammography after saying that it might interest them during an interview. And other new candidates are not as good as they seem. These sorts of issues occur much less often when you recruit your own!

You Can Recruit For The Specialty You Need

Say that your practice is short of MSK radiologists. If you run a residency program and you like a candidate, you can tell them you will have a job if you complete an MSK fellowship. By targeting great candidates for your practice, you can also guide these individuals into areas your business may need. Of course, residents may not want to do what your imaging practice requires. But, if you choose between several fellowships that you might like the same, it would not hurt to complete the one that helps your future practice.

You Can Choose Those Resident Features That Will Grow Your Practice

If you are looking to hire, your practice probably needs certain types of faculty. Perhaps, many of the faculty members in your hospital are introverted, and you need a future extroverted leader to run the business. Or, your desired resident is a techie, and you require someone who knows their way around a RIS system and PACS. Recruiting residents who will help build the practice in these respects can fulfill all the niches you might need in the future.

Working At Your Home Residency Base

Don’t dismiss the possibility of working for the institution where you have trained. Even though the grass may seem greener on the other side, staying put has distinct advantages. Take into account all the opportunities that arise as you make your choices for your career. But your original experiences working at the same site as where you trained may be the best!

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Why Radiology?

why radiology

Interestingly enough, at this point, we at radsresident.com have published around 500 posts on all sorts of topics. Yet, I have never addressed why radiology might be the right fit for you. Strange. Well, better late than never!

Let me also direct you to my previous post on how I decided to go into radiology (which certainly was not a straight path!). As a supplement to this article, hopefully, it will allow you to understand that you can enjoy a specialty even though you may not know what you want to accomplish in your career yet!

Now, with all that background, we are ready to go through some radiology features that present unique reasons for new students to consider entering the field.

Intellectual Stimulation

If you like intellectual challenges, radiology offers more than most specialties. To this day, I remember presenting the topic of histiocytosis X (eosinophilic granuloma) as an internal medicine resident and hearing jeers from my general medicine colleagues because the disease was “too rare” for a presentation. Well, in radiology, we are all about the rare and unusual. That is what makes our specialty tick. We love our cases of eosinophilic granuloma, Henoch-Schoelin purpura, and more. For us, seeing all these zebras is not a burden but a reward. And, with the number of films that radiologists read in the tens of thousands per year, we are much more likely to see many of these rare birds than our fellow medical colleagues and specialists. Welcome to our world!

Flexibility- Business, Hours, Location, Etc.

Radiology has some of the most flexible working environments. If you want to work from home, you can. Want to read films from California yet live in New York? No problem. We can more easily work remotely than most other specialties. If you like late-night shifts, go for it. Or, if you want to own your practice, it is still possible. The world is your oyster and the flexibility and ways we can practice dwarf most other medical specialties out there.

As Much Patient Contact As You Want (Or As Little!)

We’ve got specialties like mammography, interventional radiology, radiopharmaceutical treating nuclear medicine physicians, and more for those who love to see patients. Yet, for every track with significant patient contact, several do not. And, when Covid-19 came around, some radiologists were as happy as a clam to sit on the sidelines. Others had the opportunity to become a central part of treating Covid patients. Regardless, all these possibilities can allow you to practice how you want without being drained by constant patient care or insufficient patient contact.

Lots Of Contact With Fellow Physicians

There is no doubt about it. We speak and consult with more of a smattering of all physicians than almost all other medical specialties. I talk to physicians in every subspecialty for cases I have read (even the occasional dermatologist and psychiatrist!). Most other specialties cannot boast about the wide range of medicine that we cover as we can.

You Don’t Have To Be All In (Like A Surgeon)

Radiology is one specialty that allows you to practice medicine without living and breathing daily. Unlike a surgeon who must be on all the time because of the hours and pressure, many radiologists can practice as little or as much as possible. I know many senior radiologists who read films a few days a week. Likewise, if you want, you can also work a ton. The opportunities abound!

Relatively Decent Compensation

OK. We may not make as much as some orthopods or neurosurgeons. But, we certainly make a respectable income compared to most other specialties. (Check out the Medscape compensation survey from 2020) Of course, that can change on a dime. But, as it stands now, we are in relatively good shape. If you compare the highest and the lowest-paid specialties, it has never been near the bottom!

Can Be Academic Or Non-Academic

Some medical specialties are conducive to either academic or non-academic medical practice. In ours, we have a choice. Want to become the “supersubspecialist” who writes tons of papers? Practice as a neuro-interventionalist or an academic pain medicine MSK radiologist, and you’ll have many opportunities to publish. Or, if you want to work as a generalist and never see a student again, go for it! In almost any radiological subspecialty, there are many opportunities to practice in either setting!

First Clinician Users Of High Tech

Finally, we often adopt new complex technologies before almost all the other medical specialties. Whether it’s artificial intelligence, new MRI contrast agents, better PET-MR equipment, and more, we usually get the privilege of operating these bad boys before anyone else gets a hold of them. And for the tech-savvy among us, it can be a dream come true!

Why Radiology?

Well, I think these reasons say enough about why radiology can be an excellent choice for you. Our specialty may be an ideal match if you like flexibility, intellectual stimulation, reasonable compensation, high tech, and many options. Think about it. And don’t let the primary care-biased medical school Deans sway you from pursuing this specialty if these are the career options that you want. As far as I know, you only live once!

 

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How Can I Prevent Low Imaging Volumes From Causing Me To Lose My First Job?

low imaging volumes

Question About Low Imaging Volumes:

Hi. I am an R2. I’ll most likely do a fellowship in body imaging (mostly because I haven’t felt a click with any particular specialty). I keep reading about practices firing radiologists because of low imaging volumes due to COVID. I’m concerned that this will affect me when I apply for jobs because I am only interested in private practice. I want to position myself with some advantages, and I need your advice on how to do this. I particularly enjoy the IT aspects of radiology (troubleshooting PACS, EMR, making software more efficient, automation, computer hardware). In my residency, there is a faculty member who is the “Director of IT.” And, I might be interested in a role like this.

My question is, do you think this is something that is even an advantage if you are seeking private practice? If so, how can I enter this space? Is there a course? Do I do research? If this is a bad idea, are there other things I can do during residency to give myself an advantage when it comes time to apply for a job in private practice? 

What should I do?

 

Answer:

Armaments To Prevent Job Loss

These are excellent questions, and I have a few answers! Let’s start with the first one about practices firing employees because of low imaging volumes. First of all, this Covid situation will most likely all but disappear by the time you graduate residency. Nevertheless, one of the best protection against getting canned is to become invaluable in whatever area that you practice. That niche can be informatics/IT. However, it all depends on the type of practice where you work.

If you aim to work at a small private practice somewhere, it will probably not help all that much. If you work for a larger institution or an academic center, it can help a lot, depending on what you do. In an educational sort of setting, if you are pumping out tons of papers and creating lots of programs/IT solutions for your colleagues, no one will want to let you go. Alternatively, if you are in charge of a massive corporate IT program, and the business cannot function well without your knowledge, they will not fire you. On the other hand, if the IT services you provide are just a little help, and the clinical work that you provide to the practice is not so much. Well, then you will not have the same job security.

At this stage of your career, work hard, and perform well in residency regardless of your fellowship. Learn about all aspects of radiology as much as you can so that you can establish a niche for yourself when you leave your residency. To repeat, most folks that are good at what they do will be the last to be fired.

How To Get Into Information Technology

Next, how can you enter this IT space? Well, some of it depends on how much experience you have in IT already. If you don’t have the knowledge that you would need to take over the IT at a practice, you would probably want to look into the Informatics fellowship. This fellowship will give you the basics of what you will need to know about IT for radiology practices. There, you can establish connections that you would need to find a career. Additionally, research in your area of specialty is never a bad idea during residency or fellowship, especially if you want to follow the more academic path.

Final Advice

So, there you have it. Work hard, learn as much as you can about radiology, consider an informatics fellowship (if that is what you want), and perform a niche in a practice that others have a hard time filling. These are the ingredients that will keep you in practice regardless of the Covid or any other unfortunate situation that may arise to lower imaging volumes for radiologists.

Good luck,

Barry Julius, MD

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How To Prepare For Radiology Residency, Starting In High School!

high school

Question From High School Student

Hello!
I’m a 14-year-old 9th-grade student, very interested in becoming a radiologist! I’m aware that this is more of a university-level website, but would you, by any chance, be able to give some tips on courses you recommend and what to do in high school to help me to get accepted to medical school. Also, what courses will allow me to do well there?

Thank you so much for your time!
Young But Interested In Radiology

Answer/Advice

Glad to hear that you are enjoying radsresident.com. It’s never too early to start thinking about your career options in life! So, I will give a few of my recommendations to you. First of all, of course, you will need to perform very well in school in all your classes. But, if you are writing this email to me, I have a sneaking suspicion that you are doing that already! You have a slightly better chance of getting into medical school from some of the name brand colleges. However, we get lots of applicants from smaller schools as well. So, if you don’t get into Man’s Greatest University, all is not over. Doing well in your college classes is even more important than high school, regardless of which school you attend.

So, what types of courses are best? I don’t think it matters that much at any stage of the game, except to ensure that you meet the typical medical school requirements- Bio, chemistry, physics, etc. Schools like to see that you have varied interests.

Forgetting about grades and courses, what else should you do? Do a few extracurricular activities that you like and do them well. What do I mean by that? If you love music and you are good at it, take it to a high level. Play for All-State band or at other performance venues. If you are an athlete and like baseball, do it well. Play for college sports and work hard. Or, if you are into student government, make sure that you start small in your school and eventually become proactive in national organizations. Regardless of what you do, please do your best, and do it to its utmost. Don’t be one of those folks that do two hundred different things, is not that interested in any of them, and performs them only superficially. Too many applicants get caught in this trap.

Those folks that get into medical school, ironically, have other interests other than medicine. It’s what admissions counselors like to call the “well-rounded” applicant. So, make sure to enjoy and participate in other activities other than school. And do them to their fullest extent. I would shoot for these goals, not just in radiology, but in whatever goals you decide to pursue.

My two cents,
Barry Julius, MD

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Will There Be A Mass Exodus Of Radiologists From The Cities?

mass exodus

Look through the newspapers, and you will most likely find articles espousing a mass exodus of urban residents moving to less crowded communities during the pandemic. And at first glance, it makes some sense. Local governments have banned bars, movies, exercise facilities, and more in the Covid era. Moreover, there are always close quarters, more prevalent in a city, which increase the risk of disease spread in the pandemic. So, why would anyone want to move to the city when finishing residency? It makes you think that new radiologists will permanently shun the cities.

But, are there other factors that may influence radiologists to choose a location to work over the coming years? Are they increasingly going to opt for a more simple life in rural America over the years to come? Let’s go through the motivations for young radiologists to stay or leave the urban landscape. Then, we will decide how it will all play out in the end.

Reasons For A Mass Exodus Of Radiologists From The Cities

Increased Fear of Close Interactions

Knowing that a highly infectious and potentially lethal disease can spread by respiratory droplets, definitely changes how you think about taking the subway, walking the streets, and assembling with groups of friends. But will it stick over the long run? We will see a slight shift in how we feel about living in the cities for years to come.

More Difficulties Raising A Family

All the challenges of living multiply in a large urban center when you have children as well. Imagine the issues that urban families face when they have to find day-care, nannies, and school with the added problems of a pandemic at hand. Of course, this factor will most certainly lessen the charms of living in a large city.

Culture Shifts

We learn many of our habits, wants, and “needs” from our colleagues and friends. The mere suggestion of your friends hinting that they no longer wish to live in a city to work can influence your choices of where you will want to settle down. So, new residents will more apt to move where their colleagues also want to go. This attitude can also persist over a long time.

Reasons For Radiologists To Stay

Pay

Typically, when you are on the side of an employer, the harder it becomes to find employees, the more you need to pay to get excellent workers. Theoretically, for this reason, you may begin to see better jobs and higher incomes in the city than before. Of course, with the massive student debt burdens, this can somewhat counteract the perceived threats of urban living in the Covid era.

Housing Costs

With a shift of young adults moving to the suburbs and the more rural areas, you will decrease rental and, eventually, housing prices. If you reduce one of the most significant expenses that young families have when they start, you make it more attractive to the new employees, such as radiologists. Cities may become more attractive in this sense.

The Wild Card

Historically speaking, people have a short term memory when it comes to disasters. Look at the population of Manhattan after the twin towers fell. It didn’t take long for the citizens of New York to want to return to urban living. Or, look at the population of Nagasaki in Japan. At the time of the nuclear bomb, the number of residents was 263,000. Yet, today it has almost doubled at over 513,000. Finally, take the populations of most cities before and after the 1918 pandemic. Most recovered. So, the temporary cultural shifts that have occurred with previous disasters do not necessarily cause long term population shifts.

So, Will There Be A Mass Exodus From The Cities?

Well, it is true. Young radiologists will present with unique challenges if they choose to stick around in the cities for the next year or two. Additionally, pay, and housing costs will take some time to catch up to the new marketplace. So, some new radiologists will opt to live in more rural areas than would have previously.

But, this attitude will not last forever. The economics will eventually catch up. And, the culture will shift, once a vaccine becomes widely available. Based on these factors and history, radiologists will soon forget about the hazards of city life. So, don’t expect to see the competition for rural jobs to increase that much. The long term trends do not favor a seismic shift in deciding where to work and live. Logic dictates that you need to take reactive newspaper articles exclaiming a permanent mass exodus from the cities with a grain of salt!