Tag: first year

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Top Ten Signs You’re Not Ready For Call

ready for call

Last week we discussed the Top Nine Signs You Are Ready To Take Call. So, I figured I would not do justice to the topic of being ready for call without also creating a list of those signs that you might not be ready to take radiology overnights. Therefore, I have dedicated this list to those that think they are ready but are not. Maybe this is you? Check it out if any of these signs apply to you!

Never Double Checks Anything (Anything Goes!)

Our words matter, and anything that you say, the ER can use against you later on. If you recommend another test, guess what? You will probably get that test the same night! So, the resident who never checks their dictations to make sure everything makes sense and is corrected is in a world of hurt.

Anger Management Issues

If you constantly fight with your fellow residents or, even worse, your faculty, you probably need to settle down a bit before taking overnights. Ready residents can control their anger and not take it out on others because they know what they are doing. If you are in the former category, think about why that is!

You Repeat The Nighthawk Dictation Verbatim

If you rely on the nighthawk dictation as a crutch, it probably means you are not ready to strike it out on your own. You should go through every case as if it is new, even if another radiologist has already dictated it. You never know what they are going to miss. And, you certainly don’t want to miss the same things!

Never Looks Up History/Priors/Call For More Information

If you think you know it all and don’t ever need additional history or the need for priors, you are in for a rude awakening. The number of findings that you miss will be incalculable. And, you will miss the point of your imaging studies more often! It is one surefire way to mess up your cases at nighttime!

Assumes The History Is Correct And Relies On It Explicitly

Using history as a crutch is an elementary mistake that can lead to disaster. I can’t tell you how often the ER calls for hepatobiliary scans to rule out cholecystitis, even though the patient doesn’t even have a gallbladder! We need to check and recheck our work and compare it to priors to ensure we are doing a good service for the patient!

Disorganization And Routinely Forget Cases

If you forget to read films or complete your work during the daytime, do you think you will remember to finish everything at nighttime? Disorganization can lead to disaster. You can wind up dictating the wrong case on the wrong patient if you don’t watch what you are doing. So, get yourself into shape before starting!

Cannot Get Through The Daytime Cases on Time

It’s not just accuracy that matters at nighttime. Speed is critical as well. And, if you cannot get through work during the daytime, what makes you think you will get through everything at night? Cases will often come in batches, and everyone needs a timely report when this situation happens. Make sure that you are up to the task!

Only Knows The Aunt Minnie Diagnoses And Never Scrolls Through Cases

There is a big difference between knowing the diagnosis based on a solitary image and having to make your finding on an entire case that has hundreds of pictures. If you think you can get through your studies without the experience of scrolling through lots of cases, you will have lots of problems when you have to make all the findings at night.

Unintelligible Dictations

Do your attendings always tell you to edit your dictations because they can’t understand what you are trying to say? Well, listen to these folks very carefully. Dictations are the final product of what radiologists do. And, if you cannot say something intelligible, you have no business being on call!

Lack Of Rigorous Search Patterns

Every resident needs a rigorous search pattern when they are working at nighttime. Lacking a search pattern is a recipe for missing all the critical findings. If you never look for the spleen, you will never know it is absent. And so on. Hone in on your search pattern skills before starting to take call!

Are You Not Ready For Call Yet?

If one or more of these signs describes you, you may not be ready to take your first call. However, there is still a bit of time. So, go ahead and make adjustments before it’s too late!

 

 

 

 

 

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The Mega Five: The Ultimate Resources For The First-Year Radiology Resident

Wow, what a feeling! You did it! You’re officially a first-year Radiology resident! And, you just took your first step toward the rest of your life!! One full year has gone in the blink of an eye and you molded yourself into an unbeatable intern! Your mastery of surgical knots, writing extensive progress notes, rounding, and discharging patients have you feeling like you can tackle the world! In fact, you’re so eager to show off all your skills as a first-year radiology resident to your new Radiology Attendings on your first rotation that you jump right in and introduce yourself. You find a really comfy chair next to him, eagerly waiting to learn.

So, your attending opens the very first case and you already know the answer is pneumonia. Let’s face it on those long ICU rotations when was it not? To your surprise, it’s a head CT. He then gives it a quick scroll and asks those fateful words “Normal or abnormal?” … You sit there in silence… Chills run down your spine…sweat appears on your forehead…What just happened? Uttering the word ”I” a few times, you finally commit to the full sentence “I don’t know”. You have failed. You know nothing and feel like you are nothing… At least that’s how you feel for a short while. But hey, it’s your first day!

Get used to it… In the beginning months of the first year, the phrase “I don’t know” will become all too familiar because let’s face it, you don’t know! Not a thing! As an intern, you haven’t picked up a single book relating to radiology. And, you may have only looked at the impression to relay the information to your higher-ups when needed. You just did not have the time! So? What now? Where do you turn? Who can help you? You feel smaller than an insect. How can you possibly turn this around? Get ready to take all your years of what you learned and flush it down the toilet! You’re about to enter a whole new realm, the world of radiology.

The Mega Five

Enter the Mega Five. What is the Mega Five you say? Only the five most powerful resources at your fingertips for the first-year radiology resident! Sure, there are a ton more but these have been the most help in my experience. So, let’s start!

Case review series, Case review series, Case review series!!!

I cannot say it enough but these reviews are incredible. Most importantly, you don’t need a lot of background in order to learn as you go. And, the series takes excerpts of information from the Requisites (longer and wordier than the case review series!) and summarizes the material. Each case has questions and pictures. In addition, it literally contains every subject with increasingly difficult sections as you progress within each of the books.

Core Radiology

I love this book! It contains high-yield pictures and information, especially the Aunt Minnies. And, the book goes system-by-system, image-by-image. It even gives mini dictations of how you should describe the entity.  I can honestly say Core Radiology has helped bolster all my dictations positively. With all the knowledge you attain during 1st year, this book serves to solidify and maintain a steady foundation.

Radiopedia

I can’t believe I’m saying this but yes…Radiopedia is an incredible resource. First, you get fast information, pictures you can scroll through including CT and MRI studies, differential diagnoses, and links and videos. You can also sign up for these links and videos if you so choose (I did for emergency radiology before taking call). Finally, you can think of it as an underused gem like Wikipedia for radiology but even better!

RADPrimer

Oh, RADPrimer how I love you so… RADPrimer makes the list because let’s face it… What are facts without questions to test yourself? With over 4000 questions, you better just dive in and do 10 a day because it has a UWorld feel to it. And, if you’re like me, UWorld was the Holy Bible for USMLE Step 1, 2, and 3. So, why let this opportunity go to waste? Get cracking now…  Just start RADPrimer and crank out questions. You’ll see how much you really know from your studies.

Radiology Assistant

Last but not least, we have Radiology Assistant. To put it mildly, this website is incredible with detailed information, videos, pictures, and cartoons. You name it and they have it. In fact, I utilize this website as much as possible. There are even lectures to watch that break down hard topics, an amazing bonus.

But Wait There’s More…

In addition to my top five resources, of course, there are a ton more. Some of the other resources that I have used include Felsons Roentgenology,  E-Anatomy (application), headneckbrainspine.com, and Lieberman’s eRadiology. Although I poked fun at it above, I still need to mention the radiology requisites series in a better light. As wordy as they may be, you must read them. Why? Well, I’ve noticed that the question banks gather much of their information from the requisites. And finally, please do not be afraid to use free resources like Google, Google images, and even YouTube!

My Final Thoughts

The Mega Five worked well for me during my as a first-year radiology resident because these resources were readily available and came with a wealth of knowledge. If you take advantage of the Mega Five too,  your hard work, diligence, and dedication will pay off. You too will be saving lives “radiographically” one day at a time (A catchphrase for my dating app. I am a single resident, so don’t take it, it’s mine and copyrighted!) So, best of luck to you. Remember, being a first-year radiology resident is tough but there are lots of quality resources to help you out. So, never give up!

 

 

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Five Reasons Why The First Year Of Radiology Residency Can Be The Most Difficult

first year

Second-year radiology residents become overwhelmed and burdened by call. Third-year radiology residents feel exhausted from studying for their core radiology examination. And, the fourth-year radiology residents fret about all the things they need to know before starting their career. But, what about the plight of the first-year resident? Many non-radiology physicians and some long-practicing radiologists think that these residents have it easy since he does not have many responsibilities. He can merely sit and watch the radiology attending to learn the practice of radiology, right? However, in this post, I am going to dispel that notion. I will go through five reasons why I think the 1st year of radiology residency is usually the most difficult.

Little Medical School Background In Radiology

Unlike internal medicine, surgical, ob/GYN, and psychiatric residents, most beginning first radiology residents have had almost no experience in the mechanics of all things radiology. Sure, they take a few courses during medical school. However, they are usually surveys. Also, they do not provide the vast experiences needed to function as a full-fledged radiology resident.

On the other hand, internal medicine residents have worked up patients with histories during their medical school training. Ob/GYN residents have usually delivered a few babies in medical school before beginning. Surgical residents have assisted in multiple surgeries and have worked the floors before their first day of residency. And psychiatry residents have interacted with numerous patients before starting. These initiated residents can almost entirely function from day one.

Instead, new 1st-year radiology residents cannot dictate, review films to be read, or finish the procedures that we perform daily. Since a first-year radiology resident cannot complete most of the functions to be “of use” to the senior radiologist, many first residents feel inadequate until they can begin call as a second-year. At that point, they can function much more independently. However, the lack of training certainly can make for a problematic initial year.

Incredible Amounts of Reading For The First Year

More so than other specialties, radiology requires a boatload of reading during the first year. You need to understand internal medicine, surgery, obstetrics/gynecology, orthopedics, neurology, and more to become a respectable radiologist. Unlike other specialties, you cannot get away with little reading and learn only from your experience with others. If you do not read for hours every day, you will fall behind and not pass the core examination. Many residents do not know the requirements before starting and take a long time to adjust to the nightly reading regimen, a painful process.

Dictations- A Difficult Road

Imagine your frustration as you first start with never having held a Dictaphone. You click the wrong buttons and feel unsure of yourself as you talk into a stick!!! This routine is typical for the first year that starts to dictate. Not only does the first-year resident have to get the physical mechanics of learning dictation, but they also have to create a report that makes sense. This process often occurs with little instruction or regimentation. It becomes hard to put ourselves in the shoes of the first-year resident. However, as an associate residency director, I regularly recognize how hard it is to start from scratch what we routinely do as radiologists daily.

Frustrated Attendings Who Don’t Want First Years Around

Unlike more independent senior residents, radiologists typically have to take extra time out of their day to teach a first-year radiology resident. Given the increasing workloads of radiologists, many attendings see this as a burden. They would instead get home to their family on time in the evening. Additionally, the attending does not know the first-year resident well. Therefore, he cannot figure out how much responsibility to give. Other radiologists feel forced and have no desire to teach. The frustrations of many attending radiologists reflect in the personal interactions with the first-year resident. Often, the resident gets the sense that he/she is not wanted around. Depressing, huh…

Noon Conferences- A Foreign Language

Have you ever listened to a conversation in a language that you do not understand? That is the feeling that the first-year radiology resident often gets when he/she goes to the first noon conference. Attendings give noon conferences on topics such as ultrasound or MRI. Yet, these radiology residents have never seen these images. On top of that, they use language that is not common vernacular.

Moreover, the findings are incomprehensible to the uninitiated resident. Many attending radiologists do not recall what it is was like to attend these conferences. However, these esoteric conferences are standard for first-year residents.

The Final Upshot For The First Year Resident

Senior radiologists can easily dismiss and forget the challenges that first-year radiology residents face. However, please don’t discount the first-year radiology resident’s frustrations, experiences, and anxieties, as they are genuine. It takes an extended period of adjustment to acclimate to the daily work experienced by radiology residents and attendings. Give the lowly first-year radiology resident a chance!!!