Tag: job market

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Radiology Practices Feeling The National Radiologist Shortage Crunch!

shortage crunch

I can’t speak for everyone. But, nowadays, most practices throughout the country feel the pinch of an acute radiologist shortage crunch. For those on the job seeker’s side, the news right now is a mixed blessing. It is excellent for those of you searching for a job. But, once you set your career path, you may notice longer-term issues until the crisis resolves. Here are some of the problems you may encounter once you start working.

New Radiologists Making More At The Expense Of Future Earnings

Most of you probably see some of the advertisements for new radiologists on the web. Starting salaries of 400,000, 500,000, or more are not uncommon. But all this money needs to come from somewhere. Well, it is coming out of the pockets are practices, hospitals, or corporate radiology, to meet the coverage needs of the radiology work that needs completion. It just means that new radiologists are less likely to see the more significant raises they typically get when they achieve parity with the partners or own shares in the practices. Every dollar comes from somewhere!

Larger Stipends From Hospitals Means Increased Dependency

The lack of radiologists also means that hospitals are committed to ensuring that radiologists stay in the fold. Commonly, hospitals are issuing increasing stipends to practices throughout the country. Unfortunately, this process increases the dependency of radiologists on the hospital and not their work. So, when conditions change (and they certainly will at some point!), it can make it all the more painful when hospitals pull the rug out from the radiologist and stop issuing stipends upon leaner times. Eventually, hospitals are more likely to be able to take over lesser well-run practices. Too much dependency on other institutions is not ideal for the solvency of radiologists in the long run!

Unending Work And Shift Coverage

Sure, extra work is great when you are starting and are hungry for more business and money. But as you get along over time, the extra work is not so desirable. Many of you will likely have families and other obligations to which you will attend. Nevertheless, the streams of work keep on flowing to no end. And who will be covering all this work? Most likely you, whether you like it or not!

Shortage Crunch Increasing Long-Term Competition And Midlevels

I’m all for physician assistants, nurse practitioners, and other mid-levels to help the radiologist. However, suppose radiologists cannot meet the demands of the radiology world. In that case, different professionals will likely replace our roles due to a lack of ability to meet the needs of today’s imaging. These include increasing independent procedures and reads performed by these helpers. In addition, it also makes us more likely to lose work to other physicians. Cardiologists, urologists, and neurologists are just some physicians who would be happy to take over some of our business. Over the long run, this situation does not bode well for radiology practices.

More Films Going Unread And Increasing Liability

With the inability to command more staffing, more films will go unread. Patients will have more complications from a lack of appropriate imaging workups. And this can all lead to increased liability for radiology practices that are obligated to read all the films promptly. An incomplete workforce of radiologists hampers medical care and increases the potential for lawsuits!

The Shortage Crunch Continues! 

Although I do not have a crystal ball, I don’t see an abrupt end to this acute radiologist shortage crunch; The imaging loads increase every year with new technologies and the increasing age of our population. The numbers of new radiologists are not significantly increasing to meet the demands. And it takes ten years to create new radiologists starting from the beginning of medical school, so creating more radiologists is like turning a large aircraft carrier- it takes forever. Moreover, based on recent experiences with artificial intelligence, it has not replaced us or made us significantly more efficient. If these trends continue, we will continue to dive into the abyss of a shortage crunch. Good news, we’ll all be in high demand. Bad news, these pressures will probably continue for years to come!

 

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Radiology Sign On Bonuses: A Marker Of An Imploding Practice Or A Booming Market?

sign on bonuses

Nowadays, checking out any of the job websites or even the ACR career center, it’s like window shopping at a candy store. So many great opportunities. High salaries, suitable locations, and even sign-on bonuses. But, are these jobs with sign-on bonuses all that they are cracked up to be? I mean, how bad can it be, begin with an extra twenty grand before you have even started to work! Well, of course, there is more to the sign-on bonus than what you would realize at first glance. So, let’s go through some of the conditions and circumstances for that first sign-on bonus. And, let me even disappoint you some more when you find out the strings that may be attached!

The Clawback

First and foremost, when you sign on to that job with the bonus, take a look at the fine print. Often, the money will come with the assumption that you will be working there for a certain amount of time. It could be one, two, three years, or more. And, the firm will have the right to take a portion or all of it back if you have not met all the specified conditions.

Look At The Specifics

Sometimes, this signing bonus can be not exactly what you think you are signing up for. Take a look at all the stipulations. It could depend on the number of films that you have read. Or, the practice may only release the money on the condition that you have read mammograms or another specialty that does not interest you. Again, the devil is in the details!

Issues With The Practice Itself

Then, you need to ask yourself, why is the practice offering this extra money? Can’t this imaging center find great people because they are a known entity in town where all the radiologists want to work? Take a second look if they are offering you a bonus. Sometimes these entities provide these excellent bonuses because they can’t retain their employees currently. Is this “gift” just an act of desperation to find a warm body to read the films? Well, maybe yes or maybe no!

Market-Related Factors

And then finally, the most likely reason for sign-on bonuses, the market itself. Is the demand for radiologists at the moment so competitive that it forces them to compete with additional incentives? Is the location not that desirable? Is there truly a severe shortage of radiologists that they would have to make such an offer? Any or all these reasons may be at play. A practice can be an excellent place to work. But, market forces can sometimes create a situation for you to gain from their loss. And, for the end of 2019, these situations are all too common.

My Final Two Cents (A Bit Less Than Some Sign-On Bonuses!)

Really, the case for a sign-on bonus depends on many circumstances, some practice-related and others that rely wholly on the market. In any case, make sure to look at the fine print before you “sign-on” to a job with a sign-on bonus. It may not be what you had initially thought!

 

tomatoes

 

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Job Market Is Booming: Are Fellowships Still A Necessity?

fellowships

Let me clear up the facts for all the radiology residents that are thinking about fellowships in this market:  Just like any other job market, the number of radiology attending positions available is subject to market forces. Moreover, this prolific job market will not last forever. To support these claims, in my medical career, I have seen two job cycles, trough to peak. And we are sure to see others. It’s just a matter of time.

So, how does the changing job market impact the topic for today’s blog, the necessity of fellowships? Well, I have a bit of explaining to do.

Back in the early 2000s, when I completed my residency at the last market peak, great jobs were everywhere. California, New York, and  Florida were no exceptions. The theme of the job market was: “Name your price!” And, I can distinctly remember the heated discussions in the reading room about whether fellowships are necessary.

Well, it’s happening again. All you need to do, go to the recent forums on Aunt Minnie on the topic. Or, you can stop by my residency program. You will hear a few passionate debates on the matter. (We had this discussion during noon conference a week or two ago!) Regardless, I think this is a prescient indicator of a market peak. Not that it means we will experience a sudden downturn. But, we are riding somewhere along the top of the curve.

So, what happened the last time around the market went from peak to trough? Well, if you took a poll of radiologists without a fellowship, I believe a higher percentage of these folks would have had more issues with their career than those with one. Therefore, I am going to throw a bit of proverbial cold water on those of you who are thinking about going down this non-fellowship path by telling you why.

More Likely To Have Work You Don’t Like

For better or for worse, those radiologists without a specialty tend to have less control over their domain of practice. Don’t like mammo and plain films? Well, you can’t say you are an expert in another area that you enjoy more when you are starting your career. So, guess where the practice will want to place you!

Severely Limited Job Market On The Coasts

If you want to have a better chance of securing a job in the more populated portions of the country, you will have a much better shot if you have a fellowship. I can certainly speak for my part of the country, New Jersey. It’s possible, but good luck finding a quality position without one!

Not Considered An Expert In Any Area

Now, this may or may not bother you. But, many radiologists like their colleagues and referrers to perceive them as experts in a particular area. Clinicians know individual radiologists and ask for them by name because of their fellowships. That will be less likely to be you!

Much Harder To Start A New Fellowship Once Established

Once you have already been working as a full-fledged radiologist for a while, it becomes much more traumatic to start anew as a fellow. You may have a family. Or, perhaps you have become accustomed to the lifestyle of a radiologist. It’s hard to go back and do a fellowship once you’ve started your career!

Yes, You Will Have Increased Chance Of Losing Your Job

And finally, you may not want to hear this, but as an employee of a practice, when the reimbursements turn down and the market becomes sour, who is the first to go? Well, it’s not likely to be that expert in neuroradiology who the neurosurgeons love. And, it’s not going to be the nuclear radiologist who performs complicated radiopharmaceutical treatments on the referring physician’s patients that the practice cannot replace so easily. Hmmm. Who can be ousted the most quickly without a significant impact on the business? That person is much more likely to be you!

Booming Job Market: Still Need Fellowships!

I get it. You’ve been out working for so many years. And, you’ve become impatient. Maybe, you have a family and want to earn a real living. But, in the long run, it’s not worth the additional risks that you will take by not completing the additional training. So, think again before you choose to enter the job market without a fellowship now. You may regret your big decision later in life!

 

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AUR Meeting 2018- Themes And Undercurrents

Welcome to the second annual review of the Association Of University Radiologists meeting in 2018! So, why do I think we should review this meeting on an annual basis? Well, for one, many of the changes in residency you will experience stem from the academic realm.

Moreover, if you were to read the headlines and the summary of the lecture topics of the conference alone you would not get a good sense of what they will be changing. For example, this year, the heading of the meeting states “Health And Well-Being Of Profession And The Professional”. However, this theme is a small part of what actually happened at the meeting.

Yes, the lecturers did cover the topics of burnout and depression, relevant to the heading. But, if you dig a little bit deeper, compared to these themes, you would recognize that many other themes will impact future residents much more. So, what are the undercurrents that were most relevant? Basically, I am going to divide these topics as follows: continued improvement of the job market, increasing radiology residency match competition, the online longitudinal assessment, Radexam, and increasing time requirements for program directors.

The Hot Improving Radiology Job Market

Out of all the news, I think this is probably the most important. Based upon the hot topics lecture series at the AUR meeting, radiology has climbed out of its doldrums and now returns to a more normal job market. In the most recent year, over 1800 positions were available for new graduates. Very recently, the number of new hires amounted to the low 1100-1300. Furthermore, according to the conference, next year they predict that practices will need 2133 new hires. So, workforce demands are significantly increasing. My reasoning for the sudden increase in available jobs: a wave of retirements and willingness of practices to hire due to stable/good economic conditions. So, congratulations to all residents who chose radiology over the past 4-5 years! You can look forward to a great job market.

Continued Increasing Competitiveness Of Diagnostic Radiology Residency

Similar to the previous year, the competitiveness of radiology residency in the match continues to increase. As in the previous year, the unfilled spots continues to decrease and the percentage of US grads entering radiology residency continues to increase. All of these signs point to a much more difficult time for the US and foreign grads to match in radiology.

Online Longitudinal Assessment Replacing 10 Year Exam

Yes, I know that many of you have not yet thought about the maintenance of certification requirements once you have completed your residency. However, this new program will impact all residents today once you graduate and become board certified. No longer will ABR diplomates need to take an exam every 10 years to maintain certification (unless you do not satisfy the requirements of the new program). Rather, everyone who takes the online assessment will be able to skip the test and simply answer weekly questions that you receive via email.

Each year you will receive 104 question opportunities and you can choose to answer as few as 52 per year. You need to pass the scoring performance criteria based on 200 questions every 4 years. Fortunately, this system will replace the time sink of having to attend a test in Chicago every 10 years with all its expenses. I am certainly looking forward to bagging my unnecessary trip to Chicago for the recertification examination!

Radexam Now Operational

For residency programs throughout the country, many have implemented the new Radexam, replacing the old in-service examination. From my experience, the old in-service examination served a futile role in evaluating residents over the 4 years of residency. I believe no correlation existed between the passage of the core examination and the in-service exam. Now, this fact may change. The new Radexam crowdsources questions from numerous question writers throughout the country. And, the questions are vetted and evaluated for validity. In addition, the exam tests residents according to individual residency level. They can be used at the end of a rotation. Eventually, the exams can be tailored toward the types of rotations the radiology residency has (modality or organ based). I look forward to evaluating the quality of this new exam. More importantly, I believe it has the potential to revolutionize evaluation of residents, especially at smaller programs.

Increased Mandated Program Director Time Requirements Officially Implemented Starting July 1, 2018

Especially at the smaller programs like ours, the new ACGME rules about program director minimum time requirements will create an enormous impact on the management of residency programs throughout the country. Check out this webpage from the ACGME and the associated chart below:

https://www.acgme.org/Portals/0/PFAssets/ProgramRequirements/420_DiagnosticRadiology_2018-07-01.pdf?ver=2017-08-10-081454-583

0.3 full-time equivalent (FTE) for programs approved for eight to 15 residents; (Core)
0.4 FTE for programs approved for 16 to 23 residents; (Core)
0.5 FTE for programs approved for 24 to 31 residents; (Core)
0.6 FTE for programs approved for 32 to 39 residents; (Core)
0.7 FTE for programs approved for 40 to 47 residents; (Core)
0.8 FTE for programs approved for 48 to 55 residents; (Core)
0.9 FTE for programs approved for 56 to 63 residents; (Core)
1.0 FTE for programs approved for 64 to 71 residents; (Core)
1.1 FTE for programs approved for 72 or more residents. (Core)

 

Basically, the minimum required time for program directors to administrate programs has in many cases doubled. At our program, we are going from a 0.2 Full-Time Equivalent (FTE) (one day of administration time per week) to a 0.4 FTE (two days of administration time per week). As many programs have suffered from lack of administration time for programs directors, this change should enhance the quality of many radiology residencies. Some manpower/administrative issues that remained unresolved in radiology residencies can now be tackled due to decreased time pressures.

Final Thoughts About The AUR Meeting

Unlike previous meetings over the past four or five years, most of the doom and gloom has passed. Ironically, although the headline lectures were about depression and burnout, the mood was much more upbeat for new and graduating residents. Between the rising job market and the stable economy, the new MOC, increased program director time requirements, and the new Radexam, things are looking up. Even the wave of concerns about artificial intelligence replacing radiologist has seemed to pass us by! (No one believes that it will replace radiologists any time soon).  So, for all radiology residents, you are entering the field at a great time. And, this meeting certainly confirmed my suspicions!

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Should Artificial Intelligence Be Feared Or Welcomed?

artificial intelligence

Question:

Hello!

My name is Yasmin Amer, and I’m a producer for WBUR in Boston. I’m working on a segment about machine learning and medicine, and, of course, radiology is part of that discussion. I spoke to a local doctor and machine learning specialist who says artificial intelligence will make the field more exciting. Is this the attitude of many med students and residents interested in radiology? Are they primarily excited about tech in radiology, or is there any nervousness there? I’m happy I came across this blog – I would love your input.

thank you,

Yasmin Ameren

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Answer To The Artificial Intelligence Question:

Yasmin,

Speaking to my residents about the topic, several of them fear the onset of artificial intelligence and its effect on radiology. Therefore, some residents have decided to go into “hands-on” fields like interventional radiology and breast imaging.

However, most others have responded they don’t see how a machine can synthesize the context of a case, the images, and all the patient-related factors to arrive at a final impression that tailors itself directly to a patient. Let me give you an example in the next paragraph.

Sometimes, two similar ultrasound findings can lead to entirely different management scenarios on breast ultrasound. An MRI may be the most appropriate for a noncompliant patient with multiple slightly complex cysts instead of serial follow-up ultrasounds. On the other hand, in a low-risk patient with the same cysts, the most appropriate conclusion may be to follow them every six months. These are slightly different patients with the same images. How would the artificial intelligence judge who is noncompliant? So, it takes more than just pattern recognition to process the information and arrive at a viable conclusion for an individual patient. I don’t think we are quite there yet.

Then, legal barriers prevent easy entry into the independent practice of radiology. Are large companies going to take responsibility if the machines make mistakes? Billions of dollars of losses are potentially at stake.

It is also interesting that applications to the radiology field have dramatically increased over the past few years. Improvement of the job market right now likely contributes to the increasing desirability of radiology. But that cannot be all. If applicants thought artificial intelligence would rob residents of their future 25-30-year radiology careers, we would not receive so many applications for radiological residency programs.

Long story short. Some fears of the unknown consequences of artificial intelligence exist. Overwhelmingly, however, I believe most resident concerns of artificial intelligence encroaching upon the radiologist’s work are less than the expected barriers to independent widespread implementation without supervision by a radiologist.

I hope that helps,

Barry Julius, MD

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The 2017 Annual AUR Meeting- A Radiology Residency Status Report

Each year in the heart of spring in the United States, academic/teaching radiologists get together at a different part of the country to discuss the newest teaching methods, radiology residency issues, and hot academic topics at a meeting called the annual Association of University Radiologists (AUR) meeting. For new applicants and radiology residents, this meeting is extremely important as it outlines significant changes to the training of radiologists throughout the country. This year is the first annual update from Hollywood, Florida. I am going to go over what I think are the most relevant and important topics at this conference for radiology trainees.

Increasing Competitiveness of Radiology Residency

Traditionally, it is somewhat difficult to measure competitiveness of radiology residency compared to other specialties. One of the more accurate methods is the United States senior U.S. fill rate. Since 2014, there has been a gradual uptick in the senior U.S. fill rate to 72% (last year 68%). In addition, the applicant pool is up 31 percent over the past 4 years. So, it appears that all this talk about artificial intelligence has not yet dampened the enthusiasm of radiology candidates!

There are always two sides to every story, however. Since U.S applicants usually get first priority, it is a bit more difficult for international medical graduates (IMGs) to get radiology residency slots. In fact, on a survey at the AUR meeting, it stated that only 64 percent of programs are willing to take international medical graduates. That number tends to go down as radiology becomes more competitive. Furthermore, programs are no longer able to accept foreign non-ACGME accredited preliminary year internships to satisfy the requirements of the clinical year.

Improving Radiology Job Market

According to the recent AUR survey, practices are increasing both new and current radiology job hires. In fact, projections show an increasing number of available jobs numbering about 2000 today (vs. 1300-1500 jobs a few years ago). The most popular specialties are body imaging, interventional radiology, and neuroradiology.  However, practices need breast imagers, interventional radiologists, and neuroradiologists the most. And, the majority of jobs are in private practice. That being said, large corporate practices do continue to increase hiring radiologists the most.

IR/DR and ESIR

Now that IR/DR is its own distinct specialty, it commanded a fairly competitive match this year. For this subspecialty, the fill rate with U.S. seniors was 85% versus 72% for diagnostic radiology. So by all accounts, the match was fairly successful. In addition, many new residency programs are applying to start up both IR/DR and ESIR programs. Both of these programs allow a resident to complete his/her entire training in 6 years. Unlike radiology residencies willing to add on these programs, residencies that do not start up IR/DR and ESIR programs will force their residents to have to complete a total of 7 years of residency/fellowship for interventional radiology trained subspecialists. Accordingly, those residencies not willing to add either ESIR or IR/DR programs are likely going to have difficulty recruiting new residents.

Rad Exam

The current in-service examinations do not correlate well with resident performance. In fact, many residencies (including my own) cannot utilize the test as a determiner of residency performance given the wide variability. In addition, there is no distinction in the testing questions between different residency levels. To remedy this issue, a new crowd sourced examination call Rad Exam is being created with institutional benchmarks and a large database. Time will tell if it becomes a useful examination to replace our current in-service examination, but it sounds very promising!

Simulation

Although not a discussed in conference at the AUR meeting, a vendor called Simulation was present and had an interesting solution for programs that want a structured precall examination. This company created an excellent standardized test that assesses finding and interpretive skills using a simulated PACS system to help define if a resident is ready to partake in independent call. Additionally, the test is benchmarked to other programs. It seems like it may be significant improvement over the current precall testing options.

ABR Core Examination Frustrations

Interestingly, according to faculty surveys, most faculty members reflect fondly upon the old oral board examination and give low marks to the new core examination as a means of  testing residents to meet basic radiology requirements at the end of their 3rd year. However, even more disappointing to me, the American Board of Radiology (ABR) now takes a new formalized position that they have no role in testing communication skills. In fact, they explicitly stated that their only role is the testing of medical knowledge. According to them, communication skills should be taught at the local residency level.

Call me crazy, but radiology is a specialty of communication, both written and oral, and not just a specialty of medical knowledge. If that is the case, does it make sense that the ABR as an accrediting body is not willing to standardize testing for communication skills as well as medical knowledge to establish a baseline level of competency? I think not. Academic radiologists need to push the board to change their stance regarding communication competency standardization with oral/written board testing!!!

Increasing Required Administration Time For Program Directors

And finally, on July 1, 2018, the ACGME will likely approve an increase in the minimum administration time requirements for program and associate program directors. Presently, program directors at small programs in the United States can have a few as 0.2 FTE time dedicated to radiology residency administration. That number is ridiculously small compared to other medical subspecialties. Now, that number is going to increase based on a sliding scale corresponding to size of programs in July, 2018 assuming approval by the ACGME. How is that going to affect incoming radiology residents? I believe it will significantly increase the productivity and efficiency of residency programs on issues as wide ranging as educational conferences, evaluations/assessments, milestones, and more… It has been long since overdue.

Summary

As I see it, these are some of the most pressing issues tackled at the AUR conference. There are certainly other issues faced by academic radiology programs. Some of them mentioned at the conference and others largely ignored. There is a bit of good and bad news from this conference for everyone involved in radiology residencies throughout the country. Until next year at the AUR meeting in Nashville, Tennessee!!!

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How To Combat A Difficult Radiology Job Market!

job market

Once again, like in many other economic cycles, the radiology job market has hit a bit of a pause. This time, it is due to Covid-19. Although the job market is not as bad as it was back around 2010, it certainly is not the same as it was at the beginning of this year. And, in many locales, the job market froze up entirely. Competition remains fierce in desirable practices on the east and west coasts. Even with some folks abandoning the cities for the more suburban and rural areas, you will likely find it very difficult to obtain a partnership position in San Fransisco or Manhattan!!!

How do you, as a graduating radiology resident or fellow, begin to approach finding a job in this competitive landscape? We are going to cover the essentials for finding a quality job in these problematic radiology markets. I will divide the essentials into the following sections: networking, diversification of skills, location, recommendations, and research/national organization involvement.

Networking, Networking, Networking!!!

Maintain Relationships At Home

Networking does not only begin when you start looking for a job. The search for the ideal job commences at home. What do I mean by that? The first and most important part of networking is maintaining good relationships with your colleagues and attendings.

Many attendings have their proverbial “ear to the ground.” More often than not, therefore, many can tell you about opportunities in the area. Moreover, they can guide you to those jobs. So, to get access to these high-quality jobs, you need to perform and be a good team player. The resident that has not been “playing nicely in the sandbox” during training will not receive those inside tips. More likely, the poorly behaved resident will need to fend for himself. On the other hand, residents who continuously strive for excellence and relate well to their colleagues will have first dibs on those desirable jobs with connections to your radiology attendings.

Keep In Touch

It also becomes more critical than ever to stay in contact with your colleagues and coworkers. When you are ready to leave your residency to go to your fellowship, keep in touch with your former colleagues, residents, and attendings. You never know when that next job lead is going to pop up. And, most former colleagues will happily give you a tip for a new contact. These connections will be the most likely to help with finding that next great job.

What about social media? Nowadays, professional-based social media groups such as LinkedIn can play a role in getting that next job. Besides, social media can keep you in contact with your former colleagues. And, social media allows you to let others stay aware of your current training and expertise. Therefore, residents should maintain at least one account. But be careful to keep the account relevant and correct. View it as a resume. If it is not updated and contains false information, it can be detrimental to finding that next great job. Otherwise, it can be a great way to contact your former colleagues as well as a way to obtain new leads.

Always Be Nice

Finally, even when you have started on that first job, whether it be a dream job or merely a stepping stone, make sure to be cordial and appropriate to your interviewees. I remember when I was interviewing, I met with a private practice attending who was touting the merits of his work to me. I subsequently found a job with a different practice. However, six months later, that same attending who interviewed me became an interviewee at my current practice. You never know what is going to happen!!!

Diversification of Skills

As a resident and fellow, try to do things in your field slightly out of your comfort zone. What do I mean by that? You never know what practices are going to want. Things change. Sometimes an imaging business may need a cardiothoracic radiologist but also require a radiologist that can also read mammograms. Other times, a practice may need an interventionist that feels comfortable with reading musculoskeletal MRI. To become the most competitive candidate in your class, you need to make sure that you feel comfortable in as many modalities as reasonable. Therefore, you should not just concentrate on your fellowship skills or areas of comfort, but also your weaker procedures/imaging areas.

As a fellow, it also becomes crucial to moonlight to maintain your skills in other general radiology areas, outside of fellowship. It can build your speed and accuracy. So, when you start your first job, you will be able to read studies at a reasonable pace. Moonlighting will allow you to have a higher likelihood of remaining at your first job after training!

Should Location Be The Sacrificial Lamb?

Sometimes the job market in some locations becomes so ultra-competitive that good jobs may not exist in your desired area. In that case, there are times when it makes sense to alter one’s expectations and apply to other locales outside of one’s original intentions. By switching locations, the applicant may significantly increase the job market choices that will allow her to practice her subspecialty or earn more income. However, an applicant should not take this decision lightly because personal or family issues sometimes can trump job selection. But, an applicant should consider all the alternatives before selecting a job.

Recommendations

As a radiology resident or fellow, obtaining a radiology job recommendation differs significantly from asking for one as a medical student. Instead of a formal letter, a radiology resident or fellow should let the attending know to expect a phone call from a radiologist at the practice where he had interviewed. Although informal, this practice gives more information to the radiology practice than a simple letter of recommendation. A radiologist can relay the real personality and information about a candidate on the phone more easily without legal repercussions. In this situation, no paper trail exists.

In the conversation, the caller may informally ask your supervising attending about your work ethic, whether you played well with your team, and more. Other times, a member of the practice may speak with a friend of theirs within your residency program to confirm that you would make a reasonable job candidate. Bottom line: it is good manners to let your attending and program know to expect a phone call!

Research/National Organizations

For those interested in academics, completing research projects can help to snag that first academic job. Although not as crucial for the private practitioner, it also can’t hurt to have completed research projects. As I’ve mentioned in a prior post on research, if practices have a choice between two equal candidates, they may sometimes choose the resident with more research experience. You never know…

Also, getting involved in national organizations, whether it be the ACR, RSNA, or AUR, can be a great way to learn about the politics of radiology as well to meet colleagues and practitioners. Residents should consider participation in these organizations.  It could be a stepping stone to find a great job or to become the next President!

Final Thoughts About The Job Market

If the job market is tight, all is not lost. Even in the most challenging markets, some practices will usually have a few jobs available. To increase your chances of getting one of these popular slots, you may need to work a bit more intelligently and focused so that you can become a desirable candidate. Networking, diversifying your skills, making sure to get great recommendations, finding the correct location, and participating in research and national organizations can help your cause. Ultimately, these practices will choose someone that fits the expected identity of an ideal candidate. If you follow these essentials, you have a much better chance that that person will be you. Good luck!!!