During residency, most physician trainees are studying and working so hard that they vaguely realize what is in store for them when they finish their training and begin their first job. What they often expect differs dramatically from reality. So, I thought this would be the post to give you the lowdown on some expectations versus reality when you start as an attending. We will cover six employment topics: money, job performance expectations, the importance of the bottom line, teamwork, case sign-off, and feedback.
Money Issues
Scenario
You begin residency and see these large salaries that come across in your email from recruiters. And, you hear stories of friends doing well at their first job, making tons of money that they don’t even know what to do with.
The Reality:
Many residents consume themselves thinking about the relatively “large salaries” they will earn once they finish their residency. You may think, well, if I can do that for ten years, I will be out of debt and rich. However, every large salary comes with a price. Either you will be working like the proverbial “dog,” or you may be located in a place very far from your friends and family.
Other new attendings also do not realize the costs that accrue from debts, buying a house, and maintaining a luxury lifestyle. Often, these folks go into further debt, funding a lifestyle that they cannot afford. Don’t let that be you!
Job Performance Expectations
Scenario:
You have just graduated as a neuroradiologist, and you are ready to take your first job. The job post said you would be performing 50 percent neuroradiology and no mammography while on a partnership track. You are excited as can be not to have to read any mammography!!!
The Reality
As soon as you start, one of the partners asks you to help out reading mammography by taking a course and over reading one of the other radiologists’ mammograms. Since one of their mammographers left, they need the help until they can hire another.
This situation is commonplace in the world of private practice. Sometimes, undue circumstances arrive beyond the practice’s control, and your expectations for your work will not precisely align with reality. If you cannot be somewhat flexible, you may not become a partner in the practice!
Importance of the Bottom Line
Scenario:
Your academic nuclear medicine position at a high-powered center of excellence is about to begin in a few days. Since it is a large academic center, you figure you will have lots of administrative time to pursue your research interests. I can’t wait!
The Reality:
After a few days of working in your position, the institution issues rules regulating administrative time. If you cannot obtain a grant to support the institution, you will have very little administrative time.
Don’t assume that a large academic institution does not care about how much money it earns. It needs radiologists to financially support the institution by reading films just as a private practice needs to perform procedures and interpret enough films to stay solvent. An academic institution does not mean lots of free time!!!
Teamwork Expectations
Scenario
You are about to begin your first private practice job, and they told you that they treat all employees and partners equally. So, you are very excited to start a career with an equal footing to everyone else.
The Reality:
In your first week of work, a partner asks if you could help him out with reading some extra films because he and his wife want to go to a concert. You tell him that you had early dinner plans with your wife, but he continues to insist. You feel you have to stay to complete the work because he is an influential partner in the practice. Bottom line… Everyone is equal, but partners are often more equal than others!!!!
Case Sign-off
Scenario:
You are sick of waiting for your attending radiologist to sign off the reports you dictated a few hours ago. When you finish residency, now you will be able to complete your dictations whenever you are ready!
The Reality:
Now that you are the final reader and the buck stops with you, you become unsure of the findings and want to ask your colleagues before completing some of your more complex reports during your first days of work. Well, now you don’t have to wait for someone else to sign off your reports. Instead, you may need someone else to look at the cases for a second opinion before completing the study!!!
Feedback
Scenario:
The practice partners state that you will get immediate feedback about your progress after six months. Furthermore, they say that they can even tell who will be partnership material by the first year.
The Reality:
Six months roll around, and no one lets you know about your progress. You think you are doing well, but you are not sure. The patients and the clinicians seem to like you. After one year, no one lets you know if you will make a partnership after the three years they promised you. Unlike residency, feedback can be much more challenging to obtain since it is not designated. There is no guarantee!!!
Expectations For The New Attending!
Becoming a radiology attending is not like entering Shangri-La. There will be new challenges that you do not expect. Along with the added respect, you will have many additional responsibilities. So remember, as a radiology resident, try to prepare yourself for the reality of becoming a radiology attending. So, you will not be surprised about what to expect when you begin!!!
Dictating is a rarely touched upon but vital tool in radiology. Over a radiologist’s 30-year career, they may dictate over 360,000 reports (assuming 12,000 cases per year for 30 years). In today’s world, the dictation usually spurs clinicians to act on their patients. In my experience, out of 100 cases, clinicians only act on a couple of them using other forms of communication such as conversations with a radiologist or interdisciplinary conferences. Moreover, just like a manufacturing company that creates automobiles, dictations form the end product of the radiologist’s service. We leave over only the dictation in the medical record after we are gone.
Learning dictating indeed has a “steep learning curve,” meaning that residents rapidly incorporate dictation techniques. And, they acquire a lot after the initial year of training. But it takes years and years of experience for a radiologist to fine-tune their dictations to the point of maximum utility for their readers.
Resident Versus Seasoned Dictating
So, how do a radiology resident/newly minted radiologist and seasoned radiology attendings’ dictating differ? Well, certainly every rule has its exception. But for the most part, when you look at a resident or new radiologist’s dictations, you see a more verbose conclusion and a comments section that contains more irrelevant findings. And that perfectly makes sense. Why? Because it takes time for new radiologists to get a sense of what is truly important for the clinician. Most seasoned radiologists already know this information innately from years of practice.
Residents Need More Formalized Guidelines To Learn Dictating
To top things off, many radiologists assume that their residents will know how to dictate appropriately after a short period. And, many believe that a radiology resident just learns to dictate by osmosis. But, in reality, if you want a resident to know the right way to dictate, we need to provide as much guidance as possible. So, that is my goal in this post. To do so, first, I am going to discuss a little about templates for dictating. Then, I will give you some guidelines for each part of the dictation: the history, the technique section, comparisons, comments, and the impression. And finally, I will talk about the use of structured and prose dictations.
Templates:
When I was a resident just starting, I remember we had a booklet of templates for all sorts of commonly used dictation types for residents. We would carry around this book during our first days of dictating. And then, we would dictate the information on tape recorders to the secretaries upstairs. Today most institutions use dictation/voice recognition software, but the template concept is similar. It is easier than ever to gather templates from other radiologists for dictation when you are starting.
In the beginning, numerous template choices can complicate how to decide on using a template for a dictation. So, I would recommend finding the best template for a given type of study. Then, stick to this one type of template when you are starting. Sure, some radiology attendings will insist you use their templates for a given report. That is fine. You should certainly abide by your attending’s wishes because, in the end, it is your faculty’s report. Overall, just try to be consistent. The more you use a given template, the more likely you will remember all the items you need to include in a dictation.
Even as a seasoned attending, templates are still handy. Why? They save time. In addition, you can use them as a checklist to make sure you have looked at all the different organs and physiological systems within a study. (As I often do!)
Important Pitfall
However, you will encounter a few pitfalls with templates. So, you need to be wary. The biggest problem: you may forget to take out the pertinent findings embedded in the template. I’ve seen many reports with the following statement in the comments section: The kidneys are normal because it is the embedded information in the template. However, when you see the beginning of the comments section and the impression, the dictation says there is a cystic mass in the kidney. These inconsistencies confound the clinician, leading to phone calls and medically ambiguous outcomes and lawsuits. So always make sure to check your work twice before the dictation is signed off/completed.
Histories/Priors:
Over time, requirements for histories have drastically changed. When I first began my radiology residency, attendings expected a history to be a one or two-word blurb about the patient’s condition. Now, with all the new regulations, accreditation bodies, and ICD-10 codes, the histories need to be comprehensive. Our billing managers recommend putting as much relevant data as possible in the history to ensure that the study is fully reimbursed.
One example: When I first started, the attendings frowned upon putting the patient’s age in the dictation history. Now, suppose I don’t add the patient’s age in my cardiac nuclear medicine dictations. In that case, the hospital cannot send the report to the accreditation body for our hospital nuclear medicine department to continue with cardiac nuclear medicine accreditation. So, try to put in as much relevant/appropriate data as possible in the history. In addition, more history can also sometimes help the clinician formulate a proper conclusion to the clinical question.
Finally, make sure to put relevant information from prior studies in this section. Often, instead, residents will add this information to the body of the report. The body of the report should not contain the history. Why? Because the clinician can confound the timing of the findings in your dictation, potentially changing management. Remember, you can refer to the history from the body, but the history does not belong in the body of the report.
Technique:
I consider the technique section the stepchild of the dictated report. The clinician and radiologist often ignore this section. But on occasion, it comes in very handy. Moreover, as a radiology resident, you should report it accurately. Why? For instance, you may say there is a 5 mm axial slice thickness on CT scan. Suppose you didn’t see a pulmonary nodule on that study, and the subsequent study has a slice thickness of 2 mm. In that case, the pulmonary nodule may have been on the prior study but not visualized because of the differences in technique. And, if you do not state the method accurately in the dication, it can confuse the clinician and the radiologist. So, do not ignore this section.
Also, don’t assume that the template technique is always correct. Many times residents and attendings alike will create a fantastic dictation. Then, I look back at the technique section. It is wrong. Of course, the resident did not change the standard technique template format. This dictating error happens more often than physicians realize. Make sure to pay attention!
Comparisons:
The site of placement of the comparison section varies from radiologist to radiologist. I will state comparison is made to the previous study dated blank at the beginning of the comments section. Others will make this into a distinct section. Regardless, it makes your comments and impression much easier to understand. The reader always knows which study you are referring to for comparison when you state something is worse, better, or improved.
Comments:
If you want to “go to town,” I recommend doing it in the comments section. Here you should place all the pertinent negatives and positives. Be detailed and specific, especially as a radiology resident. Describe the findings well. Make sure to put in locations, size, morphology, density, and so on. And, if you see an essential finding, make sure to put the slice number in the dictation. Over the years, I have found it much easier for the attending radiologist to pick out the abnormality you are reporting, especially when the finding is subtle.
One issue confounds the novice: should you put the differential in the comments section or only in the impression section? I recommend stating the relevant findings in the comments section and then giving the expanded differential in the comments section based on the relevant findings. You can also say the reasons why you think your final diagnosis is what it is. You can hone and tighten that information in the impression section later.
Again, I can’t repeat enough, be careful with using templates. As mentioned above, we often see inconsistencies in the report because standard template statements remain in the dictation. Make sure to erase the pre-populated statements in the comments section if you state a finding that differs from the standard normal template. Be very careful. Remember the report is a legal document. The attorneys can use it against you in a court of law!!!
Impressions:
The impression becomes the standard-bearer and the central representation of the quality of the report. To accomplish that, it should contain the information that most pertains to the clinical question. For instance, if the symptom says lymphadenopathy/possible sarcoidosis, you should place the relevant answer concisely in this section. Always think of the impression as the answer to the study; if you do that, your impressions will become relevant and valuable to the clinician readers.
In addition, clinicians will almost always read the impression. (If not, they should work in another field!) Many of them skip over the remainder of the report. So, I would like to say that the impression exists for the clinician. The rest of the report is for the radiologist. So, make sure to spend the most time on this section. Check this part repeatedly to make sure what you are dictating makes sense and you state it with brevity and relevance. Also, make sure to put your conclusions in this section of the dictation. And, don’t forget to put here anything else that you think the physician will need to know, such as management or follow-up.
Beware Of Technical Jargon
Don’t use technical jargon in this part of the report. What annoys radiologists the most? You got it… Getting phone calls for unimportant questions about technical terms within your dictation. It wastes lots of time and energy. I can assure you if you put terms in your report in this section that a clinician does not understand, you will get way too many silly phone calls!!!
Stick To The Answers
Finally, the impression should contain the most relevant conclusions in your dictation. So, for instance, if you describe the following in your comments section: Within the liver, there is a hypervascular well-circumscribed mass in segment VI measuring 2.5 x 3.0 cm on image #51 with some peripheral nodular enhancement. Delayed imaging does not show typical centripetal filling. The differential includes most likely atypical hemangioma. Other etiologies such as a hepatic adenoma or hypervascular metastatic lesion are within the differential diagnosis but are less likely.MRI is recommended for further characterization. Then the impression can say something like Hypervascular segment VI hepatic mass. Consider most likely hepatic hemangioma. Correlate with abdominal MRI for further characterization.
If you notice in the last paragraph, I have placed the most likely conclusion and the recommendation for further study in the impression section. You can leave the other information in the body of the report for further reading if necessary. This way, the clinician knows what you are thinking. Additionally, you have guided her on what to do next without the excess verbiage to potentially confuse the clinician.
What terms are most frowned upon in the impression?
Avoid the usage of cannot be excluded. This statement does not help the physician. Moreover, it does not provide any additional information to the reader. The sun can swallow the earth in the next hour. This event cannot be excluded!!!! If you enjoy angering your colleagues, this statement will work the best. Many clinicians will need to order additional unnecessary tests since she has to work up an improbable possibility.
But, I do like to give one exception to this rule (as always!) In a positive pregnancy test and a negative pelvic ultrasound setting, I will say ectopic pregnancy cannot be excluded because I always want the clinician to follow the patient for ectopic pregnancy with blood work/B-HCG levels regardless of the findings in my dictation. Otherwise, make sure not to use this phrase in the dictation.
Also, do not use the statement clinical correlation is recommended. We, as radiologists, need to correlate the radiological findings with the clinical findings. Clinicians consider this phrase to be a lazy, unhelpful statement almost all the time. Don’t make the radiologist look bad!!!
In addition, you will discover other terms that may irk some radiologists. Others may not care as much. I remember one attending who hated the phrase lung zone and the word infiltrates on a chest film. To this day, I do not use these phrases in my dictation because I do not think they are specific. However, I often come across these phrases in other radiologists’ reports. So, you still need to abide by the quirks and specificities of individual radiology attendings. In the end, it is their name at the end of the report!!!
Structured Reporting Dictating Versus Prose Dictating
Structured reporting itemizes the different findings in list form. Most structured reports are organ-based. And typically, you will create the report as a fill-in-the-blank or menu choice of items the radiologist needs to pick. Using structured reporting vs. prose dictation styles has become an area of controversy. Newly minted radiologists will more often apply the rules of structured reporting dictations, and seasoned radiologists tend to use a more flexible prose style. But, you will find a significant cross-pollination of both techniques at all points in the career of radiologists.
I found a great article from Radiology called Structured Reporting: Patient Care Enhancement or Productivity Nightmare. (1) In fact, I highly recommend you go to this URL if you are interested in learning the advantages and disadvantages of each style of dictation. However, I will summarize by saying that the key to a thorough and understandable dictation, regardless of the style, is to remember to create your mental checklist and stick to the same program each time you do a dictation. You may adopt either style, as both can be appropriate. Some departments, however, may have standardized dictations and may require the use of either of these styles. So, you need to abide by the rules of your department!
Dictating Tips: A Final Conclusion
You will learn the basic mechanics of dictation rapidly. However, learning to dictate concise, relevant, and valuable reports for the clinician takes four years of residency and beyond to hone your skills. I hope the guidelines above make your transition to a more professional dictation style a bit quicker and easier!
Although not every radiologist fits the particular stereotype for their generation, some generational stereotypes ring true. On the whole, the baby boomers, Generation X, and Millennials perform better and worse in some parts of the radiology workforce and have their own particular needs. When you work with these individuals, it is vital to keep this in mind. Sometimes, we need to change the way we operate to accommodate these differences. So, today I would like to go through some areas where radiologist generations differ, arranged by different topics. I hope you enjoy it!
PACS And Social Media
Baby Boomers: These folks tend to be less comfortable with PACS system changes. So, beware of the PACS upgrade! It can wreak havoc on their lives. Social media can be somewhat foreign to these radiologists. Many of these radiologists do not have Facebook, Linkedin, or Instagram accounts. So, sending out messages via these media may be a waste of your time.
Generation X: For these radiologists, PACS utility issues tend to be a mixed bag. Some of the less tech-savvy radiologists fall into a similar category as a Baby Boomer. Others are more adept with PACS systems. On the other hand, social media outlets are generally much more native to the Generation X radiologist with broader and more frequent use. Although not all of these radiologists use social media, you will be more likely to find these folks more comfortable.
Millennials: On the whole, these radiologists cope well with PACS updates and changes as long as the network runs correctly. Their technology knowledge enables these individuals to learn quickly and grasp the most efficient ways to learn PACS. Social media is not just a tool for many of these individuals; it can be a way of life. Their online persona can become just as important as their offline interactions. They tend to engross themselves in the online world.
Barium Work/General X-rays
Baby Boomers: This group of individuals has, by far, the most expansive repertoire of experiences with both barium work and plain films. Since it was the mainstay of radiology initially, they often pick things up that their more junior colleagues will miss. They can work wonders with barium and grasp the nuances of a good barium examination.
Generation X: They can read plain films rather adeptly and efficiently. Although not as seasoned as a Baby Boomer, they can read an x-ray reasonably well and are comfortable with most barium work. During residency, they have had lots of experience with films and barium slinging.
Millennials: Since they spend a lot more time with CT and MRI than plain film work during the residency, overall, they are less comfortable with plain film interpretation. As residents, hardcore barium studies experience such as barium enemas can be minimal. So, the performance and interpretation of these studies can be a bit more challenging.
MRI
Baby Boomers: It is much less likely for the Baby Boomer to feel comfortable in this modality since they may have completed MRI training after their residency. Most Baby Boomers will avoid MRI if possible.
Generation X: Plus or minus. Depending on the experiences during residency, some feel very comfortable with general MRI work and others less so.
Millennials: Most Millenials are comfortable with all MRI since it has become “bread and butter” radiology, just as standard as all the other modalities out there. I would certainly put a lot of faith in their excellent reads!
Vacation Time
Baby Boomers: This generation believes in the adage “live to work.” Overall, they tend to take less vacation than given (although they get more vacation time than the rest of the generations!)
Generation X: They have a similar work ethic to the Baby Boomers than Millenials, although they can straddle both sides. Vacation time is essential, and they fully take advantage of their time off the job.
Millennials: Everyone needs to work around the Millennials’ schedule. Their motto is “work to live, not live to work.” They like flexibility in their schedule and will do whatever they can to get to the lifestyle they want. Every day a practice gives vacation time, these radiologists will take the day. They do not spare a moment that they can use to bolster their lifestyle.
Money
Baby Boomers: For the most part, these radiologists sit on a large nest egg, having worked through radiology during its most lucrative years. Debt load tends to be nonexistent. They have the most flexibility and can leave the workforce whenever they want. Many of these radiologists perform their job solely for the “love.”
Generation X: Most of these radiologists have paid off their debts and have done relatively well in their specialty. Money is still important to these folks because they still do not have enough to retire. But, they have good jobs and will do well overall since they have been working during the “good years.”
Millennials: Severe student debt weighs down these radiologists and can limit their opportunities to places and jobs that this generation does not want. It almost runs counter to their ideal lifestyle philosophy. These radiologists also started to work in the field during lean radiology years and are more likely to have had less opportunity to make money. Hence, there is some bitterness when it comes to discussing the topic of money!
Interpersonal Relationships
Baby Boomers: Overall, this group develops solid interpersonal relationships with their colleagues and staff. They never had the opportunity to rely on social media or other forms of technological communication, so they deal well with others. In addition, they have the least need for external approval.
Generation X: These radiologists probably have more in common with the Baby Boomers than the Millenials since they grew up in a world without social media. They were allowed to fail just like the Baby Boomers but were more protected than them. But, they do develop strong interpersonal relationships with their colleagues.
Millennials: Since many of these folks were not allowed to fail growing up, they need to be outwardly appreciated by their colleagues much more than the other generation. They spend a lot of time on their mobile devices, garnering relationships with others. Since online life can be just as important as their offline persona, some can seem outwardly unfriendly because of the time they spend on their devices.
Teaching Expectations:
Baby Boomers: They love a great lecturer and taking cases. However, after completing a teaching episode, the Baby Boomer will research and read the topic to reinforce learning. Overall, the Baby Boomer does not care about electronic media, but some will use it. Old-fashioned books instead of ebooks work better for the Baby Boomer.
Generation X: The typical generation Xer fits somewhere between the Baby Boomer and the Millenial. They will do their research and not expect the lecturer to tell them everything they need to know but understand the practicalities of ebooks and electronic resources.
Millennials: They traditionally have been spoon-fed information in lectures. And, they expect everything to be spelled out for them when others teach them. Overall, they expect the teacher to know everything about a topic and point them toward all the resources they need to read. Most Millennials use ebooks exclusively and will utilize electronic media to reinforce all learning.
Summary
I repeat, “These stereotypes certainly do not apply to all radiologists out there!” However, I think there is an overall tendency for individuals of each generation to fit some of the stereotypes. Knowing the strengths and weaknesses of each generation allows us to schedule accordingly, allocate appropriate resources, and understand what each generation needs. For instance, since the Millennial tends to have a higher debt load, allow for more moonlighting opportunities or extra work. Or, make sure to incorporate additional training with new electronic PACS system upgrades for the Baby Boomer. Bottom line- it pays to understand each generation!!!
Often radiologists deliberately take advantage of the opportunity to do legal consultation work for a fee. These services include expert witness work and legal brief consultations. Their colleagues deride some of these radiologists. Other physicians call this “selling out” to the lawyers. But is it? Today I will discuss why I think that radiologists who perform legal work provide some benefit not only to their financial well-being but also contribute to their own clinical and professional skills as a radiologist.
Better Understanding Of Radiology Malpractice
Nowadays, in the United States, radiologists encounter so many pitfalls that can potentially envelop them in a lawsuit. Sometimes the only way to avoid one is to observe others’ mistakes. Participating in legal work provides this window to see other radiologists’ errors and to understand how to prevent these hazards. We are only a hair’s width away from being involved in a lawsuit for our actions and vocabulary daily. Why not work to distance yourself from being the next lawsuit victim?
Improved Reports
Contrary to popular belief, involving oneself in legal work improves the readability of most radiologists’ reports instead of detracting from them. Those who do legal work are much less likely to leave grammar errors, typos, and other blunders in their reports. They tend to take the radiology report’s structure and final appearance much more seriously. Since they understand the ramifications of an unclear dictation, they are much less likely to confound their fellow clinicians with poor dictation.
Physicians participating in legal work are also more likely to know the jargon to not place in a report. Sometimes the wrong word choice can increase the chance of a lawsuit. Why not decrease the likelihood of it happening to you?
In addition, these radiologists tend to create differentials that consider the clinical situation because they know that subtleties can vastly change the outcomes of the patient’s management based on the malpractice outcomes of other radiologists. The final impression is more likely to consider these clinical issues, providing more benefit to the ordering clinicians.
More Thorough Documentation
Some radiologists do not take the documentation of conversations with clinicians seriously. Understanding the mechanics of malpractice increases the likelihood that a radiologist will document the critical findings and discussions with other doctors and patients. This information is vital not just for the attorneys but also crucial for the timeline of the medical record to allow for better treatment and an understanding of the events during a patient’s clinical stay.
Improved Communication With Fellow Physicians
Knowing what has happened in other malpractice situations also forces us to be more careful to communicate the results of a report on the phone or “in person” with other clinicians. Those that have completed malpractice work have a much lower threshold to trigger a phone call to their colleagues so that the report and the patient do not “slip through the cracks.” This understanding is only to the final benefit of patient care.
Is Legal Work Selling Out?
Based upon these tangible benefits of malpractice work, I think I make a case that participating in legal consultation is not “selling out.” Of course, some physicians abuse the legal system to make a quick buck and never learn from the mistakes of other radiologists. However, most radiologists that work with attorneys genuinely want to help their radiology colleagues and improve their clinical and professional skills as a radiologist. Maybe we should all consider doing some malpractice work at one time or another!
Over the years, I have discovered that the best radiologists often do not comply with the stereotypical traits of one. For instance, you would think that the best radiologists all embrace technology. However, it is sometimes the opposite. Some of the best radiologists I know are the least technologically adept people you would ever meet, not able to conjure up an email password or conquer a new PACS system.
You would say that they would be masters of video games and spatial puzzles. Well, again, you would be squarely wrong. I know many-a-great-radiologist who find video games distasteful or who have no interest.
You would guess that the best radiologists have an “eye” for radiology from day one of radiology residency. Again, you would be incorrect. Some great radiology residents that I have trained had no clue how to read a film or make a finding on day one of residency.
So what is it that makes up the traits of the best of the best radiologists? Based on my experience, it is the following: enhanced clinical training, grit and determination, extreme organization, singular focus, and the passion for learning and maintaining scientific interest in our field. So, let’s go through each of these traits. Then, I’ll give you examples of how each allows some of the best radiologists to perform above and beyond the average radiologist. Finally, I will go through some recommendations on how you can train to be this great radiologist. Try to incorporate some this additional training or these personality quirks and traits into your daily practice.
Enhanced Clinical Training In Other Medical Fields
Some of the most incredible radiologists that I met had initially trained for a different medical subspecialty. The ones I know have either completed a second residency or participated in a residency in internal medicine or pediatrics for more than the required solitary clinical year. These radiologists have a complete understanding of the clinical issues involved in the patient’s films that they are reading. They take a step past the interpretation of the image and make it relevant for the clinician on the other end. They tend to know how to manage patients to a tee and use their skills to better the patient’s welfare. Excellent clinical management for a radiologist is a rare skill.
How can you add these traits to your practice in radiology? Participate in electives that involve interdisciplinary management. Question your fellow clinicians about the clinical significance of your interpretations. Shadow physicians in other specialties.
Grit and Determination
These excellent radiologists are folks that overcame incredible odds to get to where they are today. By sheer determination of will, they take an interpretation of a film to a new level, farther than the typical radiologist. They look into clinical issues more deeply than others. They don’t just stop at the conventional differential diagnosis. And, they can tell you the hows and the whys of what they find. When a clinician stops by, they are mesmerized by the litany of what these clinicians seem to know.
How can you add these incredible qualities to your arsenal? Don’t stop at the mere interpretation of the film. Look further into clinical history. Read up everything about the disease entity. Find out facts that would be clinically relevant to your patient’s care. Always look at priors that may have relevance to your case. Don’t be lazy with any of your imaging cases!
Incredible Organizational Skills
I have never met a great radiologist who has poor organizational skills. Conversely, the great radiologists I have met all have incredible organizational skills. These radiologists tend to keep track of all the patients they have ever seen. They use this information to interpret images and extrapolate the information to other patient’s circumstances. You can ask them about a case they may have seen a year ago, and they can go into their written or mental records and find it. They use all of this information for the betterment of patient care.
How can you become organized as a radiology resident? Always keep track of your unusual cases. Take pictures of the cases you see. Maintain a written or online notebook of what you learned. All these organizational skills will come in handy when you complete your residency and have questions about challenging cases.
Persistent Focus
Some of the most incredible radiologists have a single-minded focus that allows them to read cases, do research, or teach with such precision that they are best in their fields. They are not distracted by the daily minutia, the irrelevant red herrings, and the rumors of the day. They concentrate on their work and their work alone. These radiologists tend to miss very little. They are the type of radiologists that seem to have very few reports with errors and mistakes.
How can you maintain focus on your daily rotations? Maintain awareness of what you are doing at all times. Keep conversations and distractions to a minimum when you sit or stand to read multiple cases. The patient should be first and foremost on your day’s schedule. That is why we are here- to help people!
Passion For Learning/Maintaining Scientific Interest
Finally, the best radiologists I have encountered have a mission to either teach, research, or learn. They enjoy every minute of these processes and convey their passion to others in the specialty, whether they are fellow attendings, residents, nurses, techs, or patients. Moreover, their enthusiasm is infectious and inspires others to want to be the same. These are a rare breed and help overcome the problem of burnt-out physicians through teaching and personality. These radiologists go a step farther not because they have to, but because they enjoy radiology.
How can you become passionate about radiology? Don’t let the folks that complain all the time get you down. Find your path and what interests you. Don’t look to the negative, as those folks tend not to be the successful ones. People that love their specialty tend to become excellent at what they do. So, find your interests and passions and go with them all the way.
Final Inspiring Words
It is not typical traits such as being a techie, having “an innately good eye,” or being a puzzle master that makes a great radiologist. Instead, it is often those skills that we can work on that make us better than the average radiologist out there. So, go forth and learn about other specialties, keep determined, stay organized, maintain focus, and develop a passion for learning and radiology to become the best radiologist you can be!!!
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Join our mailing list for free to receive weekly articles and advice on how to succeed in radiology residency, the best ways to apply, how to have a successful radiology career, and more. Also, get a copy of the free ebook Called The New Attending Physician Guidebook: How To Search For The Right Job And What To Do Once You Start.
Join our mailing list for free to receive weekly articles and advice on how to succeed in radiology residency, the best ways to apply, how to have a successful radiology career, and more. Also, get a copy of the free ebook Called The New Attending Physician Guidebook: How To Search For The Right Job And What To Do Once You Start.
