Tag: residency

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How To Keep Up The Momentum For Residency?

momentum

 

Question About Maintaining Momentum For Residency

Hi Dr. Julius,

I’m a first-year DO, and I am just finishing up the final exams for the first term. I’ve done very well so far and am on track to be near the top of the class, if not first (Though it is just the first term, much can change). I’ve had a strong interest in radiology before medical school, much of it due to my physics background as an undergrad.

I wanted to ask, how can I keep the ball rolling to make for a successful radiology application? I’ve heard conflicting answers about research. Some say that research isn’t as important in the eyes of PDs, but most of that advice I hear is towards MD candidates and may not necessarily apply to me.

I have two publications from undergraduate in my specialty field of physics. Still, I am a little lost on finding opportunities in radiology research, given that my school does not have a radiology department. Is it unprofessional to reach out to nearby departments to see if residents have any ongoing projects?

The Momentum Chaser

Answer About Maintaining The Momentum:

Hi Momentum Chaser,

I’m glad to hear that you are starting your medical school on the right foot. However, remember that the first couple of years are very different from your school’s clinical portion. Many students who do well during the first two years do not repeat the same grades when they make it to the clinical years when the medical school evaluates you on some of your softer skills. (Although some do) So, try to play nice in the sandbox to keep the momentum when you get to your clinical years!

Importance Of Research For Residency

Regarding research, the importance of it to residency programs differs widely depending on where you apply. And, I don’t believe it changes anything if you are DO or an MD. Some highly academic programs rely on their residents performing research during the four-year residency program. So, a Mass General type of program is going to want to see lots of research. On the other hand, a community program will not care to the same extent about the research you have conducted already. They will worry a lot more about having a good quality clinical resident. Specifically, they want one that can handle the overnight call and the residency workload. So, the answer to your question about the importance of research is it depends.

What To Do If Your School Doesn’t Have Radiology Research Opportunities

To answer your last question, it is certainly appropriate to ask other departments within your school or other sites for ongoing research opportunities. You may also want to consider finding a project within your school that may overlap with radiology, although not radiology specific. For example, there may be an internal medicine project that requires some imaging. I mention this because it can be more challenging to find projects outside your institution (although possible). To also answer your question, it is also professional and appropriate to ask about projects in nearby departments. It may be helpful to continue the momentum for your application and career!

I hope that helps a bit,

Barry Julius, MD

 

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How Critical Are Connections To Getting Into Radiology Residency?

connections

Let’s face it. In any job, position, or institution, connections can make all the difference between getting an opportunity or falling short. Even in medicine and radiology, nepotism is alive and well. Sometimes, a lesser qualified applicant can get an interview because the father is a large donor to the institution. Maybe, a cousin of the applicant is a physician on staff and asks the coordinator to give her nephew an interview.

So if you ask the question, does influence sometimes trump qualifications on an application? The answer is still yes. Unless egregious, it is easy to disguise. Why? Because the evaluation of applicants for an interview is so subjective.

All this said, I believe most programs and program directors strive to take the best applicants possible to make sure that the most qualified applicants get the position. And I think that the radiology field is more equanimous than most!

So, How Critical Are Connections In Radiology Residency?

Well, all this discussion leads us to the theme. For the average applicant to radiology residency, how critical are these connections? And, my brief answer to that is not so much. Of course, this statement comes from someone who has vested interests not to expose the radiology program to undue scrutiny. However, in all sincerity, we strive to be as fair as is humanly possible. And, I believe for most program directors, the answer is the same.

It is exceedingly rare that a connection will have more influence than allowing a candidate to receive an interview that otherwise wouldn’t. But even if the candidate with a relationship gets an interview, most program directors and chairmen are unwilling to take candidates that cannot get through the rigorous requirements of a radiology residency no matter how “powerful” the connection. A resident who can’t make it through a four-year residency is far more damaging to the program’s reputation than the opportunity cost of an “upset connection.” The amount of time and effort wasted to support an unqualified candidate is enormous. And, the pain and suffering of having to terminate an incompetent resident is worse. Even more so, when the resident who we admitted is a relationship to a “connection.”

Should You Use A Connection If You Have One?

Given all this questionable power of the “connection” and how it affects the application process, you may ask, is it even worth it to use one. Well, as always, the answer is it depends. If you are a borderline candidate who may not score an interview, a kind word from a known connection can push your application into the interview pile. On the other hand, if you have excellent qualifications that speak for themselves, too much name dropping can irk the interviewers. Yet, a well-placed phone call from a trusted source can confirm the quality of the candidate.

So, you can see using a connection appropriately can be a bit tricky. You need to thread the needle, so to say. And make sure to do it diplomatically.

Using Connections To Get Into Radiology Residency- A Mixed Bag

So, there you have it. Connections can help, to some extent. But, more importantly, you need the appropriate qualifications to get the spot. No matter how good the link, make sure that the program is the right fit for you. And use the relationship discreetly so as not to overpower the admissions committee. A connection should confirm the candidate’s quality, particularly when the admissions committee may otherwise skip over the application before the interview ever happens. If used as a battering ram to push an unqualified candidate into an open residency slot, it doesn’t work. (At least at our program!)

 

 

 

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Benefits Of A Career At Your Home Residency Institution

home residency

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

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

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

The Resident’s Perspective

You Know What You Are Getting Into

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

It Feels Like Home

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

You Know Your Location Beforehand

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

The Program’s Perspective

You Know What You Are Getting Into

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

You Can Recruit For The Specialty You Need

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

You Can Choose Those Resident Features That Will Grow Your Practice

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

Working At Your Home Residency Base

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

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DO Friendly Programs- Should I Bother To Apply?

do friendly

Question About DO Friendly Programs!

 

Hello! Thank you so much for this website; it has helped me out immensely. What is your take on small community programs with lots of DO residents? They seem to have a pretty good fellowship match (IR in some top programs, a pretty good mix of fellowships overall).

 

Thanks a bunch,

Low Tier

 

Answer:

 

I am somewhat biased as our program has welcomed both DO and Caribbean medical school graduates for years. And, yes, folks consider us a “community” program. (although that will change with our impeding merger)

 

My philosophy on radiology education is that a residency is only as good as what you put into it. Regardless of the name, if you work hard and read a lot, you will come out of your residency as a great radiologist. The big difference some of the more popular programs afford is additional subspecialty work that you might not get elsewhere and hardcore research that you may or may not want. However, all is not lost if your residency does not fit this category. Indeed, you can get some of these experiences during your fellowship. And, most residents complete a fellowship after residency.

 

In terms of being a DO friendly program, I have no problem with that. As long as education is of high quality and the program’s resources are adequate, it should not matter if the residents are Caribbean, foreign, or DO. In our residency, some of our best residents tend to be Caribbean grads, for one reason or another. That should not dissuade you from applying to a program if you know that the program’s quality is high, and you will receive the training you want. We have had excellent residents from American, Caribbean, and DO residencies alike.

 

Hope that helps,

Barry Julius, MD

 

 

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Top Eight Radiology Residency Changes Since The Pandemic

radiology residency changes

Covid-19 has changed the face of radiology residencies throughout the country in a matter of months. But, what are some of the most significant differences compared to life before all of this started? Let’s go through the top eight most significant radiology residency changes since the pandemic began.

Noon Conferences

Before

Rows and rows of residents and students would gather in the conference room to listen to the faculty member lecturing. Attendings would call on the folks to answer questions.

After

Who would have ever thought that you would receive your lectures on a computer screen in any location of your choosing? That has precisely happened over the past several months—no more in-person lectures at many institutions. And, you are much less likely to get called on in the middle of a conference!

Empty Reading Rooms

Before

Reading rooms were much quieter than they were twenty years ago since the advent of PACS, reducing the number of physicians visiting the reading rooms. But, you could still find some activity with residents and faculty present, discussing cases.

After

Now more and more faculty are not showing up at all. They are working from home. In many cases, all you have is a resident fielding occasional phone calls. But, for the most part, you can hear a pin drop!

Learning To Dictate With A Mask

Before

You would pick up a microphone and start dictating. And, that was hard enough as a first-year radiology resident.

After

Now first-year residents no longer only need to learn to dictate. They also need to learn with an encumbrance on their face, making sure a mask does not stifle their voices. They will become the most articulate class ever!

Extensive Cleaning Procedures

Before

You would enter a reading room and pick up a microphone. Only a minority of physicians would come in and wipe down the desk, microphone, and computer. And, many folks thought these doctors were crazy neat freaks!

After

Instead, you now come in with an arsenal of cleaning supplies to ensure you don’t get Covid-19. Those faculty members that don’t use all those cleaning supplies are considered nuts!

Less Residency Social Events

Before

Not that we considered radiology residency to be party central, but residents and faculty would get to know each other well on the outside of work. Or, at least you would have a few arranged meet and greet sessions.

After

Residents are lucky if they get to know the new first-year residents’ names! And, attendings are even having a harder time. It’s much more challenging to get to know your colleagues when you need to stay away.

Less Elective Cases/Decreased Volumes

Before

Patients would get mammograms, thyroid screening, DEXA scans, virtual colonoscopies, and more with impunity. Residents and attendings needed to read tons and tons of these scans all times.

After

We have seen a noticeable drop in elective volumes. Patients think twice about completing their screening or low-impact studies because of the inherent risk of personal interaction.

Less Free Food

Before

The hospital was a food fiesta of sorts. On any given day, you could find attendings purchasing pizza for residents, resident appreciation day festivities, and corporate-sponsored lunches.

After

It has become much harder to find free food in the hospital. Although occasionally available, far fewer purchasers and employees want to risk having physicians to dive into a free sandwich!

Easier Commutes

Before

Traffic may catch you on a bridge, a tunnel, or a highway for hours if you have a terrible morning while you were driving to work. You were not the only working soul!

After

Both unemployment and more remote working have taken a toll on the number of cars on the road. You can now enjoy speeding into your rotations in the morning. It is harder to blame being late on the traffic. See, there are one or two benefits to this unfortunate pandemic!

Radiology Residency Changes- A New Way Of Life

It’s remarkable to see the myriad of radiology residency changes in our daily lives. Only four or five months ago, Covid-19 was barely an afterthought. Now, it encompasses our whole way of being. And radiology residency is affected just like everything else!

 

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Not A Good Test Taker! Can I Make It Through Radiology Residency?

test taker

Question:

Current radiology resident, just finishing up the intern year, with concerns whether I’m cut out for this. I was a miracle match: Low MCAT scores. Pretty much barely passed all shelf exams. I’m not a good test taker.

Am I smart enough to be doing this, or am I kidding myself? If I fail this crazy 80% pass rate core exam, will they fire me? And then what will I do?

Any advice, uplifting stories, anything would be appreciated. Should I transfer out now? Or, should I stick it out and see if I can pull out another miracle? I don’t want to ruin my life here.

Help!

 

Answer:

First of all, you need to separate the following two issues, being a good radiologist and being a good test taker. I know of excellent radiologists who have had to take the core exam or the oral boards with multiple attempts to pass. So, don’t confuse taking tests with being “smart.” It is an entirely distinct skill from working as a radiologist. Moreover, don’t count yourself out. You may find that you are a better test taker than you think when you study material that is more relevant to your future career. You never know; maybe you’ll even pass on the first attempt.

 

Also, no program should fire you for failing a core examination if you are a good resident. Residencies should be looking at other characteristics other than the core exam and test-taking skills to assess their residents. If you do well in your residency, it should go noticed by your program directors and faculty regardless of your testing scores. No one test will ever be the judge of your abilities. And, if needed, you can retake the exam until you finally pass.

 

Finally, I don’t think you need another miracle. You have already accomplished a challenging feat, getting into a radiology residency program. It will just take a bit of hard work, grit, and determination over the next four years to do a good job and get to the next phase of your career!
Regards,
Barry Julius, MD
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Radiology Resident Myths Versus Reality

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

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

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

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

It’s A Cush Residency Compared To Others

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

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

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

All The Residents Will Be Nerd Techies

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

We Hedge More Than Everyone Else

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

It’s The Best Way To Get Away From People

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

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

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

Radiology Resident Myths Versus Reality

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

 

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Off Cycle And Need Funding: Can I Get A Fellowship I Want?

off cycle

Question About Off Cycle Fellowships And Funding:

Hello Dr. Julius,
I hope all is well. Thanks very much for creating this site. It shares a lot
of very valuable, helpful information that is difficult to find elsewhere.
I have a few questions I was hoping you could answer for me.
I matched into a categorical Internal Medicine residency last year, during
which I realized I wanted to pursue radiology because it better aligns
with my interests, strengths, and personality. I discussed this with my
program director, who fully supported my decision. I completed my
internship a few months ago and left the program on good terms, receiving
strong references. I am now involved in radiology research at an
academic medical center. I recently became aware of an unexpected PGY-2/R1
residency opening for this year, which would start shortly, as
an off-cycle position.
1. Does completing an off-cycle residency limit fellowship opportunities?
Would fellowship directors be less interested in a candidate if he or
she finishes residency training after July, thus complicating the schedule
for incorporating a new fellow into the schedule at later point?
2. Since I matched into a 3-year Internal Medicine program, do the
remaining two years of my funding follow me to the next residency?
3. Is it possible to have more than one source of funding for a single
resident? For example, could one theoretically have funding remaining from
the first match and then also have partial funding through the military
or a foreign government? I’ve noticed there are positions on ERAS
dedicated for external financing through the military or international
sponsors. I am just curious if sources of funding can be combined.
Thank you very much for your time! I appreciate it.
Best Regards,
The Off-Cycle Resident

Answers:

You posed some interesting questions about particular issues that residents of mine have encountered in the past. So, I can help you based on my experiences.

Off-Cycle Issues

Let’s start with the problem of being off-cycle. Yes, most program directors would rather have a resident that is on-cycle. But, life happens, and it does not always work. For personal reasons, we had one resident who started residency three months later than the typical July 1 beginning. In his case, we were able to get a dispensation from the ABR to allow him to start his fellowship on time. On the other hand, if you are way off-cycle, you may not be allowed to do so. In that situation, it would make it a bit more challenging to find a fellowship position that can conform to the timing that you need.

That said, since the market for fellowship now favors the applicants, many programs would be willing to create a spot that allows you to start a fellowship soon after finishing. Right now, I know of many 6-month fellowship positions that would be happy to take an off-cycle resident at almost any time. It might be a bit more difficult if you were interested in a more competitive fellowship like interventional radiology.

Funding Issues

In terms of the funding for residency, typically, the government bases it on the amount of time completed in residency, not the expected time in a residency. So, if you only have completed a year or two of a three-year categorical spot, you will still have as many options as those that did a one or two-year preliminary program.

For those that have completed more than two years of a government-funded residency, you can also get foreign or military funding to supplement the rest, if available. And finally, some spots I know are entirely privately funded, so it does not matter how many years have been supported by Medicare.

Most programs, however, will utilize the government Medicare program for funding. So, if you are in a residency and have used up government Medicare resources, the program can rely on other sources of financing afterward, if your residency can find it and if it is available.

Thanks for the great questions,

Barry Julius, MD

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

university program

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

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

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

Resources

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

Number Of Faculty

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

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

More Subspecialists

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

Support For Research/ Statisticians

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

More Stringent Curriculum Requirements

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

Medical Students/Opportunities To Teach

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

Let The Buyer Beware

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

 

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Full-Time Practicing Primary Care Physician: How Do I Get A Radiology Residency Slot?

primary care

Question:

 

Hi.
I am a physician in a primary care specialty looking to go back to residency, specifically in radiology. I have been in practice for ten years and have realized that I do not want to practice primary care for the rest of my life. Have you had a resident in a similar situation? What factors do I need to consider? How does Medicare funding for residency come into play?

Thank you so much for your blog and the book. I realize this is a rather late stage to make a change, and I would appreciate your input.

 

Answer:

So, this is the deal: I would love to have physicians that have previously trained in other specialties. They make the best radiologists because they understand the clinical implications of diagnostic imaging. Some of my best radiologist mentors had completed another specialty first.

However (and this is a big caveat), it does become more challenging to obtain a slot because of the Medicare funding situation. Once you have graduated from a U.S. residency and start to practice medicine, Medicare does not fund the additional years of training.
But all is not lost. If I were you, this is what I would do. Some residencies throughout the country have their spots funded by private sources in addition to Medicare. For instance, I know in New Jersey that University Radiology Group supports several residency slots privately for the Robert Wood Johnson program. These are the slots that you would need to find. You may want to try calling the departments up individually to find out if they would take a previously trained physician. Otherwise, you will potentially waste your time and money applying to places that would not enroll you regardless of how excellent your application.
And finally (and perhaps most critically), you need to be ready to go through the mental and financial hardships of repeating another residency. Depending on your family situation, you need to make sure that all members are “on board” with the change. It’s certainly not an easy four years. But, I can tell you that going into radiology was one of the best decisions I have ever made!
Good luck with the decision process,
Barry Julius, MD