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Wednesday, September 7, 2016

10 myths about radiology

Hello MiM community,

It has been awhile since my last blog post. I graduated residency in June and I am currently in month 3 (where has the time gone?) of my breast imaging fellowship. I stayed in the same institution as residency for fellowship. My little C is less than 4 months shy of being 4 (!!). Big C finished his orthopedic spine fellowship on the east coast in July and after a nice 5 weeks of having a stay at home husband, he started his attending job in a city 2 hours from me and little C last month. It has been a busy summer!

I am currently surrounded by medical students applying to residency, which made me want to do this post. And now that I'm a PGY 6 in my radiology training, I think I feel somewhat equipped to dispel some myths about my specialty and I thought it would be a good opportunity to go into the medicine aspect of my life since most of my posts have been about my role as a mom.

1. We are anti-social. A huge part of our job is communication not just with patients but with other physicians. We talk to physicians from all specialties throughout the day. We often present at multidisciplinary tumor boards. I can't speak for all radiologists but the ones I work with and myself included, we are very extroverted and approachable!

2. We never see patients. This may be true if you decide to go into teleradiology post residency. However, during residency, we see patients all the time--whether it be giving results, scanning patients or performing image-guided procedures. As a breast imaging fellow, I spend half my fellowship doing mammographic-guided, ultrasound-guided or MRI-guided biopsies/localizations. In addition, we often have to speak to patients to relay biopsy results. There is the option to not see patients but this will not be the case during residency and the choice is always there for patient interaction post training.

3. We are lazy. Being married to an orthopedic surgery resident, I have the utmost respect for these grueling specialties. We may not wake up the hours of other specialties but we are definitely not lazy. The time we spend having to study plus the time we spend at the hospital would often sum up to 60-80 hours of week during the earlier years of our residency. In addition, our residency is 5 years plus an extra year of fellowship (which is typically not an option as everyone does a fellowship post residency.) Our radiology boards are 2 days--that includes 18 subsections including physics! The amount of reading on top of working in the reading room equals so many hours that we put in outside of work that most people don't realize.

= 4. We love sitting in a dark room all day, every day by ourselves. This is definitely not true especially during residency. Radiology is a unique residency in that we are often one on one with an attending all day, working together and learning from him or her. In fact, this also debunks the fact that we are anti-social as we need to learn to interact and get along with someone we work with all day. In addition, our dark rooms are often frequented by visitors usually in form of clinical teams and occasionally patients.

5. The job market is horrible and no one can get a job. The job market may not be what it was in the past but there's always a supply and demand when it comes to medical imaging. As the reliance on medical imaging only continues to grow with the increase in number of CT and MRI scanners, the job market for radiologists will always be open. As someone who is only looking for a job in one city (one that is super competitive I might add), I have been surprised at the number of listings as well as the number of responses as a fellow in only month 3 of fellowship. In addition, I have only just begun my job search (literally 2 weeks ago).

6. Radiology is boring. I may be biased but I find radiology incredibly interesting. We see different pathologies across specialties on a daily basis. We often get to make the diagnosis and provide a differential. We are not involved in the treatment but for me at least, coming up with the diagnosis is the most satisfying part of my job as a physician. In addition, it is a field that is constantly changing as technology evolves. Imaging utilization only continues to grow and different applications of imaging for both diagnosis and treatment are constantly being researched and incorporated into our specialty.

7. Women should stay away from radiology because it will fry our ovaries. I was pregnant my first year of residency. I have a perfectly normal, adorable daughter. Yes, to be completely honest, radiation can affect a woman's reproductive capabilities but you would need direct radiation to the pelvic area and the amount of radiation would have to in the amount that is used for radiation therapy in oncology treatment. Therapeutic doses are often 1000X more than diagnostic doses (even a CT). Furthermore, as a radiologist, we are shielded from significant radiation doses with the use of radiation equipment and radiation protection practice shields (lead, lead glasses).

8. Radiology as a profession is useless because physicians can interpret their own films. Physicians across all specialties order medical imaging and it should be their responsibility to look at the images they order. However, a formal interpretation by someone who trained in this field for 6 years is completely different. There are many times that the ordering physician has more clinical information that helps in the interpretation of the study. However, when it comes to interpreting the study as a whole that is what we are trained to do--we look to see if its an adequate from a technical point (are there any artifacts on the study? is there too much patient motion?), we look at the entire study (for example, CT abdomen/pelvis is ordered for belly pain and on the few slices of the lung bases, we find a pulmonary emboli), we decide on how to make image quality better (do we need to increase the field of view? what should the slice thickness of the images be?) and lastly, we often decide if the correct study is ordered for the right indication while minimizing radiation dose to the patient (does the study need to be done with contrast? can we do an MRI rather than a CT in a pediatric patient? what study should we order in pregnant patient?)

9. We make too much money for what we do. I can't speak for all specialties except my own but I find it unsettling when I hear this about radiologists. We put in our time with our 6 years of training. We take our boards. We have written reports that cannot be disputed--if we miss something, it is evident that we missed something. Just like any other specialty, we are learning a valuable skill set that helps our colleagues and patients. 

10. We are not real doctors. This one applies more to the general public. We are not the technologists. If I got a dollar for every time somebody asks what I do for a living and I say I'm a radiologist and I get the response "oh yah, I met a radiologist last week when getting my "insert imaging modality" done," I would be incredibly wealthy. However, for someone interested in radiology, the prevalence of this myth one is something to be aware of. I always discuss with my husband who often gets cookies/cupcakes sent home from his patients that as a radiologist you have to be okay with sometimes not getting the direct satisfaction of "saving a life." It's not always "saving a life," but often times we do make the diagnosis but we're not the ones who relay the good news (or bad news) to the patients. I am okay with that. People choose to go into medicine for different reasons and some thrive off the direct acknowledgement from their patients. For me, as a radiologist, the internal satisfaction that I am helping my patients is enough.

Lastly, good luck everyone in their residency applications regardless of specialty!

X-ray Vision

1 comment:

  1. Except for the ovary frying, I thought you could replace this entire post with pathology and it would ring true. The physics behind radiology scared me away. One of the favorite parts of my job is working with interventional radiologists, helping them get enough sample and triage it correctly. Love this post!! Congrats on being almost done and good luck with your job search:)

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