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Accepted to Radiology starting July 2014, now with serious doubts about choice
- Thread starter elloco
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What changed your mind about primary care? I had plenty of exposure to clinic during my first 3 years of med school and knew it wasn't for me right away.
You didn't have any outpatient/clinic exposure at all? I hated clinic, no matter which specialty it was for. Clinic was all the same for me. I knew I wanted to be the hospital, seeing the sickest patients, and having tons of tools at my disposal. Outpatient/clinic is totally the opposite. Instead of reading a MRI and coming up with a critical diagnosis you are figuring out someone's vaccine schedule. At least in surgery clinic you have the OR to look forward to. (Just some perspective from someone who thinks he is a good fit for radiology. If you love family then go for it.)
just be careful not to let one rotation totally cloud your judgment. A couple things may be happening.... you are enjoying yourself more with less stress since you already matched; you have an awesome attending with great patients; you work in a good neighborhood; etc. There are probably very good and solid reasons why you chose radiology. I'm not doing rads (considered it heavily) but I would suggest not to be so quick to change before you have even been a radiology resident for 1 day. Honestly I'd at least do 1 year of radiology residency and if after that you really hate it then apply FM. It's not like it'll be hard to get a spot afterall and the training for FM is only 3 years total - meaning you really wouldn't have wasted your time and if anything your 2 extra years of training would make you that much better in the end.
If you liked family medicine go for it.
If you don't like radiology, don't do it.
Be careful about your rapid judgement from a single rotation.
Just be careful, diagnostic radiology needs its own personality different and very very different from family medicine or IM.
Also be very careful with doing a year of radiology. You will find the true nature of radiology in your third year of radiology. You will find out whether you like radiology or not near the end of your residency. Yes, that sucks, but is the truth.
Very very few people who like radiology even think about family medicine. If you are really a patient type person, go for family medicine. You will be miserable in radiology.
For me, it was clear from the beginning. I never ever liked patient care, esp continuity of care. And this is the same for most radiologists.
If you find yourself interested in family medicine, switch. You can even negotiate with some programs to integrate more rotations into your transitional year, so you may be able to save some time or at least add some skills like OB to your training. My guess is you can integrate at least part of your transitional year to you family medicine.
Family practice is in high demand and will be in high demand always. The residency is easy, the pay is OK. You can find a job almost anywhere. You can add some cosmetic stuff to you practice to boost income and also the life style is really good.
Just be careful about your rapid conclusion after a just one month rotation.
If you don't like radiology, don't do it.
Be careful about your rapid judgement from a single rotation.
Just be careful, diagnostic radiology needs its own personality different and very very different from family medicine or IM.
Also be very careful with doing a year of radiology. You will find the true nature of radiology in your third year of radiology. You will find out whether you like radiology or not near the end of your residency. Yes, that sucks, but is the truth.
Very very few people who like radiology even think about family medicine. If you are really a patient type person, go for family medicine. You will be miserable in radiology.
For me, it was clear from the beginning. I never ever liked patient care, esp continuity of care. And this is the same for most radiologists.
If you find yourself interested in family medicine, switch. You can even negotiate with some programs to integrate more rotations into your transitional year, so you may be able to save some time or at least add some skills like OB to your training. My guess is you can integrate at least part of your transitional year to you family medicine.
Family practice is in high demand and will be in high demand always. The residency is easy, the pay is OK. You can find a job almost anywhere. You can add some cosmetic stuff to you practice to boost income and also the life style is really good.
Just be careful about your rapid conclusion after a just one month rotation.
I've never been convinced that a personality can be put into a neat little box that is "right" for one specialty over another. On my specialty interest tests, I came up high for IM, psychiatry and rads. Seem at face value to have nothing in common, but for me the common thread was critical thinking and solving the puzzles. I chose rads in part because of interest in technical aspect, in part because of a better lifestyle and in part because it has the strongest emphasis on problem solving / diagnosis of any specialty I know, and that's my favorite part of medicine.
A majority (though certainly not all) of the radiologists I've worked with are actually very amiable people, and enjoy patient contact they get in fluoroscopy and IR.
Just be careful that your decisions are based on loving the work of the specialty itself, and not just that you liked working with your preceptor(s) for that rotation.
If you do decide to switch, I can't imagine you'd have much trouble getting into a great family medicine program if you matched successfully in rads.
A majority (though certainly not all) of the radiologists I've worked with are actually very amiable people, and enjoy patient contact they get in fluoroscopy and IR.
Just be careful that your decisions are based on loving the work of the specialty itself, and not just that you liked working with your preceptor(s) for that rotation.
If you do decide to switch, I can't imagine you'd have much trouble getting into a great family medicine program if you matched successfully in rads.
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What kind of prelim year did you match? Mine actually had prelims not only do 2 months of outpatient clinic but we also had a continuity clinic every couple weeks...that's the kind of setup that would give you a good view of what ambulatory primary care is like. I would suggest keeping your radiology spot and seeing how your outpatient months (if you get any), go. If you still love it, make the switch then. But if you don't, you haven't lost your opportunity to become a radiologist.
Good luck!
Good luck!
I feel like I forced myself to like Radiology, having an interest for computers, good board scores, lifestyle and all that jazz made me choose it. But during the rotations I did (4 months + shadowing at private offices) I was never engaged and quite frankly I was bored. The material that I read was never appealing and I felt i was just trying to hard to fall in love with it. On the other hand with Family Medicine I got hands on action and really loved the patient interactions, the variety and the challenge of every incoming patient. To add salt to the wound I matched in a not so appealing program, with almost no opportunities for rads research (not that I'm interested in doing any), old equipment, horrible location etc etc. I'll see if I can squeeze some more outpatient Family rotations at the beginning of my Transitional Year, and also the fact that I can match in a great location for FM is also very appealing (Boston area perhaps?). Thanks for your input.
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deleted116380
Shadowing is boring regardless of the field. I wasn't the most thrilled on my rads rotations and usually left after lunch most days while I loved my CT surgery and gyn onc surgery rotations because I got to do a lot (I'd never do that for a career, though).
I also liked family medicine a lot during 3rd year due to less paperwork and more time actually doing your job (I don't consider paperwork/documenting the actual job). Plus, I liked the higher turnover/volume compared to inpt where you deal with the same people and social issues endlessly. If I couldn't do rads or wasn't allowed to, I would do out-patient medicine without hesitation. Probably sports medicine rather than general family med...I like msk.
Anyway, I don't think you need to make any quick decisions on the matter. It's normal to have feelings like this imo after realizing you will become a radiologist at a certain location...however, match day doesn't set your career in stone. People switch to other fields during residency all the time so don't feel like you're pigeon-holed if you don't change your mind now.
Go through intern year and see if you like FM. Take a radiology rotation or two if your program allows it (at an accredited rads residency) that will let you dictate and see if you're 100% sure about it. One of the hospitalists at my med school decided against rads residency at the end of intern year and finished the IM program. It's not unheard of. However, our PD did the opposite and finished IM residency and switched to rads. 🙂
I also liked family medicine a lot during 3rd year due to less paperwork and more time actually doing your job (I don't consider paperwork/documenting the actual job). Plus, I liked the higher turnover/volume compared to inpt where you deal with the same people and social issues endlessly. If I couldn't do rads or wasn't allowed to, I would do out-patient medicine without hesitation. Probably sports medicine rather than general family med...I like msk.
Anyway, I don't think you need to make any quick decisions on the matter. It's normal to have feelings like this imo after realizing you will become a radiologist at a certain location...however, match day doesn't set your career in stone. People switch to other fields during residency all the time so don't feel like you're pigeon-holed if you don't change your mind now.
Go through intern year and see if you like FM. Take a radiology rotation or two if your program allows it (at an accredited rads residency) that will let you dictate and see if you're 100% sure about it. One of the hospitalists at my med school decided against rads residency at the end of intern year and finished the IM program. It's not unheard of. However, our PD did the opposite and finished IM residency and switched to rads. 🙂
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Agreed. Medical students and interns are not appreciably different on a radiology rotation.
Is doing a rotation at non-accredited residencies more common than I think it is? Otherwise, that seems like an odd inclusion.
As others have indicated, if you were competitive enough to match into radiology, then you are likely competitive enough to get into a high-quality family medicine program. Don't give away too much. That is, don't underestimate how valuable you might be to the right program. I have seen competitive applicants literally dictate curriculum to FM programs. I'm not saying that should be your goal...just that you shouldn't settle for a less than ideal situation because you feel rushed to get settled into a new program. Take your time and make sure that you find the right location.
For what it's worth, I'm married to a family practitioner, so I can tell you that you'd be hard-pressed to find two more disparate specialties than FM and radiology. Taken at face value, your comments on this thread are not in keeping with the typical radiology applicant. That's not to say you wouldn't do well in radiology...just that you don't fit the typical profile. If you feel as strongly about patient contact as your posts indicate, then it's difficult to see how you would find satisfaction in radiology.
That said, your experiences as a medical student in radiology are likely not emblematic of what it's like to be a radiologist. This is, unfortunately, a limitation of our field - that it's extremely difficult to approximate its experience before entering the specialty. The overwhelming majority of medical students who discover radiology stick with it, but perhaps more instructive is that I know many people who come to radiology from other specialties.
These are, of course, only generalities. You must decide for yourself. Again, your comments point very much toward FM, and that's fine. It's not written in the stars that medical student A must do specialty B. You're allowed to enjoy and be happy in multiple fields. Just understand the regret you might have if you end up disliking FM, considering that you already had radiology in your back pocket.
Location or the quality of program should not be a factor in your decision about a field. Residency will finish sooner or later, but you will be doomed to do that field for the rest of your life, if you dislike it.
Money also should not be a factor. No matter what field you do, you will make enough money to have a relatively comfortable life. Esp with changes to the healthcare, no matter what field you do, you will never become rich. Bottom line is don't think about income as a factor in your decision.
I agree that your post is not typical for a radiology type person, though I don't know you in person and my conclusion is based on your two posts which can be totally wrong.
Do whatever you like. You live once, so you are entitled to do what you like. Don't listen to what people may or may not say. Don't compare your life or your choice to others. Just do what makes you happy.
Good Luck.
It sounds like you should probably go into Family Medicine. Nothing could be more different from Family Medicine than Radiology. In Radiology you will sit behind a computer all day and dictate studies and rarely, if ever, interact with any person or patient. I personally love it and hated Family Medicine so Radiology is a good fit. But honestly it sounds like Family Medicine is for you and I wish you the best of luck. If you loved it that much I certainly wouldn't start a Radiology residency.
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The reason I said to make sure it's at an accredited residency is that radiology residents aren't allowed to do radiology electives during intern year at non-accredited radiology residences. And depending on the program, he may be able to actually be in the driver's seat and be the one dictating vs. shadowing like in 3rd/4th year.
This is probably true, but it doesn't mean you can't love both and be happy in either.
Again, I loved psychiatry and thought about it, but I also love radiology and am extremely happy with my choice.
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Evidently non-accredited radiology residencies are more common than I realized. Is foregoing ACGME accreditation done purposefully at some reputable residencies? The same way that many big time non-CAQ fellowships aren't accredited?
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Sorry, I may have misspoken. Interns that matched into a radiology residency are only allowed to do up to 2 months of radiology electives as long as those electives take place in an ACGME accredited radiology residency program. I don't know of non-ACGME accredited residency programs (fellowships are another story).
We're not allowed to do electives in a radiology department that doesn't have a residency so a lot of small community hospital programs can't offer those electives to radiology interns unless they have an affiliation with a program in the same city (i.e. some Baltimore prelims affiliated with UMD rads will be okay). Non-radiology interns are allowed do take those electives afaik.
From my understanding, the benefit of taking 2 months of radiology in intern year allows programs to start call for residency as early as 4 months into PGY2 because 6 months of training is complete by then. My med school's categorical spot includes 2 months in intern year so call begins around Thanksgiving.
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That makes sense.
As far as call, I trained under the 6-month system, meaning I was taking solo call in January of my R1 year. For several years (at least), that changed to 1-year, so we started counting internship rotations to put R1s on the call schedule in May or June. Has that 1-year rule changed again? Our R1s start call in March at my job, but we also have 24-hour in-house staff coverage, which makes many of the rules moot, so I haven't kept up with any changes.
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deleted116380
No R1s do solo call at my med school. There's always a senior with them unless I'm interpreting "solo" as something else. I'm not sure the earliest an R1 can do solo call if ever so maybe that's the specific rule...I'm honestly not too sure about the details other than that.
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Sorry. "Solo" is really meant to mean unstaffed. For me, the two were identical because only one resident took call at a time.
When they changed the rule, there was some talk that the upper level could "staff out" the lower level to skirt the regulations. I think that most people realized pretty quickly that was a really bad idea.
What I was trying to ask is how much training is required before a radiology resident can provide an interpretation on-call without an impending staff overread/agreement?
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Someone correct me if I'm wrong, but my understanding is that this can't be done until R2 year. Even when it was June of my R1 year, I still couldn't give a prelim impression to a clinician who called in, unless my readout was literally minutes away and I told them "I'll call you right back if anything changes." And my understanding was that this was a national rather than an institutional policy.
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As someone who is considering switching out of rads, my suggestion would be the following. Make sure you really understand the type of transition you are making. Doing rads in med school as a student can be as exciting as watching paint dry. You don't get to do much so yes it's not fun per se. I think once you are an intern you can start enjoying it more, correlating it more, seeing how it deals with every day patient care. There is a wide range of options in fellowship, you can treat every patient imaginable, you can do procedures, etc.
FM - some people love FM, but FM is not a preferred specialty for all. It's possible that you may love it sure, or it's also possible that you may have had a great rotation in FM that has made you have a more rosy idea of what FM is. FM is not an easy specialty, there is a lot of stuff to deal with, and while you will find a job anywhere, the pay is an issue for many, and hte patient population can be difficult. It is not an easy job.
I would suggest for you to perhaps use some of your rotations in FM and see if/how you like it. As a resident you'll have more responsibility and will be able to gauge whether you like it more. Also, you cannot get out of your rads spot before your internship finishes unless you ask for a waiver. Be mindful of not having a match violation.
I would suggest you not giving up your rads spot until you have more experience. Like others have said, it's not going to be hard for you to transfer out of rads and into FM if youdecide you don't like it later, but if you do give up your rads spot you will likely never be able to go back to it again, especially if you get a waiver (you can never apply to that specialty again). Also if you do your internship you may have to start as a partial PGY-1 again since you may not get full credit for a PGY-1 of FM.
Good luck!
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I'm not sure what you mean by "this", but your post seems in keeping with the letter of the law, so to speak. However, practically speaking, I know of no one who follows the guidelines as exactly as you indicate. In my experience, if an 11-month seasoned R1 calls diverticulitis, then they'll call it and notify the ER physician.
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Oh, by "this" I meant providing independent interpretations. Maybe I'm just naive, but because I assumed this was a hard-and-fast national policy (in other words, I thought it was "illegal" for R1s to give official prelims), I never did. And because of the policy, we were told not to. I embraced that, though, because it protected me (and the patients, for that matter). Even though I may have been 11 months into my R1 year, maybe i was only 1-2 weeks into body CT and wouldn't have been comfortable calling diverticulitis on my own without getting confirmation from a higher up. And it didn't have to be an attending, just an upper level resident.
Of course, in the span of one day I went from not giving prelims to being on late neuro call where I was the only person reading neuro CTs. That first day was kind of a scary shift...I definitely don't think I would have been ready 6 months earlier. But I guess you deal with what you're thrown into.
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Your experience is how it's supposed to work, I believe. However, even as an R1 in my first 6 months, I was permitted - even expected - to post my preliminary interpretation for public viewing. And my experience as an attending has been similar.
And by "public viewing", I mean that the dictation is available in the PACS but not the official EMR. For routine studies, providers are relying almost exclusively on the EMR, so they'll never see the preliminary read, but it's different when on call, since the ED knows to look in PACS first. Even then, when on call it's not a huge deal because 1) the residents mostly get it right, 2) when they don't, they frequently have to place a phone call to document updates in the read, and 3) we have a turnaround standard, so the ED understands that a staff read is impending.
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I should have stated that an attending is always there on the weekend call the R1s take at my med school so I don't think any R1s are giving prelims at all...
My input is that if you like both, then do FM. Its three years and done and your out and if you really like it then do it. I do agree that one rotation is tough to judge a whole field on, especially FM since you may have just liked it do to other environmental factors that you may not have at your future job.
Do know that there are nice areas of rads with more pt contact such as peds, if thats what you're looking for.
Do know that there are nice areas of rads with more pt contact such as peds, if thats what you're looking for.
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I was in a very similar situation as you were, and am posting to let you know that this is not a unique situation. At the end of the day, you have to do what you enjoy, while taking into consideration the perks (reimbursement, job security, practice options, etc.) of the specialty which as also important. I decided to go with what I enjoyed and could see myself practicing for a lifetime as a profession, not as a job, and chose psychiatry and have to say I am very satisfied. At the end of the day, you just have to do what makes you intrinsically happy, rather than using extrinsic factors to justify happiness; the latter does not work for very long, and I have seen this, in practice with medical professionals receiving care.
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You went to medical school to be a doctor not someone's mother. If you think you will have a fulfilling life counseling patients about their bull**** then you should switch to FM. If, not otherwise stay. However, quitting right now is kinda dumb (waiver or not). You will get exposure to medicine in your preliminary year. Try it out before you sign the waiver (this is a big life decision and what is a year in a long career).
In addition, your hasty change of heart makes it sound like you want to switch because you had an awesome clerkship experience (perhaps from an awesome attending?). My advice is that you should not go into a specialty because you really loved the people you work with. It is the same reason why you shouldn't exclude a specialty for hating the people. Because at the end of the day, you have to love the job (the people are secondary). Do the internship and see if clinical medicine is really for you.
Personally I am not a great fan of clinical medicine, but it you like it go for it. Switching later is much much harder than now. IMO, switch sooner that later, if you life clinical medicine.
You remind me of a classmate who wanted to switch to OB early in her internship. People recommended her to finish her internship to see whether she liked clinical medicine. At the end of her internship, her answer was yes. At this point she could get a spot in Ob residency in our medical school, but she did not take it because the same people recommended her to start radiology to make sure that she did not like it. She did two years of radiology residency and after spending a lot of time and energy, eventually she switched when she was R3. She went to a residency which was much much lower in ranking compared to our Ob residency and in an undesirable location to her.
IMO, radiology is the greatest field in medicine, but only if you like it. I see radiologists around who hate every moment of their job. I see people who come to work miserable and leave work miserable. Radiology needs its own personality. It is mentally intensive. It can be exhausting and tiring. Don't do it if you don't like it, because people say it is great. From what you say, I see a lot of red flags. If you think FM makes you happy, do it.