Best Radiology Fellowships for Job Prospects?

[RadiologySWITCH]

Currently a PGY1 in a small DR program. I know it is a bit early to start thinking about fellowships but we start applying for those in PGY3/4, so it does not hurt to ask around. Looking forward to what the pm101 hive mind has to say.

I am interested in all subspecialties and I know that will probably change as I progress in my training. But really my goal is to practice in either Toronto or Vancouver, so I will pursue whatever fellowship/subspec that will get me there. And yes, I know almost everyone wants to move to those two cities but hey, I am no different. I am a single dude with no attachments. I have lived, worked, studied in my province my whole life so I need and want a change. I have always wanted to move TO or Van, so I am unflexible on just this one aspect. Taking an income cut, working worse hours, high COLA and all that other stuff does not bother me.

Looking at job postings online, most of the ones in TO/Van are for IR. I have tried reading other forums online but those are mostly US, and seem to say mammo and neurorad are the ones who have no problem finding jobs in desirable locations. Is it the same in TO/Van? Am I oversimplifying this?

I know it is always best to ask people in my own program but I do not want to make it seem like I am unhappy with my small program and city and want to leave. Maybe I am overthinking it but I also do not want to lose mentorship opportunities or taint relationships by making it known that I have no intention of practicing here despite training here.

TL;DR which rad subspecialty will give me the best shot at getting a job in TO or Van?

Thx guys,
radSWITCH

[Applemanv3]

My tips: make yourself marketable. Unless you go full on academic with publications, research interests, etc, try to find and love procedures, breast, and chest. MSK/Neuro are great too, but tend to be a bit saturated or readily supplied. Breast/body is a great combo skillset, but I don't know if there is still as much of a need.

The ability to do anything and everything is ALWAYS an asset, but comes with the trade-off of having to either be amazing at everything or risk spreading yourself thin.

Junior residents have plenty of time to overcome "I hate MSK" or "I hate breast" or whatever else happens early on. I wish I had driven myself to love MSK more, but I never found it my cup of tea.

My humble thoughts - would love to hear others'. Open to discussing.

[garlic]

I don't know how radiology groups work, as I've only known academic radiologists who've taken years practicing elsewhere to get jobs in the big cities. And even then I don't know much as my interactions with them have been limited to being sent down by my surgical teams to review a scan (hahah). 

There is probably no right answer but word of mouth will probably be a bigger friend than simply choosing the "right" fellowship. Two of my friends worked hard EVERY day of residency - literally never took a day off in their whole 5-7 years. Everybody in the hospital knew and liked them. They are now staff surgeons in very desirable cities, just one year after completing residency. Obviously this is an n=2 but getting a job that quickly as a surgeon in Canada is pretty damn impressive

[Aslidoctor]

On 7/19/2020 at 11:43 AM, garlic said:

I don't know how radiology groups work, as I've only known academic radiologists who've taken years practicing elsewhere to get jobs in the big cities. And even then I don't know much as my interactions with them have been limited to being sent down by my surgical teams to review a scan (hahah). 

There is probably no right answer but word of mouth will probably be a bigger friend than simply choosing the "right" fellowship. Two of my friends worked hard EVERY day of residency - literally never took a day off in their whole 5-7 years. Everybody in the hospital knew and liked them. They are now staff surgeons in very desirable cities, just one year after completing residency. Obviously this is an n=2 but getting a job that quickly as a surgeon in Canada is pretty damn impressive

Cannot imagine the toll that takes on someone physically, mentally and emotionally. Suppose it was worth it in the end but geez.

[RadiologySWITCH]

Was hoping to have a conversation going like this SDN thread. Learned a lot from there (sounds like mammo and neuro are good choices?) But would be nice to hear whether this is true for Canada too

https://forums.studentdoctor.net/threads/radiology-fellowship-info.1307561/

[Tullius]

Maybe @rmorelan has a view on it?

[HounsfieldUnit]

Many programs hire internally.  I was trained at one of the largest residency programs in Canada, and then fellowship-trained in a similarly large/reputable program in the US.  Both programs have, and do, hire their trainees.  Working within a program gives both parties the experience of, for one, a very long job interview.

[rmorelan]

On 12/4/2020 at 8:51 AM, Tullius said:

Maybe @rmorelan has a view on it?

yeah this is always so hard - and it is hard in particular because the turn around time is so long, and the relative number of positions is small. There just aren't that many of us, particular when you subdivide it into particular fields or particular geographic locations. There are around 2500 of us in total over the country, and about 100 of us graduate each year. Assuming steady state or at least slow population growth that is not a lot of room for turn over. Plus the relative number of us has slowly creeped up over the past 15 year per 100K of the population - now demand has also bumped up but we have this annoying habit of just absorbing the work with in existing staff, particularly as billing rate have also fallen so there isn't a  lot of new room. 

Plus the timing is hard.  let's say field XYZ is hot in rads right now and there open spots. So you want to do it. Even waving any time in residency trying to be competitive for it you still end up applying for a fellowship by the end of PGY3 and then it takes 3 entire years to finish residency and then graduate the fellowship if all goes smoothly - more in some fellowships like mine. That in any job market is a long time. Others have the same idea you had and then you all graduate at once and boom, there isn't a shortage at all. 

Hard to plan for that. Thus there is always an element of luck, particularly if you want a job in a particular area - which is seems like many people have. To put it in perspective of my class of 6 I am the only one that is in a major city at present I believe or currently is acting as an academic radiologist. That still seems very strange to me as my classmates are very strong radiologists and some in particular wanted a more academic career.  Still as time goes on they may move to other places. 

So some of this will simply depend on what your jobs are - if you just want a job well 70% of all radiologists are in the community so there for are generalists and often in demand are procedural skills and breast imaging. No perfect fellowship can do all of that of course, but there are body fellowship that allow for some flexibility with mini fellowships in things. 

If you want something specific then some again luck will be involved. You have to hope something in the area you want in the sub area of radiology you want will open up. Asking around can help with that ( I have had some of my friends simply go to the group and say I will do a fellowship in anything - doesn't matter and ask who is retiring in the next 3-4 years and I will do whatever that is - usually that works, but even then things can change). 

Overall and I think this is probably a good idea, be as general as you can be if you can live with that outcome. Do a fellowship that makes you as useful in as many ways as possible if you are prioritizing getting a job and if you can really push at the places you what to go for what they probably would be looking for. 

Also keep in mind sure right now you are willing to do whatever - even crappy radiology ha - to get where you want to go. What about 10 years from now? That is the issue in my field - I am the only Canadian graduate in the last few years (I believe) with an ER fellowship. I was lucky that 4 jobs in that field were open when I graduated. However of course ER radiology is not for everyone and the nights can grind some people down (I am a night owl so it works for me). 

Ok to the OP - yes right now IR is pretty hot stuff. Ultimate get hired anywhere can involve doing two fellowships (again more useful means more job opportunities). Also when you are looking for a fellowship remember that is who will actually set you up for the job in the end (for instance my fellowship the director basically picked up the phone and called. 30 min later things started to happen...... that is the kind of interaction you want). 

 

Edited December 15, 2020 by rmorelan

[W0lfgang]

Judging from recent job ads, breast, neuro, and IR have been in demand recently. But my advice is to do what interests you. We are under ever-increasing scrutiny and pressure to deliver. You need to be good. Jobs are bound to open up in your specialty, especially in Toronto and Vancouver. Be the best candidate on the market when that happens (and also be a nice person) and good things will happen. You get there by working in something you enjoy, not to mention you're in it for 20+ years!

I met a seasoned radiologist who chose a specialty for a specific job, which he got. The problem is he didn't care for the specialty. In the end, he wasn't happy. 

[RadiologySWITCH]

Thanks for the insightful reply @W0lfgang

When you say "bound to open up, especially in toronto and vancouver", do new grads get these jobs? Or is it more like, yeah the job opening is there but honestly they're looking for someone who's been a sub specialized staff-researcher in Europe for 10 years

How have your co-residents fared in the job market over the years? Must they relocate to smaller cities? And for yourself, did you get your gig through word of mouth/people knew and liked you, or was it a cold application for a posting?

[W0lfgang]

On 1/22/2021 at 12:59 PM, RadiologySWITCH said:

Thanks for the insightful reply @W0lfgang

When you say "bound to open up, especially in toronto and vancouver", do new grads get these jobs? Or is it more like, yeah the job opening is there but honestly they're looking for someone who's been a sub specialized staff-researcher in Europe for 10 years

How have your co-residents fared in the job market over the years? Must they relocate to smaller cities? And for yourself, did you get your gig through word of mouth/people knew and liked you, or was it a cold application for a posting?

Good point. Someone with experience will have an edge over you. Be open to the having to locum or working in a less-desired practice until you get your ideal job.

My cohort have all landed jobs but not all of us got our ideal jobs.

[W0lfgang]

On 1/22/2021 at 12:59 PM, RadiologySWITCH said:

And for yourself, did you get your gig through word of mouth/people knew and liked you, or was it a cold application for a posting?

Word of mouth but my colleague applied far and wide, and got interviews for non-advertised positions.

[Tullius]

On 1/16/2021 at 12:23 AM, W0lfgang said:

I met a seasoned radiologist who chose a specialty for a specific job, which he got. The problem is he didn't care for the specialty. In the end, he wasn't happy. 

I don't really understand why people do this, unless they are extremely restricted geographically and figure they can live with whatever type of work as long as they are in one particular desired place.

For those who are open to major centers in the US as well as Canada, and have a network in both countries, does that change the calculus at all?

[HounsfieldUnit]

Getting a radiology job you want is multifactorial.  Some of the factors involved:

• What happens to be in demand at any given centre (which, in itself is multifactorial, i.e., are radiologists retiring, is a department expanding, etc.).
• If you're well liked and your home institution targets you early on for a job and keeps on in mind (and possibly on hold) for you until you finish your training.
• Your skillset: if a certain department is looking for body rads who have OB, for example, and your residency/fellowship didn't offer that experience, well...  Or if whatever subspecialty job is looking for someone who can do procedures in that area, e.g., chest biopsies, body biopsies, etc., and you've got limited experience...
• Research experience, or not.  The academic centres often like a bit of that, and if you have a whole lot of it and that's what they're seeking then there's a chance that you'll be at the top of the heap of that category (since most rads don't do research).
• Where you went for fellowship (some fellowships open doors, whether that's just or not, it happens), as some fellowships have the reputation for being tough and if you could make it there then you could make it anywhere, so to speak.
• Who you know--the golden radiodex (just coined that, incidentally).
• Serendipity.

There are likely a bunch more factors that I haven't mentioned here, but that's a start.

[RadiologySWITCH]

Thanks for the really helpful insight everyone. The points brought up here have helped a ton during my rotations so far!

Could someone shed light on how neuroradiology fellowships work. In the US, seems like the 2 year option is only if people want to be academics reading only neuro studies and often residents don't find the extra year of losing out on staff pay worth it financially. But in Canada it is different as academic positions are highly competitive and sought after, compared to this being the opposite in the US...

In Canada, some schools offer 1 and/or 2 year neurorad fellowships. What is the difference other than more practice/exposure to cases? Does this affect job prospects significantly (esp for TO in Van)? Does doing the 2 year mean you'll pretty much only be reading neuro studies in your group, whereas the 1 year is more like other fellowships where you can be an MSK rad reading abdo regualrly?

[offmychestplease]

11 hours ago, RadiologySWITCH said:

But in Canada it is different as academic positions are highly competitive and sought after, compared to this being the opposite in the US

are you sure this is the case? Community radiologists can make literally 3x as much as academic radiologists so not really much incentive to do academics here

[1D7]

On 7/24/2021 at 3:13 PM, RadiologySWITCH said:

Thanks for the really helpful insight everyone. The points brought up here have helped a ton during my rotations so far!

Could someone shed light on how neuroradiology fellowships work. In the US, seems like the 2 year option is only if people want to be academics reading only neuro studies and often residents don't find the extra year of losing out on staff pay worth it financially. But in Canada it is different as academic positions are highly competitive and sought after, compared to this being the opposite in the US...

In Canada, some schools offer 1 and/or 2 year neurorad fellowships. What is the difference other than more practice/exposure to cases? Does this affect job prospects significantly (esp for TO in Van)? Does doing the 2 year mean you'll pretty much only be reading neuro studies in your group, whereas the 1 year is more like other fellowships where you can be an MSK rad reading abdo regualrly?

Most of the time you can find a job after doing 1 year of the 2 year neuroradiology fellowship. If you want the neuroradiology Royal College designation though I believe you actually need to finish 2 years.

"Diagnostic Neuroradiology Subspecialty Training: 1 Versus 2 Years; the Canadian Perspective" - Essentially the 2 year options helps with finding an academic job, probably in part because you can job hunt longer.