Radiology lifestyle & job market in comparison to other specialties

[Nirvanesthesia]

Hi all, 

I've read a lot of the threads in this forum and get the sense that radiology is no longer a lifestyle specialty and like all specialties, has challenges in terms of residency workload and finding a job in a bigger city. However, I'm interested in knowing how does it compare to other specialties (in particular surgery and internal medicine) in terms of: 

1) Residency lifestyle

2) Staff lifestyle: # of hours worked? How easy is it to work part-time, take time off, etc.?  

3) Job market: Finding a job in a more urban centre? 

Thanks!

[dooogs]

Hope you dont mind I add one more question:

Is a fellowship or more necessary for a good job ?

[rmorelan]

4 hours ago, dooogs said:

Hope you dont mind I add one more question:

Is a fellowship or more necessary for a good job ?

that depends on how you define a good job - I mean ha ANY radiology job is good on income fronts overall at least at present. 

I would have to say yes though overall - 90% of us do fellowships not just to advance our skills but also to just get hired at all. Of course particularly at any academic institution where the jobs are organized for the most part around sub-specialities. Almost 0% chance of getting hired at one of those, or most major cities (if not all) without a fellowship. May be very odd exceptions. 

[rmorelan]

10 hours ago, Nirvanesthesia said:

Hi all, 

I've read a lot of the threads in this forum and get the sense that radiology is no longer a lifestyle specialty and like all specialties, has challenges in terms of residency workload and finding a job in a bigger city. However, I'm interested in knowing how does it compare to other specialties (in particular surgery and internal medicine) in terms of: 

1) Residency lifestyle

2) Staff lifestyle: # of hours worked? How easy is it to work part-time, take time off, etc.?  

3) Job market: Finding a job in a more urban centre? 

Thanks!

I don't think it ever was a lifestyle speciality in terms of residency (maybe someone would disagree with me there ha). Right now call is still variable between institutions but I will say as a resident the call was quite hard where I trained - they are constantly changing things in an attempt improve both coverage and keep residents sane but I was lucky to get an hour of sleep on any of the call shifts I had which in the beginning was 1/5. It was hard, busy and exhausting and really took a toll on me. For most programs you are still done by 8am on the call day though - unlike some other fields which can go to noon (it is a balance - usually, but not always, in internal for instance you would expect some rest overnight - and non CTU/ICU rotations would be lighter - you have to look at the overall situation. In rads every call shift is the same. In many other fields they have various rotations where it is different). 

In rads in the beginning it is hard to get part time work and be permanent staff - that just isn't how it is done in most places. Few grads want part time work, so the system isn't set up for it. There are locums which you can do - and many people do some of those. 

Staff jobs do have a bunch of vacation time - basically when you are on you are on, but you do have times when you are not on at all. 

I have always found the jobs to be hit and miss - you pick a fellowship in something, but you do that 2+ years prior to graduating and thus 3 years prior to actually starting as staff. No one really has any idea what the particular job market will be in a particular area that far out so you are guessing. If you are very lucky you can get on as staff at a major centre right way - I was very lucky that way. On the other hand most graduates I know even from good schools and great fellowships are in community positions in less urban areas (sometimes that was their choice all along to be clear - there are a lot of benefits in those jobs). It all appears to be hit and miss but there are things you can do to improve - works hard, learn lots, network, do an excellent fellowship and be flexible in the site you are hoping to work (even if it is among different urban centres - and what exactly is urban for that matter). 

 

 

Edited August 3, 2020 by rmorelan

[Nirvanesthesia]

4 hours ago, rmorelan said:

I don't think it ever was a lifestyle speciality in terms of residency (maybe someone would disagree with me there ha). Right now call is still variable between institutions but I will say as a resident the call was quite hard where I trained - they are constantly changing things in an attempt improve both coverage and kind residents sane but I was lucky to get an hour of sleep on any of the call shifts I had which in the beginning where 1/5. It was hard, busy and exhausting and really took a toll on me. For most programs you are still done by 8am on the call day though - unlike some other fields which can go to noon (it is a balance - usually, but not always, in internal for instnace you would expect some rest overnight - and non CTU/ICU rotations would be lighter - you have to look at the overall situation. In rads every call shift is the same. In many other fields they have various rotations where it is different). 

In rads in the beginning it is hard to get part time work and be permanent staff - that just isn't how it is done in most places. Few grads want part time work, so the system isn't set up for it. There are locums which you can do - and many people do some of those. 

Staff jobs do have a bunch of vacation time - basically when you are on you are on, but you do have times when you are not on at all. 

I have always found the jobs to be hit and miss - you pick a fellowship in something, but you do that 2+ years prior to graduating and thus 3 years prior to actually starting as staff. No one really has any idea what the particular job market will be in a particular area that far out so you are guessing. If you are very lucky you can get on as staff at a major centre right way - I was very lucky that way. On the other hand most graduates I know even from good schools and great fellowships are in community positions in less urban areas (sometimes that was their choice all along to be clear - there are a lot of benefits in those jobs). It all appears to be hit and miss but there are things you can do to improve - works hard, learn lots, network, do an excellent fellowship and be flexible in the site you are hoping to work (even if it is among different urban centres - and what exactly is urban for that matter). 

 

 

Thanks so much rmorelan for the helpful answer.  Do you know how radiology compares in terms of those factors to other specialties, say General Surgery or GIM? 

[Bandicoot]

On 8/2/2020 at 6:03 PM, rmorelan said:

I don't think it ever was a lifestyle speciality in terms of residency (maybe someone would disagree with me there ha). Right now call is still variable between institutions but I will say as a resident the call was quite hard where I trained - they are constantly changing things in an attempt improve both coverage and keep residents sane but I was lucky to get an hour of sleep on any of the call shifts I had which in the beginning was 1/5. It was hard, busy and exhausting and really took a toll on me. For most programs you are still done by 8am on the call day though - unlike some other fields which can go to noon (it is a balance - usually, but not always, in internal for instance you would expect some rest overnight - and non CTU/ICU rotations would be lighter - you have to look at the overall situation. In rads every call shift is the same. In many other fields they have various rotations where it is different). 

Staff jobs do have a bunch of vacation time - basically when you are on you are on, but you do have times when you are not on at all. 

 

 

Does this call amount/difficulty differ by residency program?

Also, how much vacation time is typical for jobs in radiology?

 

Thanks!

[rmorelan]

5 hours ago, Bandicoot said:

Does this call amount/difficulty differ by residency program?

Also, how much vacation time is typical for jobs in radiology?

 

Thanks!

Yes it does - it varies in a lot of ways - there are various call configurations - old school 24+ hour call, night float style call, various call splits......, you can have busier and less busy centres while on call, you can places where call is more frequent than others (it is a function of the number of residents, the number of people on call at the same time, and the call configuration), and some have staff 24/7 so you aren't alone, and others you are alone for all or part of the night. Some places have you also review you cases in the am with staff and finalize reports, others you do only preliminary reports, and some full reports. 

Each of those patterns has advantages and disadvantages - and I should add that call really is a huge learning opportunity and particularly if you are alone you really do learn to be faster, better and more confident (when you have to make the call and the buck stops with you then yes forcing you to commit is a powerful experience  it is like that with anything you do). Trouble is the better the learning experience the worse the call structure tends to be ha (sweat now or bleed later type of learning). It is in part for that reason that many staff really do believe in the necessity of that sort of training (and I have to say you can usually tell if someone has come from a heavy or light call environment at the fellowship level. Heavy call people tend to be more "practical" radiologists and faster). 

Vacation varies but  say around 10 weeks just to put a flag in the ground. Now that isn't like go sleep on a beach time as a lot of it you have to spend maintaining your college certifications, fitting in research, doing admin work, and so on. In the US some radiologists only get 4 weeks vacation but provisions are made for the above in other ways. 

 

[Bandicoot]

Thanks @rmorelan! Your comments are always very helpful

[interestedinrads]

On 8/2/2020 at 2:30 PM, rmorelan said:

that depends on how you define a good job - I mean ha ANY radiology job is good on income fronts overall at least at present. 

I would have to say yes though overall - 90% of us do fellowships not just to advance our skills but also to just get hired at all. Of course particularly at any academic institution where the jobs are organized for the most part around sub-specialities. Almost 0% chance of getting hired at one of those, or most major cities (if not all) without a fellowship. May be very odd exceptions. 

So based on reading posts here and hearing from my school's program, a solid chunk of the residency class do fellowship in the states. If there are issues getting a job in a major center in Canada, do a significant chunk of our radiologists end up working in the states?

I remember you posting about fellowship in the states as well, do you know if rads volume in Canada vs US are similar?

Super helpful thread thanks for this!

[cotecc]

On 8/6/2020 at 9:29 PM, rmorelan said:

Yes it does - it varies in a lot of ways - there are various call configurations - old school 24+ hour call, night float style call, various call splits......, you can have busier and less busy centres while on call, you can places where call is more frequent than others (it is a function of the number of residents, the number of people on call at the same time, and the call configuration), and some have staff 24/7 so you aren't alone, and others you are alone for all or part of the night. Some places have you also review you cases in the am with staff and finalize reports, others you do only preliminary reports, and some full reports. 

Each of those patterns has advantages and disadvantages - and I should add that call really is a huge learning opportunity and particularly if you are alone you really do learn to be faster, better and more confident (when you have to make the call and the buck stops with you then yes forcing you to commit is a powerful experience  it is like that with anything you do). Trouble is the better the learning experience the worse the call structure tends to be ha (sweat now or bleed later type of learning). It is in part for that reason that many staff really do believe in the necessity of that sort of training (and I have to say you can usually tell if someone has come from a heavy or light call environment at the fellowship level. Heavy call people tend to be more "practical" radiologists and faster). 

Vacation varies but  say around 10 weeks just to put a flag in the ground. Now that isn't like go sleep on a beach time as a lot of it you have to spend maintaining your college certifications, fitting in research, doing admin work, and so on. In the US some radiologists only get 4 weeks vacation but provisions are made for the above in other ways. 

 

Do you see radiology being replaced by AI in 10-20 years. I mean, AI has advanced so much in the last couple of years and will certainly advance in the next couple of years.

What do you think the role of the rads will be then? and do you forcast unemployment ?

And how is the job market for rads in major centres or community hospitals near major cities now?

[rmorelan]

2 hours ago, cotecc said:

Do you see radiology being replaced by AI in 10-20 years. I mean, AI has advanced so much in the last couple of years and will certainly advance in the next couple of years.

What do you think the role of the rads will be then? and do you forcast unemployment ?

And how is the job market for rads in major centres or community hospitals near major cities now?

I am an AI research and from that base I would say no not at all. Even if or when such a thing happens there would also be a huge upswing in our productivity first which under our current system would be quite lucrative. By the time AI can replace radiologists the entire world economy will be under similar revolution (reading images is a very hard cognitive task - if AI can do that then it can also do a lot of other things. This is a long term issue for the human race really - the point of technology is to let one person do the work of many. What happens when almost all the work can be done by the very few? The world will change, as it has changed many times in the past so thinking in terms of our current structures and then projecting is hard). 

right now it is for lack of a better term "meh" but there are relatively few of us so there is a bit of randomness to things (only about 90 of us created a year Canada wide). Most of the people I know got hired at hospitals in community places not terribly far from major centres. It was hard to get an academic place - I was the only one in my year that got on but there are again pockets of things that open up here and there. 

[HounsfieldUnit]

On 8/6/2020 at 6:29 PM, rmorelan said:

Yes it does - it varies in a lot of ways - there are various call configurations - old school 24+ hour call, night float style call, various call splits......, you can have busier and less busy centres while on call, you can places where call is more frequent than others (it is a function of the number of residents, the number of people on call at the same time, and the call configuration), and some have staff 24/7 so you aren't alone, and others you are alone for all or part of the night. Some places have you also review you cases in the am with staff and finalize reports, others you do only preliminary reports, and some full reports. 

Each of those patterns has advantages and disadvantages - and I should add that call really is a huge learning opportunity and particularly if you are alone you really do learn to be faster, better and more confident (when you have to make the call and the buck stops with you then yes forcing you to commit is a powerful experience  it is like that with anything you do). Trouble is the better the learning experience the worse the call structure tends to be ha (sweat now or bleed later type of learning). It is in part for that reason that many staff really do believe in the necessity of that sort of training (and I have to say you can usually tell if someone has come from a heavy or light call environment at the fellowship level. Heavy call people tend to be more "practical" radiologists and faster). 

Vacation varies but  say around 10 weeks just to put a flag in the ground. Now that isn't like go sleep on a beach time as a lot of it you have to spend maintaining your college certifications, fitting in research, doing admin work, and so on. In the US some radiologists only get 4 weeks vacation but provisions are made for the above in other ways. 

 

I would also note, however, that depending on the US centre, US radiologists receive a LOT more research time, i.e., anywhere from 2-4 days per week.  That's far more than I saw any Canadian radiologist receive.

[rmorelan]

33 minutes ago, HounsfieldUnit said:

I would also note, however, that depending on the US centre, US radiologists receive a LOT more research time, i.e., anywhere from 2-4 days per week.  That's far more than I saw any Canadian radiologist receive.

academic ones yes! - although you are right it depends. Usually that only kicks in as well once you advance a bit (the clinical instructors at MGH and BWH didn't get any significant academic time for instance which is the starting position). Often getting grants is required as well

In the US as well vacation time is a lot less which can blunt that effect. Where I was at the staff started at 4 weeks (in Canada start and end with 11). Our pay is also higher - in part because we are actually doing the clinical work rather than research ha. Some staff here just go to 80% income to pick up a day a week of research and then use their vacation time to add more. 

 

 

[HounsfieldUnit]

On 12/13/2020 at 5:11 PM, rmorelan said:

academic ones yes! - although you are right it depends. Usually that only kicks in as well once you advance a bit (the clinical instructors at MGH and BWH didn't get any significant academic time for instance which is the starting position). Often getting grants is required as well

In the US as well vacation time is a lot less which can blunt that effect. Where I was at the staff started at 4 weeks (in Canada start and end with 11). Our pay is also higher - in part because we are actually doing the clinical work rather than research ha. Some staff here just go to 80% income to pick up a day a week of research and then use their vacation time to add more. 

 

 

At my (US) fellowship centre, even spanking new staff received at least one research day per week--no grants required.  They relied quite heavily on the fellows doing all of the work, which freed up a lot of attending time.

[rmorelan]

3 hours ago, HounsfieldUnit said:

At my (US) fellowship centre, even spanking new staff received at least one research day per week--no grants required.  They relied quite heavily on the fellows doing all of the work, which freed up a lot of attending time.

Do you happen to know their academic rank? (things do vary of course from site to stie) You are definitely right about the fellows (which I found quite interesting again particular compared to Canada). 

 

Edited December 19, 2020 by rmorelan

[HounsfieldUnit]

5 hours ago, rmorelan said:

Do you happen to know their academic rank? (things do vary of course from site to stie) You are definitely right about the fellows (which I found quite interesting again particular compared to Canada). 

 

Yes I know their academic ranks, i.e., low.  I reckon that my fellowship centre is foremost in allocating research days to staff radiologists as I've not seen this anywhere. 

The norm is definitely to allow the fellows to run the show and do the lion's share of the diagnostic and procedural work, if not all.  The attendings generally read plain films as well as the odd cross-sectional study here or there, i.e., one per day, if any.  Quite a contrary experience from my residency years at one of the biggest centres in Canada.

[rmorelan]

3 hours ago, HounsfieldUnit said:

Yes I know their academic ranks, i.e., low.  I reckon that my fellowship centre is foremost in allocating research days to staff radiologists as I've not seen this anywhere. 

The norm is definitely to allow the fellows to run the show and do the lion's share of the diagnostic and procedural work, if not all.  The attendings generally read plain films as well as the odd cross-sectional study here or there, i.e., one per day, if any.  Quite a contrary experience from my residency years at one of the biggest centres in Canada.

well it sounds good from a research point of view - I wonder what their "complete package" looks like ha. 

 

[HounsfieldUnit]

On 12/19/2020 at 10:10 PM, rmorelan said:

well it sounds good from a research point of view - I wonder what their "complete package" looks like ha. 

 

It's pretty good. 

[stayblessed]

Bringing this thread back to life!

What’s the process of finding a job in radiology? Is it through word of mouth and connections (like certain surgical specialties), or is it through job postings open to all?

And that’s the job market looking like for southwestern Ontario the next 6-7 years? I know that’s difficult to predict but curious about the trend. 
 

Thank you!!

[W0lfgang]

Can be worth of mouth, cold-emailing, or job posts. I know people who got jobs from each avenue. Some job posts are shams.

Outlook is good for radiology in general, not just sw Ontario. Demand is ever-increasing and it doesn't look like we're training rads any faster. Be prepared to do a fellowship.