Which radiology programs have the most brutal call? Volume and frequency

[calcitonin]

Guessing Vancouver or Toronto because of large population going to the ED with 30 scanners working 24/7? Or smaller programs like Queens with 1 in 3 call but only 2 scanners for small population?

[1D7]

No one really knows what program's call is busiest, though as a resident you have a vague understanding based on talking to friends & fellows from other programs. Although call is certainly unpleasant, having high volumes is what will push you to be faster. You're going to be pushing yourself to be faster in your 1st year of independent practice no matter what; missing something in residency is much less consequential than missing it on your own license.

As for frequency, it depends on how many residents are on call per night vs total number of PGY2-5s. If many hospitals require individual coverage, then frequency will be a bit higher (this will tend to be larger programs). If it is a very small program, frequency can be higher due to # of residents available. Most programs will tell you how call is structured if you ask, and you can sort of figure it out from there.

If you want more specific numbers you could probably ask a few of the residents from that program... If not that then you could probably ask medical students from that school.

[anonymouspls]

From word of mouth I've heard Queens is one of the better lifestyle programs for call and in general. Western is particularly bad for call because it's still a small program despite covering a huge catchment area and having large volumes. You can read 35-40 CTs overnight at Western whereas the average in Queens is in the 20's I believe. I've heard that going to bigger schools like Toronto can actually be better because you have a lot of fellows and co-residents to rely on whereas that's not the case in Western. Not sure about other schools. 

Also factor in other things like Queens has no ultrasound techs so residents have to do their own ultrasounds on call, whereas in Western you won't have to do that. Anyway in general Rads is really not a lifestyle specialty and I think it's only going to get worse with each passing year haha but hopefully this helps. 

[anonymousyolo]

Can confirm from very close sources that programs such as UBC and Toronto actually generally have the easiest call (maybe not in terms of frequency, but in terms of stressors/consequences). This is due to the support from numerous fellows and dedicated emergency radiology departments. At programs like western and queens, every call you make is essentially yours for 12+ hours unless there is a supportive staff signing off (of which there are many).

Western is widely known to be the worst call in the country surprisingly, with CT volumes up to 80+ per night at times (they have now recently moved to having two residents on call each night). To have them also perform ultrasound on their patients simply is not possible (especially when its one person on). Queens is known to be "ok" in the sense that they have lesser volumes.

Call everywhere is difficult. You really need to reach out to residents at each site to understand what they deal with.

[anonymouspls]

Another thing, I was fortunate in fourth year in that I did a community radiology elective and got really close with a couple of the community radiologists. OP if you're asking this question consider that no matter what program you go to, you're eventually going to be working as staff, and most likely in the community. Radiology is one of the only specialties in Medicine where your quality of life goes down when you transition to independent practice. The call structure is brutal at most practice groups, and no matter which remuneration model is used by the practice group you join, you will be expected to clear your queue in a timely manner. For the community docs I was with they were regularly working 55-60 hour weeks ontop of call to keep up, and as you gain seniority this eases up. 

Honestly with how insanely competitive rads was this year I get the sense that a lot of people are not realizing what they're signing themselves up for and are in for a bit of a shock. 

[rubikscube]

3 hours ago, anonymouspls said:

Another thing, I was fortunate in fourth year in that I did a community radiology elective and got really close with a couple of the community radiologists. OP if you're asking this question consider that no matter what program you go to, you're eventually going to be working as staff, and most likely in the community. Radiology is one of the only specialties in Medicine where your quality of life goes down when you transition to independent practice. The call structure is brutal at most practice groups, and no matter which remuneration model is used by the practice group you join, you will be expected to clear your queue in a timely manner. For the community docs I was with they were regularly working 55-60 hour weeks ontop of call to keep up, and as you gain seniority this eases up. 

Honestly with how insanely competitive rads was this year I get the sense that a lot of people are not realizing what they're signing themselves up for and are in for a bit of a shock. 

Do you think that radiology will eventually become shift work like EM because of the increasing demand for 24-hour availability?

[anonymouspls]

1 hour ago, rubikscube said:

Do you think that radiology will eventually become shift work like EM because of the increasing demand for 24-hour availability?

I don't think so because it's not about putting in the hours, it's about clearing the queue. If it takes you 14 hours to get through the abdo CTs that have piled up from 3 days ago, then it takes you 14 hours, it's not like you can go home because you just finished your 12 hour shift. 

In my opinion the future of radiology in Canada is likely headed towards outsourcing of work to radiologists abroad. People don't like it and there will likely be push back but I think it's inevitable. I don't think there is enough money to go around to train the number of radiologists that are needed to keep up domestically. 

[jonbonezjones]

On 3/1/2023 at 8:02 PM, anonymouspls said:

Another thing, I was fortunate in fourth year in that I did a community radiology elective and got really close with a couple of the community radiologists. OP if you're asking this question consider that no matter what program you go to, you're eventually going to be working as staff, and most likely in the community. Radiology is one of the only specialties in Medicine where your quality of life goes down when you transition to independent practice. The call structure is brutal at most practice groups, and no matter which remuneration model is used by the practice group you join, you will be expected to clear your queue in a timely manner. For the community docs I was with they were regularly working 55-60 hour weeks ontop of call to keep up, and as you gain seniority this eases up. 

Honestly with how insanely competitive rads was this year I get the sense that a lot of people are not realizing what they're signing themselves up for and are in for a bit of a shock. 

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[mtbdoc]

Probably too late to matter now, but Queen's does not have 1/3 call.  In your most junior years you do ~55 shifts per year.  Volumes range from 20-50 studies per night (CT/US/MR); avg probably ~30.  You do have to scan for certain indications and you are the smartest radiologist in the hospital on call as you are the only radiologist in the hospital on call.

[rmorelan]

On 2/26/2023 at 10:05 PM, calcitonin said:

Guessing Vancouver or Toronto because of large population going to the ED with 30 scanners working 24/7? Or smaller programs like Queens with 1 in 3 call but only 2 scanners for small population?

Missed this thread ha - the population doesn't matter so much as the catch basin for each hospital. For instance Ottawa has a large catch basin per hospital while TO has a bunch of hospitals and each hospital has less. Also sure TO is busy but it also has 24/7 staff ER radiology and an ER fellow at most of the call sites (but not all). Some places you are by yourself at 5, and some places have staff until 11-12pm, and some all night long. 

Not to imply that call is easy - programs are trying to balance things so that there truly is a busy shift (that is the point of the educational value of call - at some point you need to learn to make decisions independently and move relatively quickly.) 

Also ha everyone only has their local experience so even those that gone through this have a hard time to compare things.