For the New Rad: 10 Survival Tips

Whitney J. Palmer

What residency doesn’t teach you, but that you need to know for your practice.

Taking those first steps into actual radiology practice after finishing up residency or a fellowship can be daunting. There are plenty of challenges ahead and being able to manage the workload is only one of them.

But, it is possible for you, as a new radiologist, to set yourself up for success. In an opinion article published March 31, in the Journal of the American College of Radiology, four veteran providers offered up 10 tips that can make the transition easier. Their goal was providing guidance not routinely found in residency programs.

“Residents may not be well prepared for their first job as a radiologist,” said the group led by Thomas C. Kwee, M.D., Ph.D., from the University of Groningen in The Netherlands. “We composed a top 10 list…our purpose was to fill in some important practical knowledge gaps that are typically not addressed in traditional residency programs.”

Kwee was joined by Ömer Kasalak, M.D., Ph.D., Derya Yakar, M.D., Ph.D., all from the University of Groningen, and Robert M. Kwee, M.D., Ph.D., from Zuyderland Medical Center in The Netherlands.

For a smoother move into practice, here’s what they suggested:

Match expectations: Be sure a new work environment is a good fit for your competencies and interests, as well as your future career goals for advancement. Inquire about it during interviews and expect interviewers to ask you about your preferences.

“Matching realistic expectations is the key for success and satisfaction from both sides,” they said.

Examine your contract: It can feel awkward to go over your contract with a fine-tooth comb before signing, but it’s critical that you do. Remember, oral agreements are not legally binding. Even if the job market is tight, check the contract and be willing to enter into negotiations – it can help you sidestep future regrets. If the contract is complex, consider engaging help from a legal or financial advisor.

Check your insurance: Although you hope to never have to use it, it is vital to have appropriate medical liability insurance. Research medical malpractice policies before choosing one, and be sure whatever policy you select offers clear parameters around the local medico-legal and compensation culture and the risk you have of becoming a defendant. In addition, the group said, new radiologists should also consider occupational disability and term life insurance policies.

Manage your finances: Unfortunately, most radiology residency programs do not offer any guidance in financial competency even though 76 percent of medical school students carry significant debt upon graduation. To help mitigate this stress, consider hiring a financial advisor. It would also be helpful, they said, for radiology residents to consider optional financial literacy courses prior to graduation.

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Prepare for scrutiny: New employees are always more closely watched to see if they’re performing well and fitting in. It’s normal, so expect it. Your new colleagues will be analyzing how well you can carry the workload, whether you fit in with the culture of the office, and whether you can positively contribute to the practice.

“Being under the magnifying glass may introduce additional stress,” they said, “but, it can be considered an inevitable process one has to go through, for which one needs to be mentally prepared.”

Word hard; stay leery of burnout: As with other professions, new radiologists frequently work overtime to manage workloads and learn processes that are critical to the job. Consequently, it’s no surprise that the earlier years as a practicing provider – typically the under-40 crowd – are fraught with burnout. Stay aware – know the symptoms, self-reflect, and look for solutions quickly when you see or feel evidence of problems.

Know your sources of errors: Mistakes are inevitable, but knowing where you might be vulnerable can help. If you’re nervous about becoming the “final read,” improve your knowledge about error prevention. It can also be helpful for relatively new supervising radiologists to conduct independent reviews before evaluating a resident’s interpretation, potentially reducing any erroneous agreements.

Sharpen your teaching skills: New radiologists are frequently tasked with teaching residents, but residency programs do not offer teaching courses. This makes it harder for you to handle instances where residents don’t perform well.

“It is highly recommended for newly starting radiologists who have a residency program in their department to pursue dedicated teaching courses early on in their career,” the group suggested.

Avoid toxicity: Keep an eye out for co-workers who will readily exploit your unfamiliarity with your new work environment. They might make unreasonable work requests or ask for a disproportionate amount of favors. Do your best not to give in, the group said.

“The best tactic is to avoid toxic personalities and to clearly indicate boundaries, non-engagement, and intolerance to unjust behavior,” they said. “Unprofessional behaviors need to be reported to leadership or human resources.”

Plan for re-accreditation: Re-accreditation is required to maintain your license, but finding time to work it into your schedule can be difficult. Do your due diligence – research what you must do to fulfill these requirements, confirm how long they will take, and mark off time on your calendar. Be sure to do this in a timely manner to avoid any problems.

In addition to being a guide for new graduates, the group said, these tips can also be of value to senior radiologists who serve as mentors, as well as to residency programs looking to augment their training.

“Most of these survival tips can be addressed well in advance before embarking on a new job as a radiologist,” they said, “and the others can be applied on the job.”