Moving on to Your First Radiology Job? Prepare for the Long Haul

May 16, 2019

In a lot of ways, going to your first job in radiology after residency is like changing from running laps to doing cross country-it’s a lot longer and lot less regular.

Barring the occasional happy encounter with someone who reads this column and feeling like a micro-celebrity in the world of radiology, I’m about as far from a public figure as it gets. I pride myself on the work I do, but I haven’t exactly broken ground on any big-time discoveries, nor won recognition from the world at large.

In other words, I think I’ve got just about 0.0% of a chance to ever be asked to speak at a graduation/commencement ceremony. This is fine with me on multiple counts, one of which being that I avoid public speaking like the plague. The other is that I get to use what might have been my speaking material for today’s column.

Radiology housestaff on the verge of completing their residency training hear all kinds of stuff about the changes they are in for: Reading independently without the “safety net” of an overseeing attending, having to generate more RVU-productivity, manning hours less defined and protected than those of a teaching-hospital, etc.

Another type of change I’d advise them to be mindful of is one that I don’t recall anybody mentioning during my training, or indeed medschool or college: Transitioning from running laps around a racetrack to going cross-country (marathoning or otherwise).

Up until the completion of one’s residency or fellowship, a radiologist-to-be has experienced her or his career in a very compartmentalized, chapter-like fashion. Maybe 1-2 years of fellowship, 4 years of residency, 1 year of internship, 4 years of medschool before that, 4 years of college, etc. And these are subdivided, such as into clinical rotations and classes.

There’s a very defined sense of where you are, where you’ve been, and where you’re going. Barring exceptional circumstances such as having to repeat a course (or, God forbid, a year), you can realistically expect to move on to the next step when the calendar says it’s time.

So, no matter how much you’re enjoying the phase you’re in, you know when it’s coming to an end, and how long you have to make the most of it, learn its material, etc. Or, if you’re finding it dreadful, you know there’s only so much longer you’ll have to endure it.

For most radfolk, that comes to an end when you complete your training and begin your subsequent career. Sure, maybe you find a gig which boasts a “partnership track,” and in a few years you get to find out how truthful such promises were. Or maybe you wind up in a hierarchical environment where you hope to climb the ranks-section head, professor, department chair, etc.

Related article: Radiology Residency: How It's Changing

Aside from such circumstances, your days of running laps-when you can count how many times around the track you’ve gone, and how many more before you graduate to another level-are done. You are now running cross-country, without such a ready mechanism for marking your time and progress. The next career milestone might well be your retirement-30-40 years down the line instead of the 1-4 year increments to which you’ve grown accustomed.

This can be a welcome, even liberating, change. You might have gotten fed up with the constant cycling through various ranks, and are happy to now be at the same level as everyone else in the profession. Not to mention the ever-present ghost of a chance of not actually making the grade at some point, and failing to rise through the ranks on schedule.

It can also mean that you are entering the doldrums, and that in a few years, your mind-now accustomed to a periodic moving-up-in-the-world dynamic-faces existential crisis. Probably not in a sudden tumultuous moment, but more of a slow burn. Such a simmering dissatisfaction, if not consciously recognized and addressed, can prove maladaptive.

For instance: Suppose you wound up taking a job with good terms, on par with the market,  but with no realistic chance to rise through any ranks. You might be completely fine with the notion of working under these terms for the next few decades-until the part of your mind that is accustomed to some sort of promotion every few years starts to murmur about how stagnant the place is.

Such a drive to accomplish bigger and better things can certainly result in attaining heights you might otherwise have not-if such drive is well-focused and directed. Otherwise, it might be best to get in the habit of setting some goals and milestones to achieve outside of your professional life, in your personal one-that little thing that you mostly set aside while you were running metaphorical laps in residency and medschool.