A variety of imaging experience can open doors to new career opportunities, but subtle communication tips can be key to landing your next job.
My CV would tell you that I’m a fellowship-trained body Imager, but you might not know it from the jobs I have had.
Sure, a healthy chunk of my 16.5-year case volume would fall under the “body” heading, but that is a big tent. I’ve written before about my sense that body imaging really has too much subject matter. It is as if body imaging gathered up all the radiology not covered by other fellowships, and then encroached a little bit on their turf for good measure. I guess it sounds better than saying you are subspecialized in “everything else.”
Even allowing for that, the four places where I worked have had me wearing vastly different hats. One employer had me doing the general stuff that didn’t fit anybody else’s niche. At another facility, I was the nucs and mammo guy. Almost as an afterthought, I was essentially put in charge of ultrasound too, probably less because of my body imaging credentials and more because my office was right next to the sonographer’s room.
My next employers didn’t so much tell me what they wanted me to do but created conditions in which reading certain kinds of imaging was more rewarding to me. Some exams were worth more per click, for instance, or generated greater political capital within the group.
In other words, the less frequently you have to say things like “No, I can’t/won’t do X,” the more doors open for you. A fellowship credential is nice and all, but I’ve found you get the best array of opportunities if you focus on what’s needed/wanted and adapt yourself to that. Like the man said, “Ask not what your rad group can do for you …”
Sometimes things dovetail nicely. That nucs/mammo/sono job put me in the position of suffering constant interruptions, so I got in the habit of cleaning up all their XR and other low-value stuff. It was easier to squeeze small cases in between other things than trying to get through a whole-body CT. As a result, I got particularly efficient at what I called “bite-sized” studies, priming me for a daytime teleradiology gig, years later, that hinged on being able to read high-volume XR and US.
Whenever I find myself in the position of talking about what aspects of rads I can do, I’m reminded of one of the attendings from my residency. A private -practice guy, he also recognized the value of never saying “no” to any particular type of imaging. He would quip: “I read everything.”
I can’t say he didn’t. He did well enough, at least, that his group’s leadership didn’t find fault with his performance to impose limits on his scope of practice. But even if he was a superstar genius at anything that got put in front of him, “I read everything” sounded flip to me, somehow cheapening his work.
I don’t think I’d be alone in that perception. Picture a rad applying for a job and the employer asking the applicant what roles he or she might fulfill there. Then the rad says simply, “I read everything.” Maybe the prospective employer has plenty of use for such a plug-n-play member of the team but I don’t see the interviewer being wowed by that exchange.
As impressive as it might be to consider that a rad has made it through years of practice without losing skills/confidence in any aspect of the field at all, the phrase “jack of all trades, master of none” leaps to mind. Perhaps a given interviewer would pursue the matter: “It is great that you read everything but what would you say you are particularly good at or interested in?”
At that point, if the rad doubles down on the “I read everything” sentiment, and doesn’t narrow the focus at all, it might set off alarm bells in the mind of the interviewer. Is this rad truly unaware of his or her own areas of strength or, more importantly, weakness? Is the rad churning out reads in the name of doing “everything” when there may be stuff he or she is not so good at, and is best left to others? Most rads subspecialize or beg off certain types of imaging. Is this rad an egomaniac who thinks he or she is better than all of them?
Even without asking twice, an interviewer hearing a flip “I read everything” or its equivalent might have such concerns. This is a lost opportunity for the applicant. Here was an engraved invitation to say something great, or at least something memorable, and the applicant verbally shrugged as if his or her work was nothing special. The applicant instead sounded as generic as possible.
Rattling through a laundry list (“Well, I read XR, US, CT, NM, MR, mammo, dexa, and do some light IR”) compromises rads. Yes, one may use more words with this approach, but it conveys the same unexciting idea. So how do you get the idea across that you’re versatile and can serve a group in multiple capacities?
Your mileage may vary, but here is a “sweet spot” I’ve found for myself. I reference how my decade of telerad has kept me comfortable with most types of imaging. Then I specify a couple areas of particular strength, and/or types of work that I find most satisfying. I especially emphasize stuff that I know my audience wants/needs from me or that other rads commonly eschew like PET, for instance, or arterial Doppler.
Plus, remember when I said I avoid saying I can’t/won’t do this or that? Well, that was not an absolute rule. I do include such “pertinent negatives” in my shpiel but just an item or two. It shows that I recognize my limits , and prevents others from leaving the conversation with erroneous ideas about what I might be able to do for them.
It’s never a flat negative statement, a la “I don’t do windows.” That can sound closed-minded and demanding. Instead, I mention it with an explanation, and leave the door slightly open if there’s a chance I could change my position.
One example might be as follows: “I avoid MSK MRI. I haven’t read much of that since training and it is best left to others who are more comfortable with it. I do read spines , of course.” Another example could be: “I don’t currently do mammo. Yes, I was the lead breast imager for my second job out of training, but my MQSA credentials lapsed when I moved to telerad. Of course, I could recertify if that is of interest.”