What Led Me (and Possibly You) to Specialize in Radiology

May 30, 2019

It’s not always talked about, but why do radiologists do what they do?

Around this time of year in the medical-academic world, everyone’s got their mind on transitions that will be occurring in June/July. Med students becoming interns, interns becoming residents, some residents becoming fellows, and other rezzies/fellows moving on to jobs in the “real world.”

I’ve come to know a few folks’ decision-making processes that led them into whatever specialty of medicine they ultimately chose. One would think that, being a radiologist, I would have rubbed elbows enough with other rads over the years to hear more “why I chose radiology” stories than any other. Bizarrely, I recall hearing few to none. I’ve got my own, of course, and it seems reasonable that at least a few other rads out there chose this field for the same reason(s) I did.

So, for students who are at a bit of a loss as to how/what to choose for themselves, or even housestaff who chose something else and are now reconsidering, allow me to offer my two cents as to what brought me into the rad-fold. Maybe some detail will be relevant to your interests.

I initially pursued medicine with near-certainty that I was going to be a psychiatrist. A couple of summer jobs in the field, and the first couple years of medschool, initially whittled and then hacked away at that interest until I was facing my clinical rotations with no real idea as to what sort of residency I wanted-aside from “not psych.”

Going through rotations, my list of “nots” steadily grew. No point in going into the specific whys and wherefores here, suffice to say nothing lit my world on fire. I found myself contemplating what I had come to consider the “odds and ends” of medicine: Rads (of course), pathology, anesthesia, etc.

Choosing my career by process of elimination didn’t seem to be a formula for enduring professional satisfaction. True, it culled the field of contenders by ruling out stuff I didn’t want, and it would be easier to wrap my mind around the issue of choosing from three specialties as opposed to 30. Nevertheless, I decided it would be best to have some other rationale-why a certain field appealed to me, rather than why it didn’t turn me off.

Related article: Memoirs of a Teleradiologist, Round One

The first strong reason for choosing rads that came to me was that, of all the options, it utilized the greatest amount of material that I was cramming into my noggin (and being tested on) during medschool. I didn’t relish the thought of learning all of this stuff just so I could proceed to only use a minority of it in my chosen specialty.

Radiology touched on just about everything. All the other specialties, sooner or later, interfaced with diagnostic imaging. By going into rads, I’d continue to deal with matters surgical, internal-medical, ob/gyn, peds, you name it. Not just dabbling in them, either; I’d need to be able to intelligently discuss detailed anatomy, physiology, pathology, etc. if I wanted to be of use as a diagnostic consultant for docs in all of these disparate areas.

Another, more pragmatic reason for choosing rads had to do with its viability as a career-choice. At the time (dating myself, here), the Internet was just beginning to hit its stride. It struck me that, probably before any other medical specialty, radiology would be able to leverage such tech. I expected that it would not be long before a radiologist would be able to read cases from anywhere in the world, no matter where he chose to live (or travel).

This, I reasoned, would render rads less susceptible to fluctuations in job markets. Do you live in NY but the supply/demand results in lousy local job-options? Work remotely for a group in Alaska! Or Nepal, for that matter. Presto: A few years later, teleradiology was a thing, and indeed has been my method of work since 2011. Yes, other areas of telemedicine have begun to emerge, but I don’t think anyone would dispute that radiology has made the most of this model.