Why I Chose Radiology

One night, months or years ago, my husband looked up from a collection of short stories he was reading, and said, “This one is interesting. The protagonist is a radiologist.”

To this, I laughed out loud. “Why would the protagonist be a radiologist?”

Judging by the lukewarm reactions I’ve received this year when I’ve told people that I was going into Radiology, I suppose most people feel the same way I did: that there is nothing interesting about a radiologist.

Don’t get me wrong, I absolutely adore Radiology and honestly feel that I’ve made the best possible career choice. But, given that my interest in Radiology did sneak up on me at the last minute after I’d already changed my mind half a dozen times between other specialties, perhaps I owe everyone an explanation.

In the beginning, as I’ve mentioned, my intention was to be a neurosurgeon. I never felt like it would give me the life I envisioned, but the work sounded challenging and heroic, and that was what brought me to medical school. I quickly realized that being away from my family for 120 hours a week was even less tolerable than I imagined. The neurosurgeons I met on my Surgery rotation, though very nice, made it clear to me that working one-third time (a normal 40-hour workweek) was not acceptable, even for a woman. In fact, I got the impression that having ovaries was entirely incongruent with Neurosurgery—people simply didn’t make time for babies and lives in that field. A Surgery resident gave me this valuable piece of advice: “Is there anything else that you like besides Surgery? Because you should do that instead.”

Then I thought for sure I would be a psychiatrist. I loved brains. Surgery was invasive, but Psychiatry was also invasive. Coming from a Psychology undergrad, analyzing people was second nature to me. The patients were interesting beyond belief, and I found plenty to write about, so I knew it would make an entertaining career. In particular, I felt at home with the idea of being a child psychiatrist—I had a knack for working with children, and I was inspired by their ability to heal and overcome. But I did not know just how difficult it would be. Halfway into my Child Psychiatry rotation, I was exhibiting symptoms of PTSD. I begrudgingly admitted that I did not have the mental resources to cope with the side effects of being a child psychiatrist.

Next on my list of “brainy specialties” was Neurology. I considered it only briefly. It wasn’t part of the curriculum, so I didn’t get a fair chance to explore it beyond my dealings with stroke and seizure patients. From what I gathered, the diagnostic aspect of Neurology was highly complex and elegant. But the treatment aspect was almost non-existent—for all the time spent figuring out exactly which part of the brain was damaged, there was usually nothing to be done about it.

From there, Pediatrics was a no-brainer (you guessed it—pun intended.) Cute sick kids, stuffed-animal stethoscope covers, doctors acting goofy in exchange for a peaceful listen to the heart and lungs. The idea of being happy all the time won me over almost instantly. Plus, this opened a new slew of possibilities for subspecialties: Pediatric Cardiology, Pediatric Endocrinology, Pediatric Whatever-ology. Since each of these would entail an additional three-year fellowship after residency, I was secretly buying myself more time to really decide what I wanted to be. (What? I like to dilly-dally over life-changing decisions!) It was a great plan, and I felt confident enough to start telling everybody about my decision. This was mid-January of my third year, and many of my classmates were jealous that I’d made up my mind so early. I went forward with it, collecting recommendation letters and setting up visiting internships, until August.

Because I kept telling myself that I loved children and hated adults, as pediatricians tend to do, I thought I was destined to hate my Internal Medicine rotation. As it turned out, I loved Internal Medicine because it was the first rotation in all of my medical training where I felt like I was personally and legitimately a doctor. Much of that feeling came from being introduced to the systematic approach to reading a chest X-ray. We were taught by a pulmonologist whose hobbies happened to include Radiology and Physics. He opened his first lecture with a discussion of radiographic density. I believe “density” was the word that changed my destiny—it activated my inner Physics geek and thereby illuminated what had previously been a black box.

Radiology is glossed over in medical school. This is a mistake, because Radiology is ubiquitous and crucial to the practice of medicine—rarely is a diagnosis made without some kind of imaging. I may not have considered radiologists to be real doctors at the time, but I wasn’t about to call myself a full-fledged doctor if I didn’t have a proper understanding of Radiology. So I scheduled two full months of it right in the beginning of my fourth year.

Those two months were tumultuous. I started out with a lukewarm feeling: The work was engaging to varying degrees depending on who was teaching me, and sitting in a dark room all day was marginally tolerable. I often felt like I was watching other people play a video game that I didn’t understand. That is, until one of the radiologists handed me a textbook to leaf through when times were slow. It was the best book I’d ever read in medical school, and I was raving about it to my husband when he asked for the millionth time if I was going into Radiology already. (My husband is himself a huge fan of Radiology.) I retorted that I did not come to medical school just to sit in an office and be nobody’s doctor. But as I became more and more intrigued by what I was learning, I found myself in a dilemma. I started to question my commitment to Pediatrics, and indeed my whole paradigm of doctoring.

It was at this time that I re-read some of my old blog posts to start compiling this book, and I came across a piece I’d written about how to choose a specialty, called “How To Make Lifelong Decisions: Don’t Compare Apples to Oranges. Just Make the Lemonade.” I had forgotten all about this, and it took me completely by surprise. Apparently, I had figured out at some point that choosing a specialty wasn’t about the nature of the work so much as about the kind of person I wanted to be—and I knew, undeniably, that radiologists were exactly the kind of people I wanted to emulate. Besides being the smartest of the smart, radiologists were sensible, sociable, happy, and generally wonderful to work with. And they all loved their families very much.

So then my gears were churning frantically. I only had a couple weeks left to submit my residency applications, and I had everything set up for Pediatrics. Radiology is a much more competitive specialty, and I frankly wasn’t sure if I would be able to get in, especially with such little preparation. I finally came to the Dean of Student Affairs, Dr. Dupey, whom I consider the “Sorting Hat” of my medical school and to whom I give full credit for ensuring that we all match into residency. She looked at my credentials and gave me the thumbs up! I still wasn’t 100% ready to burn the bridge on Pediatrics, so she challenged me to write a personal statement for both (which I’ve included in the following pages.) I found it extremely easy to say why I wanted to go into Pediatrics; that essay took me about an hour. The Radiology one took me an entire weekend. I thought really hard, I got frustrated that my writing was inadequate to express my feelings, and I cried a lot. But when I emerged from this process, I was convinced that, one way or another, I would be a radiologist.

Seven grueling months later, I opened an envelope that fulfilled all my hopes and made all the trials worthwhile: I am going to Dartmouth to become a radiologist!

21 thoughts on “Why I Chose Radiology

  1. Hello,

    An interesting story, indeed! You have mentioned that you included your personal statement in the next pages, but unfortunately I couldn’t find it. Can you please reply with a link of that page.

    Thank you

  2. Great post! I’m currently an MS3 in Canada and debating between Rads and Peds, just as you were! I am hoping some more experience and reflection will help me decide…

  3. Such an inspiring post! Thanks heaps for writing it! I’d love to become a radiologist as well. But I’m a medical student from overseas, though I do have US citizenship/passport as well as of course EU citizenship/passport (UK). Part of my family is also in USA. I wonder if you might have any advice for whether American radiology residencies would be open to someone like me? I gather I have to do brilliantly on USMLE. If you have any other advice, I’d be most grateful! Cheers, B 🙂

    • I think you’d be surprised. If you work hard and make sure that you are a good candidate in other respects, and most importantly are a likable person and easy to work with, many programs would be happy to consider you.

      • Loved your post!! So motivating! 🙂

        I’m also an IMG and was wondering what you did to make up for no Radiology exposure before applying into residency such as observerships/electives/research?
        Thank you! 🙂

      • Thanks! I didn’t really have time to make up for anything, since I decided to go into radiology 2 weeks before submitting the ERAS. I did make sure that I had two months of rotation and strong recommendation letters from the radiologists I worked with. Definitely no time for research in the field, but people were impressed enough with my undergrad research that they didn’t mind it wasn’t radiology-related.

  4. Thanks for sharing! I’m about to start my peds intern year, but fell in love with rads very late in the game. I am currently spending my time after graduation returning to my med school to “shadow” and ensure I am making the right decision, should I switch this year.
    It is a shame that we only skim the surface of such an amazing field during medical school. From what I’ve read, about 20% of radiologists switch from another field, and I think lack of exposure during clinical years plays a large role. I know that this switch may be a little difficult this late in the game, but no doubt worth it.

    • Good luck! I’d say it’s definitely worth it! But I’m a little biased.

      I really wish that medical students would get a decent exposure to radiology, if nothing else simply because it’s dangerous and embarrassing for clinicians to be prescribing radiation and contrast to their patients on a daily basis without a proper understanding of them.

  5. Thanks for sharing!! Just curious, what book was it that the radiologist lent to you? Also, do you have any introductory texts to radiology that aren’t too dense? Thank you!

    • Lucy Squire’s Fundamentals of Radiology. The fact that I loved it speaks more to my love of radiology than the merit of this old-school textbook. For a lighter intro, I would recommend the Oxford Handbook of Radiology by Lewis and McNulty. I read that during my internship year while waiting for radiology residency to start, and it gave a great overview of what we do and what clinicians should know (a lot more than they do.) Good luck!

  6. Wonderful post and I’m digging your handle/username! 🙂 I am debating between Rads and Psych. I’m more of an introvert so I’ve been inching towards rads, but how is the lifestyle different in rads? I will be a new mother starting residency and I was wondering with Rads are there ample PT positions? (jobs not residency). Congrats to you!!

    • Thanks!! If it’s a lifestyle choice, I think both are pretty good. Radiology is perhaps a little more conducive to part time simply because it’s shift work and you can always take fewer shifts. Residency will not be a great time no matter what, especially if you’re also a mom. But now that I’ve passed the CORE exam, matched into fellowship, and started 4th year of residency, I’m getting a glimpse of what my final life will be like, and I’m pretty happy. I show up for work 8-5, go home and cook/clean/hang out with my toddler and husband, have time for sleep and even hobbies. It’s like I’m finally a normal person after all these years in training.

  7. This blog is wonderful. Thank you for these excellent posts. I’m a third year student in a very similar situation beginning to assemble my radiology application. I have a question: How is it on the other side? Are you still glad that you’ve made this choice?

      • Hi Joe,
        I would totally choose radiology again! The only way I would say I feel “confined” is that I’m physically quite sedentary in my job, but I have plenty of time outside of work to make up for that. I don’t “miss” feeling like a real physician, because in many ways I feel more like a physician than ever before. Radiologists are involved in the care of more patients than any other specialty (this weekend, I took care of 100+ patients per night on call Friday and Saturday) and the work we do is pure clinical problem-solving all day long. Compared to other specialties, a far larger proportion of our hours are spent doing the thing that we bargained for. For example, as a Medicine intern, I spent maybe 2-3 hours a day actually talking to patients and thinking up treatments, and the other 9 hours were spent documenting, placing orders, and answering pages. I would say we as radiologists also have a better grasp of diagnostic tools and the role they play in patient management than most people, whereas many clinicians nowadays have an unfortunate tendency to order a lot of tests and lose sight of how this is actually supposed to help the patient. I do get to have meaningful interactions with patients too, but in small and powerful doses rather than drawn out over a long time. For me, this too has been a good thing, as I personally tend to get too empathetic and it was really intrusive to the rest of my life. I’m planning on writing a series of posts about my experiences is residency after I graduate this year, and I’ll go into a lot more detail about all these things.

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