MD IM vs radiology: 2017 edition

[Anicetus]

Hi everyone,

Yes it's one of these and I have done my research to learn that some of the comparison threads for IM vs Radiology are outdated considering the changes coming along with Radiology. A couple things to mention.

I have made posts about considering surgery in the past on whim after being sleep deprived and they didn't go well. All in all, I am scratching surgery off my list.

Additionally, I had previously expressed boredom from IM during the clerkship but after talking to multiple deans and attendings, I just didn't enjoy being a third year in IM, but am intrigued by the job itself. More explanation below. Likewise I made judgements about radiology before actually seeing what the overall picture is about.

IM: pros:
- I have a knack for laying out all the pathology well and coming to a diagnosis and marking it as the diagnosis is what gives me satisfaction from what I have realized. (Did not get to claim this in third year since it was the attendings and residents calling the shots which bugged me).
- attendings and residents seem happy.
- it's nice to see results from my actions. (Did not get to have this in third year)
- I am not afraid to be social with my patients.
- shouldn't be considered a pro but I received one of the best grades in the class for this (honors, and only about 5-10% of students get the honors, which is mentioned on the transcript). This may help in terms of options for location since I won't be screened out necessarily from honor-snob residencies, which may continue to keep doors open for fellowship.
- I don't mine the busy work at all believe it or not. It's a nice break from having to think too much.
Cons:
- Lack of hands on procedures (which is something I went into medicine for in the first place.) ended up not feeling the lifestyle of surgery. I guess the only solution to this would be to pursue GI (my favorite experience of medical school so far).
- I have heard of lots of misery with the note writing. Didn't experience this as a student since I didn't have to write too many notes.
- if I decide to pursue fellowship, I will have to continue to work insanely hard for 3 more years to impress and face the possibility of moving my family away for 3 years.
- the call schedule may be rough and I am one who needs sleep.

Radiology:
Pros:
- sounds and looks like the sweetest gig. It fulfills my liking of calling the diagnosis. About 100x a day via films.
- no wear down of the patient interaction, not sure if this will be an issue or not but it seems to correlate with physician job satisfaction.
- very good hours and more shift work vs call. This lets me determine time for family or traveling/other hobbies since I don't intend to be one who dedicates their life to their job.
- I am a visual learner and person in general and ideally this fits the bill.

Cons:
- nowadays people are saying radiology is definitely not the same as it used to be. How it is not going to be the lifestyle career it once was due to changes in the system. This is a huge worry for me.
- IR doors will be closing over the years as a fellowship since it's not its own integrated program. I fear this will drop the number of diagnostic radiology spots.
- the job saturation remains a problem and I intend to live in a major metropolis. I've been a city lover all of my life and do not intend to live in rural or middle states. I fear I may be squeezed out by the current job market.
- once in a while I hear radiologists warn not to go into the field despite the amazing things heard which doesn't seem to match what older threads used to say about radiology.
- I have a slight fear that I may just be enamored by radiology since I have yet to do a rotation in it yet but see and hear great things about it.


Other things worth noting about me:
-money doesn't matter. I'm serious. If it did I wouldnt be in med school anymore.
- step 1 in 230's.
- low/mid tier US allopathic school
- no publications, but designed and presented my own research etc
-no AOA but top third of the class.

I couldn't be more torn or have wasted more time researching this topic. Any help is welcome.

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[motu]

Could you please explain some of your thoughts on the changes coming to radiology? In my opinion, as computer scientists improve their image processing algorithms for diagnostic problems, radiologists will be relied on much less. Furthermore, to some extent, is there a sentiment that radiology may not actually need a medical degree?

 

[Warderino92]

Could you please explain some of your thoughts on the changes coming to radiology? In my opinion, as computer scientists improve their image processing algorithms for diagnostic problems, radiologists will be relied on much less. Furthermore, to some extent, is there a sentiment that radiology may not actually need a medical degree?

The major problem with the computer doing the scans, even if it happens in the next 30 years is who takes the liability. Let's say the computer does 1000 reads a day. If it is 99.9% accurate (realistically the accuracy will be much lower) that is still 1/1000 scans it will get completely wrong. Will the company that makes the scans assume the liability for a missed diagnosis? If they cover many hospital systems, thats a whole lot of lawsuits waiting to happen. And I honestly believe that in jury trials machines will be far less sympathetic to the jury than a physician would be. This could mean hundreds of thousands of dollars to millions in malpractice potential every single day to the company. I honestly don't think any companies are willing to take on that risk in the end.

 

[colbgw02]

Could you please explain some of your thoughts on the changes coming to radiology? In my opinion, as computer scientists improve their image processing algorithms for diagnostic problems, radiologists will be relied on much less. Furthermore, to some extent, is there a sentiment that radiology may not actually need a medical degree?

lol

 

[DrfluffyMD]

Could you please explain some of your thoughts on the changes coming to radiology? In my opinion, as computer scientists improve their image processing algorithms for diagnostic problems, radiologists will be relied on much less. Furthermore, to some extent, is there a sentiment that radiology may not actually need a medical degree?

Radiologists serve as consultants to other physicians by integrating all aspects of clinical data, including imaging. Pretty difficult to evaluate a case and be a "doctor's doctor" without a medical degree.

With that being said, if OP is deadset on the coast you should go for medicine. Only primary care can for sure get you into NYC, SF bay or socal.

 

[Anicetus]

Radiologists serve as consultants to other physicians by integrating all aspects of clinical data, including imaging. Pretty difficult to evaluate a case and be a "doctor's doctor" without a medical degree.

With that being said, if OP is deadset on the coast you should go for medicine. Only primary care can for sure get you into NYC, SF bay or socal.

Not to totally convert this to a WAMC but I surely wouldn't mind, but do you say this due to my step 1 score?

 

[DrfluffyMD]

Not to totally convert this to a WAMC but I surely wouldn't mind, but do you say this due to my step 1 score?

The SUREFIRE way of getting a job at say, SF bay area as a radiologist, from my conversation with people out there, is to have trained in places like UCSF or Stanford. Not saying you cAn't if you didn't train in those places, but not as surefire.

Unfortunatey 230 isn't a great score for the best big city programs. If you absolutey MUST live in a very large metro area medicine is a far safer, far safer bet. Your score means decent IM programs on the coasts are still wide open for you.

I personally had to move to the midwest for the training I need myself, met someone out here and probably will settle down out here (grew up in socal).

Again the advice applies only if you think location is more important than specialty. I got that vibe.

 

[Anicetus]

The SUREFIRE way of getting a job at say, SF bay area as a radiologist, from my conversation with people out there, is to have trained in places like UCSF or Stanford. Not saying you cAn't if you didn't train in those places, but not as surefire.

Unfortunatey 230 isn't a great score for the best big city programs. If you absolutey MUST live in a very large metro area medicine is a far safer, far safer bet. Your score means decent IM programs on the coasts are still wide open for you.

I personally had to move to the midwest for the training I need myself, met someone out here and probably will settle down out here (grew up in socal).

Again the advice applies only if you think location is more important than specialty. I got that vibe.

You're right in that location is a huge priority to me but it doesn't have to be SoCal but I'd prefer a coastal town.