Why Choose Radiology?

Am. College of Radiology-AMCLCThis post was contributed by Jacqueline Bello, MD, FACR, chair of the American College of Radiology Commission on Quality and Safety.

Friday, March 16 is “Match Day” – when the National Resident Matching Program (NRMP) releases results. This may be the most significant day of the year for approximately 40,000 medical students seeking residency positions in the United States.

Recently, a medical student debating between radiology and another specialty reached out to me with several questions.

Here is the abridged version of my responses:

Q – What is a typical day like as a radiologist? 

As a radiologist, every day counts – not only in terms of personal satisfaction, but also for the difference I make in the care of each patient whose scan I read, or procedure I perform.

I have the opportunity to discuss patients’ care with them, or with their primary doctors who come to me for help. In between reading scans, I often take phone calls asking what is the best imaging study for this condition, or can I explain the significance of the findings I reported?

Surgeons ask whether I agree that surgery is (or isn’t) necessary, and whether I think a tumor is likely to be benign or malignant. Medical specialists ask me to compare pre- and post-treatment scans for patients on experimental drug trials, to see whether they should continue or change treatment.

I used to also do a lot of neurointerventional procedures, ranging from “busting” clots in acute stroke, to coiling ruptured aneurysms, embolizing arterial venous malformations, draining abscesses and performing pain management procedures, all under image guidance.

Q – What factors did you take into consideration when deciding on a specialty? 

I tried to objectively judge my “happiness level” during various clinical activities. I tried NOT to assume that my professional experience would necessarily mirror that of a physician with whom I was impressed. Instead, I tried to imagine myself in that particular daily work experience.

I also “ruled out” certain specialties based on their limited focus. I enjoyed learning about the entire human body in medical school, so did I really want to deal with just eyes if I specialized in ophthalmology? (Not to underestimate their importance, especially for a radiologist!)

Q – What do you like, and dislike, about radiology?

What I like most is being the “go to” person in diagnosis, and being able to contribute to treatment. Hard to think of dislikes… my pager comes to mind.

Q – If I decide to pursue a residency in radiology, what do you recommend in terms of rotations, extracurricular activities and research? 

Places, like people, have personalities, and you will do best in training where you feel most comfortable, based on the people and the program’s style.  Consider joining an interest group in radiology (if your school has one), and become a student member of the ACR and RSNA.

Now a question for you – How would you respond to medical students interested in our specialty?

  • Why did you choose radiology or radiation oncology?
  • What do you like best – and least – about your job?
  • What recommendations do you have for rotations, extracurricular activities and research?

Please share your thoughts in the comments section below and join the discussion on Engage (login required).

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Wheels Are Turning for CT Colonography

Dr. YEE

Judy Yee, MD

 

This post was contributed by Judy Yee, MD, chair of the American College of Radiology Colon Cancer Committee.

March is National Colorectal Cancer (CRC) Awareness Month. And while CRC deaths are declining, shocking racial and ethnic disparities remain.

Latinos living in the United States are more likely to develop – and die from – this disease than those in many Central and South American countries. Black men and women are at least 41 percent more likely to die from CRC than whites. These populations are less likely to get screened, and as such, their cancers are often found at a later stage.

CT colonography (CTC), or virtual colonoscopy, has been shown to greatly increase screening rates. It is as accurate as standard colonoscopy in most people.  The virtual exam can also overcome cultural stigmas, increase screening and reduce unnecessary deaths.

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Cecelia Brewington, MD

The ACR is working with minority health care advocates, other medical societies and patient advocacy groups to make that happen.

Cecelia Brewington, MD, has written on the subject in the Huffington Post Black Voices Section. Jorge Soto, MD, is a strong advocate for CTC use in the Latino community. And the wheels are turning.

Thirty-six states now require that insurance policies sold in their state cover virtual colonoscopy (up from 24 a year ago).  The ACR and others worked hard to educate the US Preventive Services Task Force (USPSTF) on the merits of CTC. The USPSTF has since included CTC in their list of recognized CRC screening tests.

Soto_Jorge

Jorge Soto, MD

That triggered a provision in the Affordable Care Act, which requires insurers who take part in federal exchanges to cover the exam. CIGNA, UnitedHealthcare, Aetna, Anthem Blue Cross Blue Shield and a growing list of insurers cover these tests irrespective of ACA requirements.

We are currently working with other groups to gain Medicare coverage for CT colonography. Screening those on Medicare with virtual colonoscopy may cost nearly a third less than with standard colonoscopy, but the screening is not yet covered by Medicare.

Gains are being made, but we’re not there yet. Patients are steadily gaining access to this American Cancer Society-recommended (and less-invasive) screening option. We just have to keep moving forward.

I invite you to check out the ACR Colon Cancer Resources. You can use these to educate patients and referring providers on CT colonography.

For average risk patients – who just are not going to get a standard test – CTC is a great option that could save their lives.

  • Do you perform CT Colonography at your site?
  • If not, would you start doing it if screening CTC was covered by Medicare?

 Please share your thoughts in the comments section below and join the discussion on Engage (login required).