How to be a First Year Radiology Resident

This is a brief companion post to my original post on approaching the radiology R1 year. This is what you need to do to succeed in radiology and life:

Be a decent human being and use common sense.

If that’s not enough to go on, here’s a longer list:

  • Be on time
  • Be excited
  • Be nice
  • Be dressed
  • Take responsibility
  • Do what you’re told
  • Read cases, not just books. Be hungry.
  • But…um, also read books, not just cases. Practical knowledge is often different from book knowledge, but you’ll eventually need both to succeed
  • Be knowledgeable. If you can’t know radiology, then Know the Patients. Know the Histories. Know the Priors.
  • Again, always look at the priors and read the prior reports. Prior reports will teach you more than your attendings will face to face.
  • Proofread. Please, please, please. A report is a radiologist’s will manifested. Who do you want to be?
  • Anatomy is the foundation on which all else is built.
  • Develop a search pattern.

Real expectations for a first-year resident in July: are you ready?

In addition to the important life skills I outlined above, I want to stress that really no one expects you to actually understand radiology at this point, but you are expected to learn fast. What you can do—even on day one, even if you don’t actually know anything—is learn the details of the exams: especially patient history and priors. Look at this before you read out because this is literally your one chance to save your attending time and effort. A junior resident is graded more on attitude and attention to detail than on fund of knowledge.

Anyone who cares about what they’re doing can craft reports (almost) free of transcription errors, template mistakes, missing comparisons.

It’s not uncommon to hear from your chairman or program director during orientation that they want you to have a life and be well-rounded. Like, they’re not asking you to do anything crazy, just an hour or two of reading per night. If you were worried that a deep belly laugh might escape to your great embarrassment, then you are not alone. In an ideal world, you would read every night from textbooks and articles and then rapidly move onto writing your own and contributing to the great growing body of truly meaningful radiology research.

Well, sometimes life happens.

While I like knowing things and doing my job well, I wouldn’t have exactly described myself as a radiologist residency completionist. I didn’t necessarily read as much as some people suggested was prudent, and I’ve certainly never enjoyed and found meaning in trying to memorize long differentials for all the things that can occur in a given area when A) those differentials often include things that are radically different either clinically or by appearance and thus would never be confused and B) I have the ability to, you know, access the internet when I’m stumped by an unusual finding.

Keep in mind, this little list was generated from my own experience (in hindsight) and ruminations. The intrinsic variability across programs and training means that parts of my perspective may not or should not apply to you.

But I suspect if you do all of the above to start each of your rotations you’ll be on the right foot.

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