Recommended Books for Radiology Residents

[This updated/revised article was originally published way back on December 21, 2013]

There are lots and lots of radiology books out there.

Rather than list oodles of options, I’ve made a short editorial selection for each section. There are obviously many good books, but your book fund is probably not infinite and you need to start somewhere.

First-year residents, in addition to Brant and Helms Core Radiology, might start with these recommendations prior to buying any additional texts that they are unlikely to read at length during their first exposure to each section.

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Recommended reading for first-year radiology residents

[This updated/revised article was originally published way back on December 12, 2013]

Expectations for first radiology residents include a whole lot of reading. Tons and tons of reading. The follow-through on that expectation may be somewhat less impressive, but you’ll still do your best to pretend. Given the dizzying array of options, a curated list of book recommendations seemed like a good idea.

With your limited resources, as an R1 I recommend first buying the general books that will serve you well throughout the year (and beyond). If you still have more funds, you can figure out what to buy next based on your interests and needs (and this list) after you’ve read what you’ve got. At that point, your program’s library (and/or unofficial digital library) will be a good place to see what’s worth your money. You’ll be doing a lot of your reading for free online anyway.

Last Updated April 2022. Since I initially wrote this list, I’ve also added an additional post on Approaching the Radiology R1 Year.

General goodness

The quintessential Brant and Helms’ Fundamentals of Diagnostic Radiology was historically gifted by many programs. Find out if your program still does so before buying your own copy.

The huge single edition looks better on a bookshelf but is cumbersome. It’s too heavy to carry in a bag and honestly too heavy to sit in your lap. Get the 4-volume edition if you actually want to use it. I owned the single edition, and as a result, I only really used the online access. And, to be frank, while B&H may be the classic introductory text, it’s overrated and definitely not uniformly good throughout. Too much text with too few pictures, often overwhelming for the junior resident. If your program doesn’t use it, I probably wouldn’t bother.

Core Radiology: A Visual Approach to Diagnostic Imaging is the “new” monograph (first published in 2013, its title shamelessly taking advantage of CORE exam dread and a pattern subsequently used in many radiology books since). It’s a better introductory approach than B&H for new residents (or those at the beginning of board review). It was finally revised for a second edition in September 2021, so it’s fresh. Bullet points, shorter paragraphs, bigger font, more diagrams, and (an initially) single authorship with tailored content mean that this volume presents a coherent and more practical approach than the old standby.

Aunt Minnie’s Atlas and Imaging-Specific Diagnosis is a fantastic quick read. It’s organized by section with a collection of classic “Aunt Minnie” cases that you must learn because they’re common or classic fodder for conferences and the like. Each section is short so you can spend an evening or two reading it at the start of a rotation.

Top 3 Differentials in Radiology is another quick, excellent general book. While Brant and Helms may have been the quintessential introductory text, textbooks don’t necessarily serve as the best introduction to day-to-day work. Each page presents a single finding (e.g. solitary pulmonary nodule), the most likely diagnoses with brief descriptions, and a few pearls.

The text that concisely supplies the radiology facts (but not the images) was classically the Primer of Diagnostic Imaging (the “purple book” aka “First Aid” for radiology), which has lists, outlines, and diagrams galore. It was historically well-liked but has the potential to cause death by bullet point (personally not my cup of tea), and I’d argue Core Radiology now handles this task better overall. A slightly cheaper, question-and-answer formatted alternative is Radiology Secrets Plus. In my opinion, these two volumes are more of historical interest and can be safely skipped.

One step up in terms of detail from Top 3 Differentials is Clinical Imaging: An Atlas of Differential Diagnosis, which is organized by a pattern recognition approach. It’s a huge, atlas-like book, which you may or may not be that interested in reading.

So, in my opinion, Core Radiology, Aunt Minnie’s, and Top 3 Differentials are three things I would buy at the very beginning, as they’ll serve you well throughout the year.

Some people like to start with textbooks. Others prefer cases. I think there is something to be said for cases and classic findings, which give you a sense of familiarity with the subject prior to digging into a dry textbook chapter. For every rotation, you could go over your atlas to get a grip on the anatomy, then follow it with the relevant sections of Top 3 Differentials and Aunt Minnie’s, and the combination wouldn’t take more than a few days.

Most books focus on pathology and rarely provide a practical approach for how to review studies in real life (i.e. how to develop a search pattern). It’s something people slowly figure out on their own or try to derive from attendings. One adjunct some might find useful for approaching different exam types is Search Pattern.

Anatomy

You can use a variety of free online atlases and tutorials as early anatomy resources:  UVA’s  Introduction to Radiology, Radiology Masterclass’s CT Brain anatomy, the very cool RAAViewer software, HeadNeckBrainSpine (RIP), FreitasRad’s Musculoskeletal MRI, Stanford’s MSK MRI, CaseStacks, Learning Neuroradiology, etc etc.

Good dead tree atlases include Fleckenstein’s Anatomy in Diagnostic Imaging (on the pricey side) and Imaging Atlas of Human Anatomy (on the affordable side, and well worth it for someone who wants a paper atlas). Sectional Anatomy for Imaging Professionals is more of an anatomy textbook, with descriptions, diagrams, and selected cross-sectional images.

The most useful overall is IMAIOS’ e-Anatomy, which is an excellent website and app available as an annual subscription. If your program doesn’t buy you access, you should come together as a residency and request it. Radiopaedia has supplanted StatDX in a lot of use-cases, but e-Anatomy is pretty clutch (though still painfully detailed in some situations and yet wimpy in others).

Physics

Physics may be essential for the boards (and life), but understanding MRI physics is the subset most likely to help you both interpret studies, troubleshoot technical challenges, and understand pathophysiology. Learning MR physics early will help you make the most of your MR rotations (if your program relegates you to reading plain films for your first nine months, then nevermind). My favorite introduction is the Duke Review of MRI Principles, which is surprisingly affordable for a radiology book and a must-buy content-wise. It’s quick and case-based.

Another fantastic MR physics book for the non-physics crowd is MRI made easy (well almost), which is old but relevant, out of print, impossible to buy, and very easy to download online. For the rest of physics, the cheap book is Huda’s Review of Radiologic Physics (Bushberg’s costs more and says more than you probably want to know; I’m not sure anyone reads it anymore in the era of the Core exam). You don’t necessarily need either. The RSNA modules are fine content-wise, but the online flash design/format is truly horrible and painful to behold.

Sectional

What books you should supplement with on each rotation will depend both on what rotations you have during your first year and how much reading you actually get done. A more complete list can be found here, but here are a couple of guaranteed hits:

On chest, Felson’s Principles of Chest Roentgenology is what you need to read for plain films. For cross-sectional chest/body, Fundamentals of Body CT is a more portable and readable replacement for Brant and Helms.

Call-Readiness

A new resource (as of April 2020) that I think is super neat is CaseStacks, a new subscription service that puts a ton of high-yield bread and butter cases with actual DICOM images and a serviceable web-based PACS that lets you actually experience real scrollable pathology as you do in real life (and not just an image or two as in most question banks). Each case also has findings (often including ancillary findings, like real life) and a pretty solid sample report, which will help you see practical examples of how to put some words on the page. I would absolutely have done this as a first-year or early second-year before taking call. (If my program had a subscription, I’d probably try to knock out the relevant cases first thing during the rotations like neuro CT as well.) As per my usual affiliate MO, I reached out and was able to secure you 15% off with the code benwhite.

What should I read as an intern to prepare for radiology?

Nothing. You can go in blind and not look particularly stupid.

That said, you can often pick up old books for ridiculously cheap if you want to get a headstart. Most of it won’t stick without having the volume of daily reading and dictation to put it into context.

A more useful book to read as an intern (any intern for that matter) is Felson’s, which is the book for plain film chest interpretation. Everyone should know how to do this. As a bonus, you may get to see how full of it some of your senior residents and attendings are “who read all of their own films.” Save the big book-buying for when you have a book fund to burn through.

If you’re really interested, you can hammer home some anatomy and familiarize yourself with basic radiologic pathology online. The Radiology Assistant is a really nice concise resource for a wide variety of normal and pathology. Radiopaedia concisely explains a great number of topics and has become the true Wikipedia of radiology. You can also browse the web and watch online lectures. Most societies have oodles of resources and free membership for trainees.

Once you’re ready for further reading, here is my compilation of highest yield texts for residents broken down by section/modality.

External Medicine

I was on the External Medicine podcast for a wide-ranging conversation about medical education, training, blogging, and even nanofiction. It’s a really well-edited show run by two brothers (who also happen to be starting radiology residency in a few months).

Check it out here or on your favorite podcast app.

The COVID-related PSLF boon continues

You probably know by now that the pandemic student loan payment pause was officially extended through Aug 31, 2022. Given midterm elections in November, I suspect there will be one more round of good news announced this summer and payments won’t actually start until–for example–January 1.

So that 0% rate continues to save people lots of money, and those $0 payments still count toward loan forgiveness including PSLF. There is probably no group this helps more than attending physicians.

But for anyone with rising incomes and especially more recent attendings, the additional pause extension news is likely even better than you’d think. From the recent announcement:

You won’t be required to recertify before payments restart, and the earliest you could be required to recertify is March 2023.

You may still see a recertification date that is earlier than March 2023 on your account Aid Summary. We are working to get those updated, and we thank you for your patience. If your recertification date falls between now and March 2023, it will be pushed out by one year. For example, if your account says your recertification date is Dec. 1, 2022, that date will be pushed out to Dec. 1, 2023.

For many borrowers, the next recertification deadline will be pushed even further into the future, potentially way past the point when student loan payments start again. Even if payments begin in August (or January), a lot of doctors will enjoy months if not almost a year of payments based on their last recertification from years ago, which means that a relatively recent graduate may enjoy trainee-sized payments for that much longer, and some residents may enjoy $0 payments for a while even after repayment restarts.

So a lot of folks–especially a lot of attending physicians–will get to benefit from significantly suppressed payments after the $0 period ends, likely resulting in thousands of dollars of additional eventual PSLF savings.

The Cost of PCP Burnout

Continuity of care is valuable.

While the paper’s methodology requires some significant guesswork, “Health Care Expenditures Attributable to Primary Care Physician Overall and Burnout-Related Turnover: A Cross-sectional Analysis” by Sinsky et al attempts to estimate the cost of primary care physician (PCP) turnover.

They combined several data sources to estimate excess expenditures and then used a large survey to estimate the proportion of PCPs leaving due to burnout (by assuming that 25% of those who claimed they intended to quit in the next few years due to burnout actually did).

Their result?

Turnover of PCPs results in approximately $979 million in excess health care expenditures for public and private payers annually, with $260 million attributable to PCP burnout-related turnover.

What a waste.