Derm vs rads?

[finalpsychyear]

Exactly.
In most radiology private practices, out of Thanksgiving, Christmas and New Year, you have to work at least one of them. This is not the case for many other fields.

During my career, I have missed a good number of family gathering and special occasions due to the vacation structure of radiology.

I am not saying radiology is good or bad. But when you hear about 10 weeks of vacation, take into account that the devil is in the details.

Also let's point out "downtime". In your 8 hour work day how much downtime is there in rads ? On some of my remote work days I've managed to go grocery shopping, gym, lunch, to the point it didn't feel like a real work day as 5pm rolled around I had done all these things and could simply go to a happy hour/dinner out...felt odd.

---

Members don't see this ad.

 

[GadRads]

Also let's point out "downtime". In your 8 hour work day how much downtime is there in rads ? On some of my remote work days I've managed to go grocery shopping, gym, lunch, to the point it didn't feel like a real work day as 5pm rolled around I had done all these things and could simply go to a happy hour/dinner out...felt odd.

Not a lot of downtime in rads. 30 mins typically or 1 hr at most?

 

[qwerty89]

Yes. In most practices you have to take vacations in a week block.

To make things worse, I am telling you that in most practices you have to decide on your vacation schedule many months in advance. For example, in October they decide on vacation schedule of January through June.

Also to make things even worse, you probably can choose only half of those vacation weeks. Then you have to pick the leftovers. In most practices, only certain number of radiologists can be off at any time.

And to make things worse, if there are only 3 IRs or 3 mammographers in a practice, probably only one of them can take the week off.


In my opinion, having 4 weeks of vacation with the option to choose them whenever you want and with the option of taking single days off is ten times better than 8-9 weeks of vacation in a way that is designed in traditional radiology practice practice.

Yeah one of the things I love about my practice is that the base 8 weeks vacation is 2 weeks per quarter. 1 week must be taken as a full week and the other can be taken as a 5 individual days. Then you add in a flex week if you don't care about having the entire week of new years or Christmas off. Additional random days off a quarter. 1-4 days typically. Then 6 major holidays. You can work 4 day work weeks essentially half the year with 4 additional full weeks off if you want. Vacation requests are taken just a few weeks before the start of the next quarter. Residents should know that many practices will not only force you to take your vacation in 1 or even 2 week increments, but often make the entire years schedule at once.

 

[qwerty89]

When comparing jobs, I find it more useful to conceptualize time off in terms of total shifts, rather than vacation time, etc.. Obviously, this works better the more alike the jobs are otherwise, and clearly some people would rather work 12 hours a day in a derm clinic than 6 hours in front of a PACS workstation. Still, I think it helps.

Let's just say that there's a private practice radiology job in which partners get 10 weeks of vacation and work every fifth weekend. Then there's a dermatology job with 4 weeks of vacation. On the face of it, the radiology job seems like it's the way better deal vis-a-vis time off, but let's dig a little deeper.

The dermatology job is much more likely to have a 4-day (Monday-Thursday) work week. Let's further stipulate that the derm job requires no nights, weekends, or holidays, whereas the radiology position requires everyone to rotate through holiday shifts, averaging 1.2 holidays worked per annum.

That works out to 232 shifts per year for the radiologist, while the dermatologist is working 186 shifts. If the dermatologist has a 5-day work week, then it's virtually identical (232 vs. 234).

Yes. A Rads job with 8 weeks vacation and Q5 weekends is actually less overall time off than working at the VA (26 days vacation + "sick" days which I didn't even take into account). 8 weeks vacation with Q5 weekends is essentially the same time off as a 4 week vacation job + 0 weekends. Unless you really travel a lot its actually worse since the volume on weekends can be easily >2x that of a normal day.

 

[Tiger100]

Yes. A Rads job with 8 weeks vacation and Q5 weekends is actually less overall time off than working at the VA (26 days vacation + "sick" days which I didn't even take into account). 8 weeks vacation with Q5 weekends is essentially the same time off as a 4 week vacation job + 0 weekends. Unless you really travel a lot its actually worse since the volume on weekends can be easily >2x that of a normal day.

Good point.

Having a lot of vacation like 10-12 weeks is a very good fit only for single people or people who have non-working spouses and no kids. They can travel 10 times a year. But for most other people esp if they have kids, it is a total waste. They can practically use 4-5 weeks at most.

 

[GadRads]

Good point.

Having a lot of vacation like 10-12 weeks is a very good fit only for single people or people who have non-working spouses and no kids. They can travel 10 times a year. But for most other people esp if they have kids, it is a total waste. They can practically use 4-5 weeks at most.

I wouldn’t call it a waste. The extra time-off is still useful to take care of errands, hang with the kids, do things not radiology-related, sleep more, etc.

 

[finalpsychyear]

Yes. A Rads job with 8 weeks vacation and Q5 weekends is actually less overall time off than working at the VA (26 days vacation + "sick" days which I didn't even take into account). 8 weeks vacation with Q5 weekends is essentially the same time off as a 4 week vacation job + 0 weekends. Unless you really travel a lot its actually worse since the volume on weekends can be easily >2x that of a normal day.

Anesthesia and rads always have 8-12 wks vaca in most cases. Is it fair that both also have q5-6 wknd call as the average? If so then the lower end of 8 wks is very misleading at first glance as its pretty much 4 wks of "real" vaca.

 

[qwerty89]

At least one of the three giant groups in the DFW area has 8 weeks vacation for partners.

 

[Tiger100]

I wouldn’t call it a waste. The extra time-off is still useful to take care of errands, hang with the kids, do things not radiology-related, sleep more, etc.

Having half a day off during the week is worth 10 times more than random vacations here and there.

This has been my experience:
If you have some important task to do, it barely falls on your vacation weeks.
If there is a family gathering, it happens exactly on the weekend that you are on call.

Just saying that 10-12 weeks of vacation is not as great as it looks on paper.

 

[qxrt]

I was previously in a practice where I got ~12 weeks off per year. I am now in a practice where I "only" get 8 weeks of vacation, but I get a half day off per week. As a result I have personal experience with both.

Both are nice in their own ways. I traveled quite a bit when I had 12 weeks of vacation, but it was tough running errands on regular workweeks.

Now, having the half day off per week is super helpful for running errands for things that can only happen during banker's hours (e.g. literally going to the bank or having to drop by a government office that's only open 8-5 on weekdays). If the schedule prevents me from taking my regular half day off, I can combine it with another week to get a full weekday off. It's pretty flexible.

Like Tiger said, more vacation is nice when you are single and can travel easily, while half day off per week is really nice for taking care of regular life stuff. I think I would be happy with either, though. Having 12 weeks of vacation is still really nice.

 

[sirspamalot]

Working 3.5/5 with 5/5 pay... FTW.

 

[lacrossegirl420]

Are the lawsuits a huge problem with radiology? That’s by far my biggest concern with this field right now, and could potentially be a deciding factor for me against pursuing it. Besides this, I really like radiology and am strongly considering it.

But it makes me question myself when everyone says “do derm/ophtho/[insert chill specialty] if you’re competitive for those” (I don’t dislike them, but don’t find them nearly as interesting as rads), because they say in 30 years the “actual interest” in the subject doesn’t matter any more when everything becomes routine. I can see the appeal of those though since they have almost no lawsuits

 

[sirspamalot]

lifestyle*10 + dollars*8 + interest*2 = net future value

 

[bigt1mer]

I don’t know how our program compares nationally, but our ER night shifts are 12 hours and we read on average 45-50 CTs/CTAs a night with about 90-100 plain films/US on top. Most I had was 240 total studies, 80 cross sectional. Every year our volume grows by ~10% so I’m not sure how newer classes will survive since residents are in charge of clearing the list. Roughly 2/3 trauma/ED and 1/3 inpatient. The inpatient complexity was pretty tough but trauma weren’t bad unless they were just a train wreck.

I'm just an R1 but I always see numbers like this online and don't get it. So in a 12 hour shift (720 minutes) as a resident you have read 80 CTs and 160 US/plain films?? Disregarding the 160 US/plain films, 80 CTs in 12 hours is 9 minutes/CT for the entirety of the shift giving complete reports. Adding in the US/plain films thats an average of 3 mins/study for an entire 12 hour shift with 0 breaks. That doesn't include talking to the trauma team, answering protocol questions from techs, fielding pages from the clinical team, viewing priors, looking at clinical info. I'm at a hybrid program that covers the entire health system on call with nighthawks working beside you and I see our attendings are not even working at close to that speed. We have our fair share of negative exams but we get a ton of trainwrecks. I just don't see myself ever being that fast as a resident.

 

[Womb Raider]

I'm just an R1 but I always see numbers like this online and don't get it. So in a 12 hour shift (720 minutes) as a resident you have read 80 CTs and 160 US/plain films?? Disregarding the 160 US/plain films, 80 CTs in 12 hours is 9 minutes/CT for the entirety of the shift giving complete reports. Adding in the US/plain films thats an average of 3 mins/study for an entire 12 hour shift with 0 breaks. That doesn't include talking to the trauma team, answering protocol questions from techs, fielding pages from the clinical team, viewing priors, looking at clinical info. I'm at a hybrid program that covers the entire health system on call with nighthawks working beside you and I see our attendings are not even working at close to that speed. We have our fair share of negative exams but we get a ton of trainwrecks. I just don't see myself ever being that fast as a resident.

It’s sink or swim, you really don’t have a choice. You cut corners In the ER. You learn where to look to avoid missing a life threatening “can’t miss” problem. You ignore the simple cysts. The complex metastatic work ups are usually saved for the following day, unless god forbid there’s something legimiterely acute in which case we read them. Either way, the night attendings are just as pressured and their “quality standards” of reports also decreases proportionately with case burden - there’s just no other way without hiring more help. It is what it is. From what I’ve heard it’s great for private practice training but it’s by far the hardest I’ve ever worked in my life - I can’t say I’ve ever worked 12 hours straight at max speed like that in my life outside of radiology.

 

[90sportsfan]

Are the lawsuits a huge problem with radiology? That’s by far my biggest concern with this field right now, and could potentially be a deciding factor for me against pursuing it. Besides this, I really like radiology and am strongly considering it.

But it makes me question myself when everyone says “do derm/ophtho/[insert chill specialty] if you’re competitive for those” (I don’t dislike them, but don’t find them nearly as interesting as rads), because they say in 30 years the “actual interest” in the subject doesn’t matter any more when everything becomes routine. I can see the appeal of those though since they have almost no lawsuits

Nobody really answers or discusses this question about lawsuits on this board. The limited data shows that Rads is in the higher tier of specialties for malpractice risk. I’m guessing it’s the high volume and complexity is a contributor. I ultimately chose a different specialty, not solely because of this, but malpractice risk in Radiology was definitely a consideration.

To tie this back to the thread, Derm is one of the lowest risk specialties.

I don’t think this should be the main reason for choosing a specialty, but it’s human nature that this will a part of the consideration.

 

[Skindoc83]

Nobody really answers or discusses this question about lawsuits on this board. The limited data shows that Rads is in the higher tier of specialties for malpractice risk. I’m guessing it’s the high volume and complexity is a contributor. I ultimately chose a different specialty, not solely because of this, but malpractice risk in Radiology was definitely a consideration.

To tie this back to the thread, Derm is one of the lowest risk specialties.

I don’t think this should be the main reason for choosing a specialty, but it’s human nature that this will a part of the consideration.

if you see enough patients, or in the case of rads read enough cases, and practice long enough you will get sued or have a medical complaint made against you. It’s almost inevitable. That is not to say that you will be found at fault, but our system makes it way too easy to file frivolous complaints or lawsuits. Look at California where you now need to provide all patients in your waiting room with a QR code that they can scan to file a board complaint. I think what makes radiology especially tough is that the images are permanent so someone can always re-review them to identify something that was missed. Don’t pick a field based upon litigiousness and don’t destroy yourself when inevitably someone lodges a BS complaint or lawsuit.

 

[Tiger100]

Nobody really answers or discusses this question about lawsuits on this board. The limited data shows that Rads is in the higher tier of specialties for malpractice risk. I’m guessing it’s the high volume and complexity is a contributor. I ultimately chose a different specialty, not solely because of this, but malpractice risk in Radiology was definitely a consideration.

To tie this back to the thread, Derm is one of the lowest risk specialties.

I don’t think this should be the main reason for choosing a specialty, but it’s human nature that this will a part of the consideration.

The solution is not to choose a different specialty.

The solution is to grow a thick skin.

 

[GoPelicans]

I'm just an R1 but I always see numbers like this online and don't get it. So in a 12 hour shift (720 minutes) as a resident you have read 80 CTs and 160 US/plain films?? Disregarding the 160 US/plain films, 80 CTs in 12 hours is 9 minutes/CT for the entirety of the shift giving complete reports. Adding in the US/plain films thats an average of 3 mins/study for an entire 12 hour shift with 0 breaks. That doesn't include talking to the trauma team, answering protocol questions from techs, fielding pages from the clinical team, viewing priors, looking at clinical info. I'm at a hybrid program that covers the entire health system on call with nighthawks working beside you and I see our attendings are not even working at close to that speed. We have our fair share of negative exams but we get a ton of trainwrecks. I just don't see myself ever being that fast as a resident.

A lot of radiologists inflate their numbers online imo. Maybe they are trying to compensate for coming up short elsewhere? 🤏

 

[Womb Raider]

A lot of radiologists inflate their numbers online imo. Maybe they are trying to compensate for coming up short elsewhere? 🤏

As I said, that was my max. Most days aren’t that bad. Not inflated. Have many coresidents that read more on their max.