how imp. is prestige?

[me4peds]

Considering Radiology is a pretty competitive residency to get into, how important is prestige of the program? Is it worth it just getting into any program and becoming a radiologist? If you had a choice of taking any program you get or taking a year off to find a better program, what is recommended? Taking into account average board scores and better than average transcript.

---

Members don't see this ad.

 

[k_soze]

If you want to be chair of radiology at Johns Hopkins one day, then prestige is important. If not, then don't worry about it. Go somewhere that you fit in. That said, don't just match anywhere that will accept you, 'cause you'll be more miserable than usual for 4 years.

 

[tigershark]

If you just want to go into private practice (like 90% of rads residents) it doesnt matter all that much as long as you go to a decent university program.

Even if you wanted to be the chair of some prestigous program it still doesnt matter all that much, academic radiology is wide open.

Sitting a year out is basically pissing away 500k to a million dollars, you tell me if the prestige is worth it.

 

[p53]

If you just want to go into private practice (like 90% of rads residents) it doesnt matter all that much as long as you go to a decent university program.

Even if you wanted to be the chair of some prestigous program it still doesnt matter all that much, academic radiology is wide open.

Sitting a year out is basically pissing away 500k to a million dollars, you tell me if the prestige is worth it.

500k to 1 million? Maybe 5 years ago, but not 5 years from now. Governmental cuts are effective in 2007. Don't get me wrong tiger, you are right most of the time but let's not mislead people thinking that radiologists will make anywhere near that much in the future.

 

[tigershark]

500k to 1 million? Maybe 5 years ago, but not 5 years from now. Governmental cuts are effective in 2007. Don't get me wrong tiger, you are right most of the time but let's not mislead people thinking that radiologists will make anywhere near that much in the future.

Radiology will always be a high-paying field as long as we keep rolling out new technology. Even if rads salaries went down by 1/2 or more we would still be some of the highest paid physicians. I did a rotation with a private practice group in Texas and the top partners were making over 5 mill, and new guys were starting out at 500K.....I'd say there's plenty of room for reimbursment to come down and for us to still live pretty comfortably.

Most of those guys thought the cuts would actually help the field in the long run by reducing the rampant self-referal thats going on now. In the short run it's going to hurt alot of these free-standing imaging centers that have gotten out of control lately. But guess what, 10 years down the road there will probably be a shortage of imaging access for people in rural/suburban areas and radiology will experience another boom.

 

[wannaberad]

Ya, I wound up at a mediocre program (interviewed poorly despite good credentials) and was considering switching to path where I'd have my pick. Probably won't, it's just too risky.

 

[cdql]

I did a rotation with a private practice group in Texas and the top partners were making over 5 mill, and new guys were starting out at 500K

Alrighty...flying out to Texas right now!!!

 

[hans19]

Sitting a year out is basically pissing away 500k to a million dollars, you tell me if the prestige is worth it.

Good one. Theres a saying among rads residents, its better to have matched a rads spot at Podunk Community Hospital than IM at MGH. I don't know if I'd go that far, but come on, its not like rads residency is law school. If you get a spot anywhere you are eligible to sit for the rads boards and become a board certified radiologist.

 

[wannaberad]

No, IM at MGH is better because then you can apply for a rads spot again...out of MGH! I doubt you'd match rads at MGH but you'd match at somewhere better than podunk.

Seriously, it kinda seems like a good residency can compensate for a mediocre med school but a good fellowship can't compensate for a mediocre residency. Or something.

 

[novacek88]

I did a rotation with a private practice group in Texas and the top partners were making over 5 mill, and new guys were starting out at 500K.....I'd say there's plenty of room for reimbursment to come down and for us to still live pretty comfortably.

This is the problem with SDN. Some poor pre-med will read this and go into Rads and be shocked when he never makes close to 500k let alone 5 million.

 

[phatfarm]

Seriously, it kinda seems like a good residency can compensate for a mediocre med school but a good fellowship can't compensate for a mediocre residency. Or something.

Not so sure about that last statement. I think a good fellowship will open different doors for you, especially if you want to practice in that region. Most fellowships seem to be wide open right now. A good number of people in rads fellowships are from community programs, which some may say are less competitive than academic programs.

So keep working hard if you aren't happy where you are now. Hopefully you'll wind up where you want to be, if not during residency, maybe during fellowship. I doubt people care where you went to med school once you are a resident. Once you are a fellow, certainly nobody will care where you went to med school. You are probably only as good as the last place you were.

 

[wannaberad]

One job, two applicants.

Applicant 1:
Residency: State U
Fellowship: MGH (hopkins, UCSF, duke, take yer pick)

Applicant 2:
Residency: MGH, etc.
Fellowship: State U

Assuming everything else equal, of course, who gets the spot?
But of course case 2 never happens (and case 1 isn't so common either.)

 

[f_w]

Assuming everything else equal, of course, who gets the spot?

The one who's references say:
- he is easy to get along with,
- shows up on time and leaves when the work is done
- gets the work done without whining

(and case 1 isn't so common either.)

Actually, at this time case 1 is pretty much the norm.

Case 2 probably rarely happens.

But you forgot case 3:
Residency: St. Holy Trinomination community memorial victory hospital
Fellowship: State U

When it comes to radiology jobs, only few practices care about 'prestige'. They care that the work gets done with good quality and that the person they hire doesn't create a disruption for the group.

 

[bigfrank]

If you just want to go into private practice (like 90% of rads residents) it doesnt matter all that much as long as you go to a decent university program.

Even if you wanted to be the chair of some prestigous program it still doesnt matter all that much, academic radiology is wide open.

Sitting a year out is basically pissing away 500k to a million dollars, you tell me if the prestige is worth it.

"Piss" poor advice.

 

[wannaberad]

Quite possible, bigfrank... What would you say the case is? How is the person above wrong, and what is the real truth?

 

[f_w]

How is the person above wrong,

#1 The time you can work as a radiologist is not limited by age (you are not loosing a year of 'eligibility' if you enter the workforce later).
#2 The 500-mil is before taxes and in relation to your lifetime income (if you can obtain a job paying at that level), it becomes a p### in the ocean.
#3 It is the same stupid argument people make to dissuade others from doing a fellowship.

and what is the real truth?

'Prestige' of a residency program indeed doesn't matter all that much unless you are interested in academics (real academics, I am not talking about the dime a dozen 'clinical assistant professor' gigs at 'stateU' that are 'wide open' at this time). If you think you can improve your shot at an academic career by doing some high-end research between medschool and residency, more power to you. If you think you are going to 'get paid back' in any monetary sense for this additional investment in time, you are probably wrong.

 

[bigfrank]

Thanks, f_w.

 

[wannaberad]

Thanks. Now, here's the thing. I actually did want to go into academics but wound up at a mediocre program. Not bad, just mediocre. Technically at a university but not doing any research. Do you think a research fellowship after residency would help, or should I just suck it up and go into practice? I suspect nobody is going to give me tenure because of the pedigree issue (or at least only in very rural areas).

 

[f_w]

You are going to get a tenure track position at a real academic program if you have shown the potential that you can do tenure worthy research and teaching. So, if you are at a mediocre university program, make sure that you position yourself for a fellowship at a top-notch institution. If you do neuro, consider doing a 2 year fellowship with a research year. If you do something else, talk to the places you interview at about the possibility of doing a research year. They might be willing to throw you a 1 year fellow, 1 year instructor deal. Also, document, document, document. Give grand-rounds presentations, teach the PA students, do anything you can stack in your CV as teaching activity.
If your program doesn't do any worthwhile research, resist the temptation to do tons of case reports and 'retrospective series' in 'imaging rag weekly'. Yes, it will lenghten your publication list, but if you are really looking for an academic career it tends to dilute your real achievements.

I assume you are either a first year or about to start in july. Consider setting up your own research program. Sometimes, there are opportunities to work with some of the basic science guys at your school without being dependent on the decrepit research infrastructure of your rads department. In the basic sciences, the saying goes that you can't achieve tenure until you have killed at least 1000 rats. The corollary for radiology is probably that killing 12 rats with a novel contrast agent or growing a cooler full of cell-cultures of stenosed arteries is going to get you further than reporting on 'our experience' in implanting the newthingy PICC in patients with borderline immunosuppression. Also, the moment you do anything basic science + radiology, people will shower you with 'young investigator' money.

If you have what it takes to be a real academician (I don't), please don't let your suboptimal match result dissuade you from that path. Rads is doomed if we don't have motivated researchers in our field. You are not going to make 500 to a mil per year (or like one of our dumb_#$ 3rd years on SDN trumpets around 'easily 5 mil'). But you will make a good living while doing something worthwhile.

 

[bigfrank]

You are going to get a tenure track position at a real academic program if you have shown the potential that you can do tenure worthy research and teaching. So, if you are at a mediocre university program, make sure that you position yourself for a fellowship at a top-notch institution. If you do neuro, consider doing a 2 year fellowship with a research year. If you do something else, talk to the places you interview at about the possibility of doing a research year. They might be willing to throw you a 1 year fellow, 1 year instructor deal. Also, document, document, document. Give grand-rounds presentations, teach the PA students, do anything you can stack in your CV as teaching activity.
If your program doesn't do any worthwhile research, resist the temptation to do tons of case reports and 'retrospective series' in 'imaging rag weekly'. Yes, it will lenghten your publication list, but if you are really looking for an academic career it tends to dilute your real achievements.

I assume you are either a first year or about to start in july. Consider setting up your own research program. Sometimes, there are opportunities to work with some of the basic science guys at your school without being dependent on the decrepit research infrastructure of your rads department. In the basic sciences, the saying goes that you can't achieve tenure until you have killed at least 1000 rats. The corollary for radiology is probably that killing 12 rats for a paper or growing a cooler full of cell-cultures is going to get you further than reporting on 'our experience' in implanting the newthingy PICC in patients with borderline immunosuppression. Also, the moment you do anything basic science + radiology, people will shower you with 'young investigator' money.

If you have what it takes to be a real academician (I don't), please don't let your suboptimal match result dissuade you from that path. Rads is doomed if we don't have motivated researchers in our field. You are not going to make 500 to a mil per year (or like one of our dumb_#$ 3rd years on SDN trumpets around 'easily 5 mil). But you will make a good living while doing something worthwhile.

Another awesome post. Thanks for your insight.

 

[durban]

I matched at a community program. The job offers and fellowships the guys from that program are getting indicate to me that prestige of your residency is more for one's ego gratification than anything else unless you're doing academics.

 

[f_w]

'Prestige' doesn't matter at all, getting a good training experience and access into interesting fellowships does.

 

[wannaberad]

Thanks for the advice, that's actually a really good idea I never thought of!

Interesting you mention teaching. I was under the impression universities tended to ignore teaching achievements. (You know the old joke, the guy's been executed..."I don't think we should have killed the man, he was a great teacher." "Oh, come on! How much has he published?")

Though if you had piled up useless achievements, couldn't you just leave them out of your CV? I never heard of anyone getting in trouble for *de*flating their resume.

I don't know if I have what it takes myself...but I guess there's only one way to find out, huh? And I guess I could always bail. But it seems like a pity.

 

[f_w]

Though if you had piled up useless achievements, couldn't you just leave them out of your CV? I never heard of anyone getting in trouble for *de*flating their resume.

Well, it shouldn't leave any 'blank' periods in your work and training history, but there are just so many people who will put some 'price' for 'the most beautiful hallway closet during undergrad' in on their CV.