“If you can tolerate breast, do breast”

[odyssey2]

I hear this received wisdom all the time in my rads residency, how true do you think this is? Is the lifestyle/stress that much better in breast than other subspecialties? How achievable is a similar
lifestyle with other fellowships?

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[brownman23]

I haven't heard that in my residency. I've been told to do fellowship in the field you enjoy the most or want to improve in the most.

Breast lifestyle is nice, but it's not like the rest of DRs are working surgery-like hours.

 

[Clean7795]

Literally never heard of this.

 

[CorneliaSt]

Depending on the practice. Breast can be quite chill. Or it can be very chaotic and stressful.

 

[risus_sardonicus]

No one has ever said this. Breast day to day is boring af and they stress over lawsuits and their “positive” rates like no tmrw

 

[Cognovi]

Never heard of this. Only thing close I've heard is if you can tolerate not doing surgery, don't do surgery.

 

[Dr. USMLE]

Yes I have heard this. The trouble is most people in radiology cannot tolerate it, especially not 100% or close. Breast imagers may argue that's a good thing, since the limited supply allows them to negotiate great terms, like no call, no weekends, etc. Hence the "mammodonna"

 

[odyssey2]

Yes I have heard this. The trouble is most people in radiology cannot tolerate it, especially not 100% or close. Breast imagers may argue that's a good thing, since the limited supply allows them to negotiate great terms, like no call, no weekends, etc. Hence the "mammodonna"

Is it the screeners and monotonous diagnostic work they can’t stomach, or the patient-facing care?

 

[guytakingboards]

Is it the screeners and monotonous diagnostic work they can’t stomach, or the patient-facing care?

Can't speak for everyone but I did not enjoy the dynamic nature of the mammo workflow. Felt like being constantly interrupted to review call backs, diags, jump over to biopsies, give results, talk to clinicians, etc...

Some people thrive on that. Feel like most in radiology probably don't. I don't mind a few interruptions a day for fluoro and minor procedures but having a full day workflow specifically set up for constant interruptions would be really frustrating and draining (for me).

 

[MadRadLad]

Personally I didn't mind the dynamic element, made the day go by fast and kept things interesting. Although I agree that the interruptions were kind of annoying.

My biggest problem with mammo was how boring it was. There's no variety at all and screeners are mind numbing, but too high risk to truly go on autopilot (although experiences mamms readers probably find it easier).

 

[GoPelicans]

I've just started job hunting. The first thing everybody asks is how much mammo I want to do. I really want to just be honest and say zero

 

[Hospitalized]

I've just started job hunting. The first thing everybody asks is how much mammo I want to do. I really want to just be honest and say zero

What fellowship did you do?

 

[qwerty89]

I've just started job hunting. The first thing everybody asks is how much mammo I want to do. I really want to just be honest and say zero

In this market you should be honest. If you say you are willing to do it you will likely be given way more than what you want.

 

[GoPelicans]

What fellowship did you do?

Msk

 

[vm26]

Is it the screeners and monotonous diagnostic work they can’t stomach, or the patient-facing care?

It's likely a combo of factors. My residency training in breast was subpar and I was able to do about 10 weeks of this during fellowship which was very useful. My 1st couple of PP jobs required working at the breast center and overall it was a good experience and nice change of pace but would have been pretty stressful without the fellowship training...Also you are extremely dependent on the quality/attitude of your techs which can make/break things. Finally, the whole topic of breast cancer/imaging etc is loaded. Financially its a cash-cow for PP/hospital systems due to current reimbursement trends, and thus its protected as sacred ground and go nuts in October with pink decor etc. A lot of hospital systems/breast surgeons are demanding fellowship trained breast imagers to do the bulk of the work. In my current group, I now only do screeners a few days per month which is fine as its a nice way to bump up my RVUs, and the section is pretty toxic for the reason mentioned above.

 

[radsresident-US]

I have heard this as well. The reason is simple, right now with the radiology job market Breast imagers are in greatest shortage, and thus can negotiate the best terms. I know some that are full partner but don't take call and sometimes even do breast exclusively. That would be unheard of for any other specialty. If you do employee track somewhere you can definitely negotiate very high salary for reasonable volume but would probably require onsite or at least hybrid given the breast workflow. Telemammo exists but usually not as full time.

In any case, bottom line is that the lifestyle and comp is better for breast than other specialties, so if you can tolerate the actual work, you should do it. I actually think the advice is true. Problem is, I can't tolerate it and most rads I know can't either, so that's that. I'd rather just take the call.

 

[Tiger100]

I have heard this as well. The reason is simple, right now with the radiology job market Breast imagers are in greatest shortage, and thus can negotiate the best terms. I know some that are full partner but don't take call and sometimes even do breast exclusively. That would be unheard of for any other specialty. If you do employee track somewhere you can definitely negotiate very high salary for reasonable volume but would probably require onsite or at least hybrid given the breast workflow. Telemammo exists but usually not as full time.

In any case, bottom line is that the lifestyle and comp is better for breast than other specialties, so if you can tolerate the actual work, you should do it. I actually think the advice is true. Problem is, I can't tolerate it and most rads I know can't either, so that's that. I'd rather just take the call.

I disagree with this part.

I know at least 10 private practice groups. There is not even one case that a breast imager gets full partner's salary and doesn't take call.

Also many groups are doing a hybrid tele and onsite work and breast imagers have the most number of days working onsite. Just saying.

 

[theonlytycrane]

do you need a breast fellowship or special certifications to read mammo/do procedures in PP?

 

[guytakingboards]

do you need a breast fellowship or special certifications to read mammo/do procedures in PP?

Nope. Just MQSA like everyone else. Everyone coming out of residency can read mammo.

 

[Melkor]

Breast is awesome. You can make it super chill or be type a and stress about every little thing. It's completely up to you. Some say its boring but I'll take boring and chill over "exciting" and stressful like other subspecs. For what it's worth, I wanted to be a factory worker or UPS driver as a kid but realized they didn't pay. I also don't stress about the little stuff. ymmv. Couldn't be happier with breast fellowship training.

 

[yungspleen]

Breast is awesome. You can make it super chill or be type a and stress about every little thing. It's completely up to you. Some say its boring but I'll take boring and chill over "exciting" and stressful like other subspecs. For what it's worth, I wanted to be a factory worker or UPS driver as a kid but realized they didn't pay. I also don't stress about the little stuff. ymmv. Couldn't be happier with breast fellowship training.

This describes my personality but my worry is if you don't stress about little stuff in breast you'll get sued

 

[SeisK]

This describes my personality but my worry is if you don't stress about little stuff in breast you'll get sued

If you’re reading nothing but mammos, breast US, and breast MRI, you will get so into the swing of things you’ll relax into a habit of doing a good job and not stressing out.

It’s the guys who read the minimum to remain certified, sporadically, that do the stressing.