Radiology residency programs that prepare for the real world?

[GridCritter]

Current MS4 applying into diagnostic radiology trying to decide where to apply. My main goal during residency is to become the best clinical radiologist I can. I am not yet decided between private vs academics but will probably go private practice. I like research but don't want to go to a program that sacrifices clinical training at the expense of research.

I have heard whispers of some big-name programs that one would expect to be some of the best in the country that simply don't have the volume or focus so much on research that residents often graduate undertrained.

Obviously name brand plays a role in securing a solid fellowship but rankings out there are terribly biased and subjective. So for this, forget about rankings/name brand/etc. I just want to know which programs actually generate the best radiologists.

So my question is: What are your thoughts on the strongest clinical training programs in the country?

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[Gadofosveset]

Any list of program names is going to be flawed.

To be a good clinical radiologist you need
- Good teachers
- Normal amount of volume during the day, with good range of types of studies
- Independent call

The most important X factor is… you’ve got to want to be a good clinical radiologist even if given easy ways out during training. You’re the athlete and the program is the gym. Some flabby athletes have come out of fancy gyms, but some good athletes have also come out of fancy gyms. The program provides the opportunity, but you make yourself.

 

[maxxor]

Any list of program names is going to be flawed.

To be a good clinical radiologist you need
- Good teachers
- Normal amount of volume during the day, with good range of types of studies
- Independent call

The most important X factor is… you’ve got to want to be a good clinical radiologist even if given easy ways out during training. You’re the athlete and the program is the gym. Some flabby athletes have come out of fancy gyms, but some good athletes have also come out of fancy gyms. The program provides the opportunity, but you make yourself.

To add to this, beware programs that overdo call. I know of one program where residents do 3 months of call a year. That’s too much and prevents you from getting much if any subspecialty training.

The residents are great at covering an ER. Not so great at basic msk mri or Nucs or abdominal mr or…

 

[guytakingboards]

Your question is obviously reasonable, but I'd emphasize the fact that the radiologist you are on residency graduation day is only one point in time.

What you do to better yourself afterwards (fellowship and early career) plays as much if not more of a role in the quality of clinical radiologist you will be.

 

[MadRadLad]

Any list of program names is going to be flawed.

To be a good clinical radiologist you need
- Good teachers
- Normal amount of volume during the day, with good range of types of studies
- Independent call

The most important X factor is… you’ve got to want to be a good clinical radiologist even if given easy ways out during training. You’re the athlete and the program is the gym. Some flabby athletes have come out of fancy gyms, but some good athletes have also come out of fancy gyms. The program provides the opportunity, but you make yourself.

Many programs no longer have independent call. I think saying you "need" it is going to cross out a lot of good programs. That said, the overall point is valid and you need some sort of a setup where you can make some degree of high stakes decisions, speak to consulting docs on urgent/emergent matters, etc with relatively minimal oversight so you progress in your skills and confidence.

Agree 100%. You gotta want it. Great rads come out of poor programs all the time, and the top programs have more than their fair share of questionable products. At this stage in your career it's largely self driven.

 

[guytakingboards]

Any list of program names is going to be flawed.

To be a good clinical radiologist you need
- Good teachers
- Normal amount of volume during the day, with good range of types of studies
- Independent call

The most important X factor is… you’ve got to want to be a good clinical radiologist even if given easy ways out during training. You’re the athlete and the program is the gym. Some flabby athletes have come out of fancy gyms, but some good athletes have also come out of fancy gyms. The program provides the opportunity, but you make yourself.

To further use this analogy, if you want the most reps at the gym, you should be looking at doing a resident-driven residency and fellow-driven fellowship.

It’s a tough path bearing the weight of the list for all of training but it definitely prepares you for the real world.

 

[Cognovi]

Continuing the gym analogy,

for bulk, you want to do lower reps at higher weight
for tone, you want to do higher reps at lower weight
don't forget cardio
and
don't skip leg day

 

[GoPelicans]

I would say a place that doesn't have a lot of fellows, you are forced to get out of your comfort zone more often.

 

[MadRadLad]

I would say a place that doesn't have a lot of fellows, you are forced to get out of your comfort zone more often.

Very understated. Best of both worlds is an academic center with minimal fellow presence - good case mix and high end studies, but residents get the majority of the cases. At some of the very big names there are like 10 fellows a year, and even if volume is great the fellows are going to steal a lot of the more interesting cases and rarer studies.

 

[irwarrior]

Even worse for procedural based aspects of Radiology, where the fellow will often take the cases until the tail end of the academic year (Body, Neuro, MSK, Mammo, VIR).

 

[GoPelicans]

Even worse for procedural based aspects of Radiology, where the fellow will often take the cases until the tail end of the academic year (Body, Neuro, MSK, Mammo, VIR).

Lol yes so true. We rotate at a hospital with IR fellows and another without, and the learning experience is night and day. With a fellow around I get treated like a secretary wayyyyy more often.

 

[LongDogLife]

Current MS4 applying into diagnostic radiology trying to decide where to apply. My main goal during residency is to become the best clinical radiologist I can. I am not yet decided between private vs academics but will probably go private practice. I like research but don't want to go to a program that sacrifices clinical training at the expense of research.

I have heard whispers of some big-name programs that one would expect to be some of the best in the country that simply don't have the volume or focus so much on research that residents often graduate undertrained.

Obviously name brand plays a role in securing a solid fellowship but rankings out there are terribly biased and subjective. So for this, forget about rankings/name brand/etc. I just want to know which programs actually generate the best radiologists.

So my question is: What are your thoughts on the strongest clinical training programs in the country?

My opinion: Go to a place without fellows that has a lot of independent call, wide variety of studies to read and good fellowship matches. My program isn't very famous nationwide but it's an amazing place to train for the reasons above. We really foster independence and the volume is high with decent variety. We have a lot of call and just the right amount of attending oversight to encourage personal growth without malignant personalities or abusive call shifts. Our residents come out prepared and match at top fellowship programs. Even though we aren't a famous program like many big academic centers, many programs and employers across the country know exactly what they are getting from a resident trained at our program. I would ask about these sort of details while interviewing for DR spots, especially if it's important to you. Best of luck!