If you’re wondering what a radiologist does, you’re not alone. A lot of people have never heard of this job before. So what is a radiologist, and what does this job entail?
A diagnostic radiologist is a physician/medical doctor who specializes in the diagnosis of various diseases and pathological processes by reviewing medical imaging created from ionizing and non-ionizing radiation. Medical imaging techniques/modalities include radiography (x-rays), fluoroscopy (video x-ray), ultrasound (US), nuclear medicine which includes positron emission tomography (PET), computed tomography (CT), and magnetic resonance imaging (MRI).
Radiologists look at and interpret medical images, dictate their findings into a report, and conclude the report with a synthesis of the findings, denoted as the “impression” or “conclusion” of the report. This is frequently referred to as “reading a study.”
Interventional radiologists are medical doctors who interpret diagnostic imaging exams but are typically focused on performing minimally invasive procedures under imaging guidance to diagnose and treat various disease processes. They directly treat patients.
For example, diagnostic radiologists will diagnose the presence of an abnormality, say a liver mass, and interventional radiologists will biopsy the liver mass under imaging guidance to determine what it is.
Radiologists typically work in hospitals, clinics, or private practices. They may also work for imaging companies or health care organizations.
Note: This is not to be confused with radiation oncology. A radiation oncologist is like a cross between a medical oncologist and a radiologist. They deliver targeted treatments using medical technology employing radiation therapy using ionizing radiation to target cancer cells. Radiologists find the cancers and radiation oncologists treat the cancers.
Radiologists are physicians/medical doctors who have completed medical school and residency training in diagnostic and interventional radiology. They work behind the scenes as consultants to other physicians (e.g. emergency medicine physicians, surgeons, internists) who order each medical imaging exam.
A radiology technician is a health care worker who has completed a two- or four-year accredited radiologic technology program and is responsible for acquiring the medical images from various diagnostic imaging modalities that radiologists review. Radiologic technologists typically work on the front line with patients; they are the people from the radiology department that patients see.
Radiology technicians may obtain further training in other radiology imaging modalities including computed tomography (CT), magnetic resonance imaging (MRI), or breast imaging (mammography).
A radiologist is a physician who has obtained a doctor of medicine (MD) or doctor of osteopathic medicine (DO) from an accredited medical school. Afterward, they must complete residency training in radiology (diagnostic and interventional pathways exist).
Becoming a radiologist takes about 10-11 years after college. This includes four years of medical school, followed by a one-year internship, and a four-year residency in diagnostic radiology. Then most radiologists specialize further with fellowship training that ranges from one to two years.
A diagnostic radiologist is a physician who specializes in using imaging technologies to diagnose diseases and injuries. Diagnostic radiologists look at various patient anatomy and/or physiology and try to identify an underlying problem causing a patient’s symptoms – we are essentially diagnosticians, problem solvers if you will. Most diagnostic radiologists are also capable of performing basic medical imaging procedures (e.g., joint injection, paracentesis, etc.).
An interventional radiologist is a physician who specializes in using imaging technology to both diagnose and treat diseases and injuries. Interventional radiologists not only interpret diagnostic studies but also perform various minimally invasive interventional techniques such as image-guided biopsies, percutaneous drainage (paracentesis, thoracentesis, abscess drain placement, etc.), angioplasty (opening up narrowed blood vessels), embolization, and more. In essence, they spend their days delivering targeted treatments utilizing minimally invasive techniques.
All radiologists are trained in both diagnostic interpretation and interventional procedures, though there is significant variability in the scope of practice that varies between practice settings (academics, private practice, hybrids), individual practice structure, and individual radiologist preference/comfort level. Regardless of the practice setting, all radiologists put their medical education to use!
Yes, nearly all radiologists pursue a 1-2 year fellowship after completing a four-year residency program, and some even complete two fellowships following residency. Diagnostic radiologists further specialize in a variety of subspecialties such as abdominal imaging (frequently referred to as “body” imaging, kind of a misnomer as that typically excludes the majority of the body and focuses on hepatobiliary, gastrointestinal, and genitourinary radiology), cardiothoracic imaging (aka chest radiology or cardiovascular radiology), breast imaging (mammography), musculoskeletal imaging, neuroradiology, nuclear medicine (also referred to as nuclear radiology), or pediatric radiology.
Interventional radiology has recently (at the time of this writing in 2022) converted into a 5-year combined diagnostic/interventional residency program with 3 years of diagnostic radiology training and 2 years of interventional radiology training (think of it as being inclusive of a 1-year fellowship). The program has some additional clinical requirements.
A NightHawk radiologist is simply a radiologist who works for the company “NightHawk,” a teleradiology company. The company typically provides overnight coverage for smaller radiology groups and hospitals. NightHawk is particularly notable for being the first teleradiology company to station radiologists in Europe and Australia to take advantage of the time difference, allowing radiologists overseas to work daytime hours while providing overnight coverage in the US.
Teleradiology companies perform a combination of final reads and preliminary reads that get “overread” by daytime radiologists. This allows hospitals and radiology groups to outsource overnight coverage without limiting patient access to radiological interpretations. Teleradiology as a whole has significantly grown and evolved into a much larger market over the past few decades.
The average annual salary of a radiologist is $430,890 (ranging from $374,590 to $498,390) according to Salary.com (as of February 25, 2022). However, this varies depending on multiple factors such as experience and location.
Radiologists typically work a standard Monday through Friday, day shift hours and also provide evening, weekend, and, depending on the practice model, night time coverage. While every group structures its coverage a little differently, 24/7 coverage is generally expected for all hospitals settings. Groups that don’t provide their own nighttime coverage will rely on contracts with various teleradiology groups to help with overnight coverage. A stroke or dissecting aorta can’t wait until morning.
Radiology can be quite intellectually demanding as radiologists, especially in the private practice setting, are frequently operating at 100% mental capacity for ~8-10 hours straight. On the bright side (not too bright though, gotta be mindful of the glare…), it seems to be easier to work late into retirement as a radiologist if you so choose.
Radiologists typically dress in business casual clothing or scrubs, particularly if they will be performing procedures.
A radiologist’s typical day includes reviewing images, protocolling exams, performing procedures, and consulting with other physicians. They may also have administrative duties, such as sitting on hospital committees or serving as medical directors.
Some pros of being a radiologist include a good salary, flexible work hours, shift work, and – most importantly – the ability to help people. Some cons of being a radiologist include the amount of time it takes to become a radiologist, frequent exposure to low levels of ionizing radiation (incredibly low but not zero), and having to work weekends, holidays, and/or nights.
Some important skills for a radiologist include critical thinking, problem-solving, and excellent communication skills. They must also be able to work independently as well as in a team setting. They must be able to work well under pressure and be incredibly attentive to detail.
The job outlook for radiologists is positive; the Bureau of Labor Statistics projects that employment will grow by 17% from 2016 to 2026. This is much faster than the average for all occupations. There is currently a nationwide shortage of radiologists, which is projected to worsen over the coming years.
Radiologists are in high demand due to the aging population and the increasing use of imaging technologies. US, CT, MRI, and PET/CT are now commonplace and play a crucial role in patient management. There are several life-saving preventative screening exams such as abdominal aortic aneurysm (AAA) screening with US, low dose lung cancer screening with CT, virtual colonoscopy (aka CT colonography), and mammography.
Moreover, CT, MRI, and PET/CT are integral to the diagnosis and management of essentially all malignant cancers and are used to pre-operatively stage several cancers such as rectal cancer, prostate cancer, cervical cancer, and brain tumors. Classic imaging features may even be diagnostic for cancers such as hepatocellular carcinoma (HCC), allowing clinicians to forego biopsy and move straight to treatment. As a result, radiologists will be needed to interpret these images and help guide management for these patients.
Some common misconceptions about radiologists include that we are always on call, have poor social skills (while we do choose a profession where we typically work by ourselves in a dark room, many of us are actually quite friendly!), and that we are exposed to excessive amounts of radiation (it’s quite minimal, but not zero). Another common misconception is that a radiologist is the radiology technologist who obtains the images.
There are many reasons why I enjoy being a radiologist. As a radiologist, I’m able to help tens of thousands of patients per year, make occasional life-saving diagnoses, and help guide patient management to achieve optimal patient outcomes – overcoming illness, fighting cancer, and staying out of the hospital. I enjoy the variety of studies (X-ray, US, CT, MRI, nuclear medicine) that I get to read on a given day and love the problem-solving nature of radiology (do you think it’s a coincidence that Dr. John Watson assists Sherlock Holmes? I think not!).
I also appreciate the high salary and vacation time that come with being a radiologist – the vacation time is much needed given the consistent high-stress nature of the job. Despite some of the challenges, I find that the pros far outweigh the cons in this career. I can’t imagine doing any other specialty within medicine!
Radiologists are physicians who play an important role in diagnosing medical problems by interpreting images such as X-rays, MRIs, and CT scans. We are the diagnosticians (along with pathologists) of medicine. We are not radiology techs who obtain the images though we do work closely with and greatly appreciate our technologists who get us the images we need to make our diagnoses! We simply wouldn’t exist without our amazing techs. Teamwork makes the dream work.
Radiologists are the backbone of medicine as we serve as consultants to almost every other medical specialty, including not only diagnosis but also treatment. We are the friendly service only a phone call away.
If you are considering a career in radiology, I encourage you to do your research and talk to professionals in the field. I think you will find that this is a challenging yet rewarding career!