Year after year, medical students pose questions that reflect the same concerns and misconceptions about a career in radiology. While radiology educators and practicing radiologists may perceive many of these reservations as ill-founded or misguided, they are nonetheless important to recognize and address. Student decisions about careers are determined not only by what students know, but also by what they think they know. If students opt for radiology or eschew it based on inaccurate information, this benefits neither the students nor the field of radiology. In what follows, we briefly identify and suggest strategies for educating students about a dozen concerns and misconceptions.
#1. Radiologists are not real doctors. American College of Radiology focus group studies have suggested that approximately one-half of the general population does not know that radiologists are physicians . At most medical schools, there is no required course in radiology, and at many others, radiologists play little teaching role in the medical school curriculum. As a result, students have little opportunity to see radiologists in action. If such misconceptions are to be corrected, it is incumbent on academic radiologists to seek opportunities to expand their role in medical student teaching, ensuring that each future physician understands who radiologists are and what they do . Medical students who do not choose radiology as a career still constitute the field’s future referral base.
#2. Radiologists have little or no patient interaction. There is some truth to this. Some radiologists may go days or even weeks without interacting directly with a patient. But it is important to point out that many radiologic disciplines, such as interventional radiology and mammography, involve a high degree of patient interaction, and radiologists in all disciplines have opportunities to interact with patients . Moreover, radiologists make a huge contribution to day-to-day patient care. Until we know what is wrong with the patient, it is impossible to prescribe appropriate therapy. Radiologists are frequently the physicians who rule in and rule out diagnostic hypotheses, thus playing a crucial role in patient care . Physicians also turn to radiologists to monitor response to therapy and detect complications.
#3. Radiologists do not treat patients. Again, it is true that many radiologists focus a relatively small proportion of their time on treatment, as opposed to diagnosis. Yet some radiologists do play important roles in this area, interventional radiologists foremost among them. In addition, many non-interventionalists help to treat patients on a regular basis. Examples include the placement of feeding tubes and central venous catheters, thoracentesis and paracentesis, and abscess drainage. In community practice, many radiologists are called upon to advise referring physicians about treatment options. Because so many different medical disciplines refer patients to radiology on a regular basis, radiologists can often offer a multidisciplinary perspective on patient management .
#4. Radiology is dangerous to your health. This notion has been promulgated in popular literature by such books as Samuel Shem’s The House of God , in which the interns rule out radiology as a career in part because it “damages your gonads” and increases the risk of cancer . In fact, however, a number of safeguards are in place to protect against the hazards of ionizing radiation . There is no evidence that birth defects, cancer risk, or life expectancy are adversely affected by the practice of radiology . Moreover, becoming a radiologist provides an opportunity to understand the benefits and risks of ionizing radiation to a higher degree than most other physicians.
#5. Many physicians read their own images. For example, most neurosurgeons are competent at reading head CT and head MR images, and many pulmonologists are adept at interpreting chest radiographs and CT scans. This is especially true in academic centers. General radiologists may find it difficult to add much value in these situations, although equally specialized radiologists have much to offer. Moreover, the radiologic skills of such specialists are usually highly domain specific. Neurosurgeons are not comfortable interpreting abdominal CT scans. And of course, many primary care physicians are not specialized and do not feel comfortable interpreting studies on their own. For these reasons, radiologists will always play an important role .
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