 Woo, I'm excited about today's video because it is all about radiology. There's this huge page called medical, I can't, I can't say. There's this huge page called, there's this huge page called, sorry. Hold on. So there's this huge page on YouTube called med school insiders and they do this group of videos highlighting every specialty in medicine. It's called so you want to be or so you want to be a radiologist, so you want to be a surgeon. So they go through the entire specialty and all the specifics about the specialty and I thought I'd watch this video, react to it and give my thoughts on how well they describe radiology. Let's go ahead, get into it. That was such a bad intro, oh well. So let's go ahead and start this video. So you want to be a radiologist by med school insiders. Do you like the idea of sitting in a dark room looking at x-rays and steering clear of patient contact? This is the reality of radiology. If you'd like to see what being a radiologist looks like, check out my second channel where I do a second series in parallel called a day in the life. Now why didn't he ask me to be a part of this day in the life video? I'm kind of heartbroken a little bit. Unless that problem is skin deep, you can't actually see what the problem is with your own eyes. Only a few causes of the commonly presenting complaint of abdominal pain can be diagnosed with just history, physical exam, and lab tests. See this is so important already. I'm already loving this video because there's only so much a history and physical exam can provide you. Everybody has abdominal pain coming through the ER. You can try to localize the pain, but you don't really know what's going on until you get imaging on that patient. A CT scan will clear up everything you want to know. Radiologists are experts in interpreting these images and leverage the power of these machines to both diagnose and treat disease. Anytime a non-radiologist physician orders an imaging study, a radiologist will analyze the images and provide their assessment. I mean, I don't really look like him when I'm analyzing images. It's mostly on a computer screen, but cartoon is cute. Some radiologists use these imaging technologies to improve the precision of certain procedures. A suspicious mass in a patient's kidney can be sampled through an ultrasound guided needle biopsy rather than surgical excision. Interventional radiology, this is me. And while the common stereotypes suggest radiologists are shy, socially awkward, don't like talking to people and just sit in a dark room all day, that's far from the truth. This is exactly the reason I started this entire channel, my Instagram, everything. I kind of wanted to completely get rid of that stereotype of all of this that they mentioned here because I am not that way. None of my colleagues in residency were that way. And hardly any of the faculty I worked with were that way. I wanted to prove to everybody that radiologists are actually fun. We're not socially awkward. Not everybody's an extrovert, but I am and all of my friends in radiology are. So I wanted to shed some light that radiologists are cool too. While not as high energy as the hospital floor or operating room, physicians regularly visit or call the reading rooms for assistance with their patients. This is so true. So many times when I was working overnight on call, so many physicians would come in our room, ask us to go over imaging studies throughout the day when we're at work, when there's multiple people in the reading room, they're constantly calling our reading rooms asking us about their patients imaging, asking us about what's the next best step? How should we treat this patient next? Are there any other imaging modalities that could further elucidate the finding on the current x-ray or whatever? So we're constantly communicating with other providers throughout the entire hospital and multiple different hospitals every single day. Radiologists work isn't confined to just reading rooms. While most spend their time in reading rooms, they can also perform several procedures. I'm loving this video already. He's really hitting the nail on the head here because this is what I've been talking about through all of my past videos. You always hear me talking about how many procedures we do and we don't just sit in a dark room and read studies. We do a lot of other stuff too. Ranging from life saving procedures such as embolizing or ablating cancers with radiation infused particles, Y90 or yitrium Y90 or trans arterial radio embolization, which is what I do. Radiologists can choose to be more reading room focused or patient facing. Non-procedural radiologists choose to spend the large majority of their time in the reading room. On the other hand, you can choose to be heavily procedural as every subspecialty within radiology involves procedures and provides the opportunity to be patient facing either in the procedure suite, at the bedside, or in clinic. This is so true. A lot of radiologists choose just to do imaging only and they just crank out diagnostic studies day in and day out. Others want a mix of diagnostic studies and also procedures. For instance, MSK radiologists may read a whole bunch of MRIs on the shoulder, knee, hips, but also they may do some arthritis or some bone biopsies or whatnot. As you know, interventional radiologists do almost 100% procedures. As an academic radiologist, your responsibilities will include a combination of reading films, teaching residents and conducting radiology related research. In private practice or community-based practices, the large majority of your time will be spent in the reading room and your primary responsibility will be in completing reads of imaging films in an accurate and timely manner. I literally just spoke about this in one of the videos I filmed yesterday, the differences between academic and private practice, and how I'm trying to figure out which one I want. I'm leaning more towards private practice, but I can be convinced through the academic lifestyle as well. I don't know. After four years of medical school, radiology residency is a total of five years. The first year or intern year, you obtain clinical training focused on various internal medicine or surgical rotations. I did surgery. This internship is often performed at a different institution. Mine was at a different institution. Why is there an ambulance going by? All right. I did my surgical intern year at Linux Hill, as you probably already know from my prior Linux Hill videos. And then I did my radiology residency at North Carolina. Now I'm up in New York for fellowship. Diagnostic radiology is middle of the pack in terms of competitiveness with an average step one in recent years around 240 and an average step two CK in the mid to high 240s. This is good information because so many people ask me what the step one scores are, how competitive radiology is. This is dead on. Radiology ranks at 14 out of 22. But you see interventional radiology right there. I think interventional radiology is actually the most competitive specialty on the market. If you go directly to an interventional radiology residency program, it's a bit more competitive. Is he reading my mind or am I reading his mind? I haven't seen this video yet. I promise. This place is interventional radiology at seven out of 22 in terms of competitiveness. Oh, I thought it was the top. I thought I had like a 30% match rate last year, which is crazy difficult. Medical students that typically apply to radiology are friendly, laid back and humble. That's me. Friendly, laid back, humble. Although someone who was saying I wasn't humble on TikTok the other day. I'm getting into TikTok, by the way. So if you want to follow me on TikTok, as cringy as it is, I think I might have to jump on the bandwagon. We'll see. If you enjoyed your preclinical years of medical school more than your clinical years, you may prefer the intellectual aspect of medicine. I sort of agree with that, but I also love my clinical years way more than preclinical years. And the reason I went into radiology is because I wanted to continue my knowledge in every single field. In radiology, you have to know a lot about every single field because we read imaging on every single field. And that's what kind of drew me to radiology. You can subspecialize further with fellowship, all of which are one year in duration except for IR. Not exactly true. IR is actually one year fellowship after residency. There is a two year pathway, but that is only for somebody who doesn't match into the ESIR program while they're in residency or their diagnostic radiology residency does not have an interventional ESIR pathway. And if you don't know what ESIR pathway is, just look up early specialization of interventional radiology on Google, you'll find it. Interventional radiology is the most procedure-heavy radiology subspecialty. Procedures are minimally invasive, performed using wires and catheters. You can cure cancers, stop life-threatening hemorrhage, salvage critical limbs, and reverse disabling genitourinary conditions through an incision merely centimeters long. That is a beautiful description. Thank you for that. And as you've seen, cure cancers via the liver treatments, we stop hemorrhage. I literally just posted a video where I saved this person's life, who was hemorrhaging to death or an hemorrhagic shock. We stopped the hemorrhage with literally a small, centimeter-sized incision in the wrist. Salvation critical limbs, we treat peripheral arterial disease and genitourinary conditions such as prostate artery embolization or uterine fibroid embolization. I mean, it's kind of like we do it all. While you can do this as a two-year fellowship after completing your radiology residency, you can also go directly into an integrated interventional radiology residency after medical school, which is a six-year path. You can also do ESIR, which is what I did, so like I was just saying, that's the third option to get into interventional radiology. I'm actually surprised he knew as much as he did because this whole interventional radiology pathway is the most confusing thing ever. And while they were transitioning over to eliminating all the one-year fellowships after residency, this just got super complicated and a lot of program directors were having trouble with this whole thing for a long time. And I was too. Neuroradiology is for those who are highly intellectual, have a passion for learning, and are driven by curiosity. The job of a neuroradiologist is to diagnose pathologies involving the brain and spinal cord and to guide clinical decision-making. You can additionally pursue a neurointerventional fellowship afterwards if you're interested in more procedural interventions with the brain. Yes, you can do a neurointerventional fellowship or an interventional neuroradiology fellowship after radiology residency in which you do some high-end neuro procedures. Breast radiology is heavily patient-facing whereby you'll hold clinic performing mammograms and biopsies on primarily female patients. You'll refer to hematology oncology or surgical oncology for the next steps depending on the type of cancer. Breast radiology is like the best kept secret in medicine. It's super chill, not hardly any call whatsoever. And it's like the most straightforward hours amongst all specialties. And my brother actually wants to do this. And I'm jealous because as you see, I take a lot of call. This has the best lifestyle of all the radiologies. Again, he's reading my mind There are no breast emergencies requiring overnight call. MSK radiology, your responsibilities will revolve around sports medicine and orthopedics in both diagnosis and management. It's a highly procedural field with joint injections for pain, joint aspirations for diagnosis, and kyphoplasty to treat vertebral fractures. So they do kyphoplasty as well. We also do an interventional radiology like I showed you in a prior video. And MRI is the workhorse of radiology and the backbone of the hospital. If I didn't do interventional radiology, I was going to do body imaging. I still love body imaging. I don't know if it's like the surgical anatomy I'm used to and all that kind of stuff. I just love it. There's a lot to love about radiology. Radiology is one of the road lifestyle specialties standing for radiology, ophthalmology, anesthesiology, and dermatology. So that's kind of an antiquated acronym. Radiology and anesthesia aren't really part of that lifestyle specialty anymore. The demand for imaging has increased so much and we can actually read faster and more efficiently now. So naturally, the demand increases alongside that. Everybody wants their reports immediately, which is why private practice lifestyle radiologists, it's not super laid back like it used to be way back in the 90s where they had to like hang up all the images for a CT scan. They read like 10 CTs an entire day. It doesn't happen anymore. Given the lower acuity work environment, the atmosphere is lower stress and colleagues are more amicable and collegial compared to higher stress specialties. Your daily task as a radiologist have a direct impact on patient outcomes, whether it's helping to diagnose a disease or provide an intervention. You won't have to deal with the difficulties of healthcare delivery such as arguing with insurance, sorting out patient disposition, dealing with non-compliant patients, or pleading with consultants to evaluate your patient. This is so true and this is a lot of the reason why I went into the specialty. Radiology is an innovative field and you'll be able to play with new toys and gadgets. It will likely augment and make their job easier rather than outright replace them. See, that's exactly what I'm talking about. I did a video on artificial intelligence probably a year ago. I'll link it up here, but that's essentially what I said in so few words. It's going to help us read faster and more efficiently, but it's definitely not going to replace us any time in the near future. You won't be on the receiving end of gratitude from patients after making the critical diagnosis that allows the primary physician to best manage them. You are less commonly seeing patients in person, but rather remotely through images. That's very true. We often diagnose multiple patients every single day. It's kind of a thankless job, but it is what it is. Much less often are you the one fixing the problem, as that's the ordering physician's responsibility, unless you're in interventional radiology. If you like the satisfaction of being the one to solve the problems or treat the disease, diagnostic radiology may not be able to provide that for you. So what if you could diagnose the disease as a radiologist, me, and also treat the disease as an interventional radiologist? Now you know why it chose my field. If you value work-life balance with time outside the hospital and high compensation, you can have your cake and eat it too with radiology, but make sure you enjoy the day-to-day of what radiologists deal with, namely reading images which may leave some of the more outgoing or adrenaline-fueled individuals feeling unfulfilled. But you'll have time to do adrenaline-filled things outside of work, or exercise the creative part of your brain like I do with YouTube. If you have a big ego, radiology may not be for you. You have to be okay knowing that you'll often be underappreciated, but your non-radiology physician colleagues will find your help indispensable. A good radiologist is worth their weight in gold, especially to a lot of surgeons, etc. I'm telling you, not all radiologists are equal, and the good ones you definitely won by your side. You'll develop good relationships with your colleagues. Big shout out to the radiologists at Med School Insiders that helped me in the creation of this video. I didn't see myself on that list. I'm a little heartbroken. I'm a little upset. All right, so that video was surprisingly really, really, really good. I did a great job, and it was completely unbiased, which I thought it was going to be more biased on radiologists being introverted and all that stuff. They did a fantastic job, so shout out Med School Insiders. You crushed it. Call me if you want to do another one about interventional radiology or other radiology videos. Should we collab together? Comment below if you think Med School Insiders and me should collab. Anyways, as always, make sure you smash that subscribe button. Follow me on Instagram. Follow me on TikTok now, because that's my new thing apparently. See you on the next video.