Radiology & Residency

1. Behnam Vahdati Nia - OMSI Co-president of Rad Club Touro University – California Spring 2011 Radiology & Residency

2. Radiology: An Overview • A medical specialty in which a variety of radiologic methodologies are used to diagnose and treat diseases • Been around for over 100 years • Great technological advancements in the last 30 years • Diagnostic Radiology uses diagnostic and image guided therapeutic techniques in: • Nuclear radiology • Diagnostic ultrasound (US) • Magnetic resonance (MR) • Computed tomography (CT) • Interventional procedures • Use of other forms of radiant energy

3. Over 80% of Radiologists sub-specialize in: • Abdominal Radiology • Endovascular Surgical Neuroradiology • Neuroradiology • Pediatric Radiology • Nuclear Radiology • Vascular and Interventional Radiology • Cardiothoracic Radiology • Musculoskeletal Radiology http://www.radiologyinfo.org/en/careers/index.cfm?pg=diagcareer

4. Patient Details • Most patients are ambulatory and then inpatient • ~50% adults and ~40% 65+ • ~50% acute, ~30% chronic, the rest check-ups/terminally ill Five Most Frequently Encountered Illnesses/Conditions:

5. Work-force (2010) • Total # 26.5K = 8.48 per 100,000 • An increase from 7.70 in 1996 • Only 30% female • Work-place: • Office Based Patient Care <70% • Hospital: • 4,654 residents (<18%) , CA ~13% total • <12% physicians • Other (~5%) • Administration • Medical Teaching • Research • Locum Tenens (subs) • Other • Compensation • Academic Medicine: ~$300K-400K • Clinical Practice: ~$300K-650K • Resident: ~$49K

6. Personal Characteristics CiM

7. Residency: An Overview • Generally 5 years, including a PGY-1 year • First year in a preliminary medicine, transitional program, or preliminary surgery program • PGY-1 year must consist of training in internal medicine, pediatrics, surgery or surgical specialties, obstetrics and gynecology, neurology, family practice, emergency medicine, or any combination of these • Four years in radiology at the same or different institution • Categorical programs: less common - PGY 1-5 • PGY 1 intern year and the radiology residency are combined , and applied to together • Advanced programs: most common - PGY 2-5 • Most programs participate in the Electronic Residency Application Service AND the National Resident Matching Program.

8. What’s residency like?

9. Residency Spots • 25 AOA spots at 14 sites (7 at Michigan) • 141 ACGME PGY-1 spots at 34 sites • 8 filled by DOs • 949 ACGME PGY-2 spots at 163 sites • All DOsIn The NRMP • 2045 applied, 1444 matched = 70.6% • DOsactive in ACGME DR residencies • 2009: 178 = 4% total

10. What do Program Directors look For when…

11. What do Program Directors look For when…

12. Some tips from our matches… • Radiology, its a tough field to get into, as is all the R.O.A.D residencies, and even worse, it seems that most good residencies are getting even harder to get into • “You won't be disappointed in radiology.  No matter what anyone says, we are the happiest bunch of people in the hospital -  we enjoy our jobs more, we have less stress, we fill out less paperwork, we make more money, and we take more vacation.  It's a pretty winning deal.  Plus we are constantly evolving, we are completely evidence based, and we will always be needed.”

13. You can't compete without boards You must take and do well on USMLE: 235+ on both steps (average for matched). Use First Aid by adding notes. • Do well on first two years  class ranking • Get good letters. Consider doing a rads research rotation and getting a small paper done and your mentor should write you a strong letter. Also, you need a good letter from one primary care and one surgical doc. • Get application done early and submit it day one. Apply broadly (20-30 on average to get 10-15 interviews) • Do away rotation at places you are interested in and make a good impression. If you have a connection to a place let them know about it • Clinical grades are more important. Didactic grades don't matter much • Do research and get published • USMLE questions required understanding concepts, where COMLEX was more basic recall. • There are a few good DO programs out there, but they are small, and often not in the best locations

14. Newly matched example application: • Good grades (very good in the actual science classes, not so much in OD, OMM) • Mostly studied on his own with review books (versus lecture/powerpoints) • Used First aid, BRS Pathology, BRS Physiology, Microcards • Practice questions were extremely useful • USMLE World > Kaplan Q bank • COMLEX: ~620USMLE 1:~250USMLE 2, COMLEX 2: not taken at time of applicationStrong letters, one particularly strong one from the chief ofabdominal imaging 6 weeks research rotation and 1 case report written with said chiefVolunteering: nothing • Withdrew from AOA match, Matched ACGME on his 6th (and last) ranking • Note: He did not take Step 2s at time of applying and wished he had. Taking the step 2 and doing well on it will further support your application. I also recommend doing some volunteer work?

15. Resources: Radiology • Dr. Pera • Advising • US machines late May? • Dr. Hisley • Research • OsiriX (Mac OS) • BB site / elective?

16. RSNA (Radiological Society of North America) • http://www.rsna.org/medstudents.cfm • Cases, training, DDx, journals, etc…

17. StatDx • https://my.statdx.com/ • Cases with precise diagnostic info and images + anatomy + more • Residents/radiologist use it (on call too) • One login at a time

18. Learning Radiology • http://www.learningradiology.com

19. Others… • http://www.radrounds.com/ • Connections • Cases

20. Others… • http://www.auntminnie.com/ • Forum for anything regarding radiology/residency • News • Cases • Career • CME

21. Resources: Residency • Careers in Medicine (CiM) • https://www.aamc.org/students/medstudents/cim/ • Identify career goals • Explore specialty and practice options • Choose a specialty • Questionnaires  characteristic to specialty match • Select and apply to residency programs • Application timeline • Make good career decisions • Four-Step Career-Planning Process

22. Residency Programs • FREIDA • http://www.ama-assn.org/ama/pub/education-careers/graduate-medical-education/freida-online.page • Information + Statistics • AOA List • http://www.opportunities.osteopathic.org/ • ACGME List • http://www.acgme.org/adspublic/

23. Applications & Match • ERAS (Electronic Residency Application Service) • https://www.aamc.org/students/medstudents/eras/ • transmits applications, letters of recommendation (LoRs), Medical Student Performance Evaluations (MSPEs), medical school transcripts, USMLE transcripts, COMLEX transcripts, and other supporting credentials from applicants and their designated dean's office to program directors. • NRMP • http://www.nrmp.org/ • For matching applicants' preferences for residency positions with program directors' preferences for applicants (both MD/DO) • AOA Intern/Resident Registration Program • http://www.natmatch.com/aoairp/index.htm

24. Some Points About AOA & NRMPMatches • Match to AOA Residency, NRMP is OVER • Do Not Match AOA, ALIVE in the NRMP • No Match with AOA or NRMP, Free Agent • Match with AOA Internship, ALIVE for PGY- 2 Residency in the NRMP • Critical to Understand the Distinction Between PGY-1 and PGY-2 Matches in the NRMP • Any attempt for an applicant or program to supply specific rank order info. prior to the match is a violation of the match

25. Thank you!