Radiology Interview Preparation Guide

Download PDF

Radiology is a medical specialty that employs the use of imaging to both diagnose and treat disease visualised within the human body. Radiologists use an array of imaging technologies (such as X-ray radiography, ultrasound, computed tomography (CT), nuclear medicine, positron emission tomography (PET) and magnetic resonance imaging (MRI) to diagnose or treat diseases. Interventional radiology is the performance of (usually minimally invasive) medical procedures with the guidance of imaging technologies.

Combined imaging techniques, such as PET-CT offer exciting future opportunities for disease detection and monitoring
Functional MR imaging
Molecular imaging
Cardiac MR and CT
Breast MRI
Expanding interventional techniques

There are far too many to list. Any disease or patient presentation that can possibly have a physical/imaging manifestation from the cranial vertex down to the tips of the toes is a possibility in the radiology department. There's a lot to know, but that's what makes it challenging and satisfying!
There will not be a day that goes by that you don't see at least one great or interesting case, no matter what your work setting!

During residency: This varies from program to program depending on the number of sites covered and number of residents. At McMaster, we do call roughly 1 in 7 or 8 (averages out to 3-4 calls per month). We cover two sites on each call shift. Our hospitals have established a contrast policy whereby residents do not need to travel between sites, in order to cover contrast-enhanced examinations.
As a staff radiologist: Your call frequency will depend on the number of radiologists in your practice, as well as the imaging modalities and technologist/imaging hours your hospital offers. As a rough estimate, it there are 4 radiologists in your group, you will be on-call 1 in 4; if there are 13 of you, then it's 1 in 13, etc. This may change if you have specialized skills, such as in interventional radiology. The other determinant of call depends on whether you are working at an academic centre (with resident and fellow call-coverage) or a community setting. For the latter, another factor which influences the busyness of your call is whether or not your centre provides 24/7 CT, US or MRI imaging.

"Turf wars." As radiology explodes into a massive field with many new types of imaging studies and applications, specialists from other fields seek to read and interpret the studies that pertain to their field. This is already happening in interventional radiology, where specialists from other fields seek to do minimally invasive procedures, for instance vascular surgery. Other examples include cardiology and their interest to do cardiac CT and MRI. It will be a challenge to prevent the fragmentation of radiology and the assimilation of its parts into other specialties; however, the sheer volume of imaging studies in radiology has increased drastically in recent years and it is doubtful that other specialists will be able to take on a CT work list while also meeting their clinical demands. As a specialty, we need to provide excellent service and interpretation - that's our challenge.
"Outsourcing." Given the portable nature of radiology and high bandwidth network connections, it is possible to have a radiologist on the other side of the world report the same studies we are doing here. There is concern that work for radiologists here will be exported to markets where labour is cheaper. This is happening in the US far more than in Canada. Also, one must consider that radiology training worldwide is not necessarily equivalent. A radiologist in another country may not necessarily be able to provide the same quality of interpretation/consultation that radiologists here may be able to. Secondly, liability becomes an issue. If a radiologist in another country is consistently making misses, who takes responsibility? How is litigation pursued? These are some reasons why outsourcing outside of Canada has not been a major factor here so far. It is more likely that teleradiology partnerships will develop where one group may cover on-call overnight or in smaller groups or practice settings covering vacation or conference leaves. This can also assist with remote centres having difficulty recruiting radiologists or delivering some specialty expertise.
Radiology Training: With the expansion of the specialty comes a massive expansion in the knowledge requirements for graduates from radiology residency. As the specialty continues to grow, the training will evolve to help residents cope with the large amount of knowledge and training required. Future options may be to subdivide radiology residency early on into subspecialties as they do in internal medicine. In Canada, this isn't happening yet, but could evolve to this in the future.

Impulses

.25 seconds

a. amalgam

b. low contrast

d. 0.05 Sv/year