Derek Smith is Radiology Registrar and Clinical Teaching Fellow with NHS Lothian. He tells us about the transition from medical school to career in radiology.
When I started medical school in Edinburgh in 2007, I had no idea what a radiologist was, where they lived or what they did. You never saw them on Grey’s Anatomy or House, and to be honest I never 
met one for most of medical school!
In the later clinical years, it became clearer to me that the big decisions and the interesting cases relied on what the radiologist thought – from the front door in resus, medical and surgical admissions and into bigger complex MDMs. The radiologists are the problem solvers and usually have the answers. I did a lot of peripheral placements in my last year as a student, and these teams had lots of in-person discussions with radiologists, which was a great way to learn by osmosis.
I love imaging because of the difference we make to patients and the massive advances that are happening as we speak: the X-ray was discovered 125 years ago, the first CT in 1971 and MRI is only 40 years old. The techniques we have to detect, diagnose and monitor disease is changing all the time: AI and the “machines” will only help us (and not take away our jobs). This doesn’t even start to consider the role of interventional radiology which revolutionises the care of a number of life-threatening emergencies, keeping radiology an essential specialty.
Tips for making the change to FY doctor
When you become a Foundation Year doctor (FY) there are a lot of changes, but one of the biggest ones is that you’re expected to be able to go and sort out a scan for your patients by yourself!
Here are some of my tips to make your life easier, and to get the best for your patients:
Get the basics right: Have a CHI number to hand and have a particular question you want answered. Know the white count, CRP and if they are in crashing renal failure; the rest you can look up and get back to us with.
Radiology is a clinical opinion: Ask for help with a problem instead of demanding what may turn out to be the wrong thing at the wrong time. You don’t walk into a consultant cardiologist and demand someone has PCI so why should you think this patient needs this type of MRI now? Trust the imaging experts!
Be curious: Come and see the scans happening, and ask the radiologist if they can explain what they are looking for. Even if you don’t become a radiologist yourself you will definitely keep working with imaging in the future so get familiar with it from as early as possible.
To get more of an idea of what the future of radiology looks like, come to RiiSE20 on Saturday 4 April (a one day student/junior doctor conference in Edinburgh; riisedinburgh.com).
You can follow me on Twitter @derekrad and see some of my favourite cases on Radiopaedia.org (which also has some great student friendly teaching content).
