5 Truths about being an ST1 Radiologist

5 Truths about being an ST1 Radiologist

So I'm writing this article with a smile on my face. Thankfully someone close to me has started radiology. Seems the Donnie crew just got bigger 🙂 I like to think I was a source of inspiration (!) Anyway, it got me thinking about what advice I should give them and thought, actually, a lot of this would be useful for any ST1. So here goes:-

1. You will have the ST1 Blues

This phenomenon will depend on what your level of seniority was before you came in as an St1.

At first you will walk in with a skip in your step. You've finally got to where you wanted to. But then you start to miss 'social' interaction with patients. you start to miss ward rounds and most of all you miss having an opinion that matters.

You will start to convince yourself that actually you didn't mind the wards. You miss patient contact. You miss ward rounds and you miss having a bleep. In reality you miss being comfortable. In radiology you find yourself uncomfortable. You feel like a faker. A fake registrar. Not a real registrar like the medical reg failing (yet again) to calculate a Wells score or the surgical reg who is incapable of piecing together right iliac fossa pain and appendicitis.

I have had the unfortunate occasion of seeing ST1s get very upset about all this. Really suffering the ST1 blues. The whole thing can get so overwhelming. Will I ever be good? Will I ever know enough? Maybe I should just go back to what I was good at...etc. First things first you need to 'let it go' (cue the music).

You are part of the radiology family now. If you are reading this you are part of the Donnie Crew. Your fellow registrars should understand where you are coming from, so talk to them. If they don't, then I certainly do. I've seen it so many times. It's OK to feel like this, it's perfectly normal.

What I will say is...stick at it. It will get interesting. Your opinion will matter sooner than you realise. The seemingly steep learning curve is conquerable. You will look back and be happy you powered through. It does get better and it will be all worth it in the end. Your reports will make a massive difference in patient care. You will play a pivotal role in patient management. In some ways you will be the unsung hero. The one who looked at the clinical picture properly and came to the right conclusion. You will matter soon, I promise.

2. You Know Nothing

Leading on from the last point. You will often feel out of your depth. You will often feel like there is just too much to know, and again you will start to feel uncomfortable.

Radiology is just so different a subspecialty. Suddenly you are no longer a 'day walker' and the bright sunlight bothers you.

You sit there watching others reporting (which is worse than watching an episode of Gilmore Girls...ooooo I went there!) and no one takes your opinion very seriously. Worst of all you went from knowing a fair bit about something to not knowing anything at all. For some this dawns on them only when they are sitting in front of the CT scan for the first time and are told to write a report...where do you even start!?

Like I said before, hang in there. It'll all make more sense soon.

3.  It's all a bit boring

Er...yes. in the beginning it really is. I'm not going to lie. You go into medical school with dazzling dreams of slicing someone open in theatres and saving the day only to find yourself sitting in a dark room watching people talk about random bits of the body that you had no idea mattered.

After a while though you do remember what you originally loved about medicine and radiology delivers that in spades. It is piecing together the clinical picture and coming to a diagnosis.  Solving the clinical puzzle. It is what drives a radiologist...it's also nice to be the cleverest person in the room...some of time 🙂

4. Some of the Consultants are a bit odd

I'm being honest. You'll meet some absolute characters. I guess that's true with any field but I do think that some people, especially the old school ones become radiologists for a reason. They fit the stereotype perfectly. No interpersonal skills, odd affect and an inability to switch on a monitor without screaming for help. I noticed some (who unfortunately wield a bit of power) don't really understand what it's like to be a trainee in this day and age. They can't relate to the exams, the horrendous on calls or even you as a person. They come from a time when clinicians had true fear of them and CT scans happened about once a week....and dare I say it...the exams were much easier too 😛

My advice is to not take what they say seriously. If you are faced with any negativity try and remember how rubbish it must be on wards and let your own hard work do the talking.

General tips would be. Be punctual and always seem super interested in whatever you are being told/taught. Try not to fall asleep...as I have done on a few occasions! It gives a good impression and sometimes they warm to you. If they don't...life's too short. Move on.

5. It's all about Exams

I really wish this wasn't true, but it is. Radiology is exam heavy and the exams are really really hard. I've met people who are much cleverer than me (Ok, I know that is not that difficult ) fail repeatedly. People who have never failed anything (smash through med school, passed MRCS/MRCP) waltz into radiology and really struggle. Never lose heart. Sometimes it's lonely failing, especially if you have to watch others fly through. If you end up being one of the stragglers...you are not alone, you are not the first and you won't be the last. Hang in there...life could be worse...the alternative would be you still holding a bleep and having a patient scream/vomit/poo on you.