How to Become a Radiologist

Overview

By Michael Sapko, M.D.
Radiologist studies a patient's X-ray

Radiologists are physicians who use cutting-edge imaging technology to examine organs and tissues inside the body in gentle, noninvasive ways. Their expertise in physics, anatomy and the disease process allow them to diagnose injuries and illnesses so treatment can begin. A growing subset of these specialists called interventional radiologists performs surgical procedures under imaging guidance in order to minimize damage to healthy tissue.

While early radiologists had only film X-rays to work with, modern professionals have a variety of tools at their disposal, including:

  • X-ray radiography
  • Ultrasound
  • Computerized tomography (CT)
  • Magnetic resonance imaging (MRI)
  • Positron emission tomography (PET)
  • Nuclear imaging

Radiologists generally work behind the scenes analyzing studies, making diagnoses and consulting with physicians. In some cases, they get involved in the procedure in order to help prepare the patient or outline further instructions to the technician.

Interventional radiologists take imaging technology a step further by using it to treat certain diseases and conditions. These professionals create electronic maps to guide their instruments as they insert catheters, remove malignant tissue and perform other delicate procedures. This gentle approach allows patients to recover faster and with fewer complications.

Physicians who thrive on intellectual stimulation find radiology an especially rewarding area of practice. Because the field advances so rapidly, there is always something new and exciting to learn. These specialists are among the first to pilot cutting-edge imaging technologies and procedures developed in research laboratories. Radiologists also enjoy the challenge of interpreting complex studies and putting together medical clues to arrive at an accurate diagnosis.

Work Environment

Though most radiologists still work in hospitals and outpatient diagnostic centers, advances in digital technology now allow imaging studies to be transmitted electronically. This practice, which is known as telemedicine, means radiologists can now practice in any location equipped with a computer, high-resolution monitor and Internet connectivity. Telemedicine helps emergency departments and intensive care units obtain emergency consultations after hours and also promotes consultation among experts around the globe.

Unlike most other physicians, radiologists have limited patient contact. In fact, some go weeks without a face-to-face consultation. Instead, these specialists spend their time analyzing image results and formulating diagnoses.

Radiologists who work in the hospital work long, irregular shifts that include nights, weekends and holidays. Those employed by outpatient centers are more likely to work regular business hours.

Requirements

Education

The first step in becoming a radiologist is to obtain a bachelor’s degree. Pre-medicine students may major in any subject but need to meet prerequisites in math, biology, organic and inorganic chemistry, physics and the humanities. Students can strengthen their medical school application by earning academic honors, volunteering, conducting scientific research and achieving high scores on the Medical College Admission Test (MCAT). Many four-year colleges and universities have pre-med advisors who assist students in planning an appropriate program of study. 

Next, aspiring radiologists move on to medical school. Because radiology is an extremely competitive specialty, candidates must excel academically in order to compete for available residencies. They will also benefit from top scores on Steps I and II of the United States Medical Licensing Examination (USMLE).

Training

During the final year of medical school, students should apply for a four-year diagnostic radiology residency through the National Resident Matching Program (NRMP). Residents work an average of 60 hours per week and spend some nights on call. Upon completion, some candidates pursue a 1-3 year fellowship in a subspecialty such as neuroradiology or interventional radiology. 

Licensing and/or Certification

State licensure is mandatory for all practicing physicians, including radiologists. Most employers require radiology candidates to hold board certification. Effective 2013, this will require passage of a two-part examination covering medicine, anatomy, imaging modalities and physics.

Necessary Skills and Qualities

Because competition for radiology residencies is fierce, students seeking to enter this field must be top academic performers with excellent test scores. More so than other medical specialties, radiology requires a strong interest in and knowledge of physics and math. 

Opportunities for Advancement

Radiologists earn excellent salaries throughout their careers. As they advance, many choose a more comfortable lifestyle over pay increases. This usually takes the form of fewer nighttime, weekend and holiday shifts.

Other radiologists advance their careers by gaining new skills and expertise. It is not uncommon for an interventional radiologist to be the only professional in the region performing certain cutting-edge procedures. This allows the person to command a higher income and may present opportunities for leadership, research and community outreach.

Experienced radiologists sometimes leave the clinical setting to pursue research opportunities, take teaching positions or move into health care administration.

If you would like to gain the necessary education to become a radiologist, we highly recommend that you check out our free School Finder Tool located HERE.

Salary

The U.S. Bureau of Labor Statistics states that the median annual pay among specialist doctors (a group that includes radiologists) was $396,233 as of 2012. Meanwhile, Medscape surveyed 24,000 doctors for its 2012 Physician Compensation Report, finding that the median annual pay of radiologists was $315,000. Salary.com’s data as of September 2014 suggests that radiologists nationwide earn a median salary of $379,323.

All of these figures are well above the median pay of primary care physicians. Earnings increase with experience and vary by location and subspecialty.

Job Outlook

According to the Bureau of Labor Statistics, the job outlook for physicians in general is strong, with growth of 18% expected between 2012 and 2022. This is faster than average growth. Radiologists in particular may find their job prospects better than other physicians as well, due to the needs of an aging U.S. population.

O*Net projects the growth rate of radiology positions to be 15-21% between 2012 and 2022. The American College of Radiologists (ACR) conducted a 2013 survey of radiologists nationwide and concluded that job growth would remain stable and provide jobs for the number of new radiologists projected to look for work through the year 2016 (the extent of their survey). Their study did conclude, however, that while overall growth was projected to be adequate for job candidates, those candidates might need to be flexible in terms of job location and chosen subspecialty within radiology.

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