Radiology is an essential component of the clinical life of a hospital. It involves a range of medical imaging technologies, such as x-ray, ultrasound, and magnetic resonance imaging (MRI). Medical imaging is crucial for doctors to be able to diagnose and monitor a variety of different conditions. This book evaluates how the use of medical imaging has changed the ways in which medicine is theory and practice. I aim to provide information about the development of the specialty of clinical radiology and the ways in which medical imaging is currently being used. I also want to evaluate the impact of the use of medical imaging throughout the process of diagnosis and treatment. So far, when you type the term ‘radiology’ into a Word document, ‘radiologist’ comes up on the spell checker. According to me, this epitomises the lack of understanding outside of the medical world about what radiology actually is. Radiology has historically been a very technology-based medical speciality and has rapidly expanded as new imaging modalities, such as ultrasound, MRI and CT scans. MRI was first developed in the 1940s. However, it has only recently been used as a safe and effective way of imaging the body in the clinical setting. As I will explore throughout this book, developments in medical imaging technology have been essential in driving the advances made in the sub-specialities of radiology. For example, the development of image guided biopsy techniques has enabled interventional radiologists to diagnose conditions such as cancer at their very early stages. The eventual innovators and patients are able to benefit from these. The use of imaging technologies in both conveying and teaching diagnoses to patients has made the communication of medical knowledge – known as ‘medic register’ – much easier.
Table of Contents
1. Education and Training
First and foremost, completing a bachelor’s degree is the most important step in beginning a career as a radiologist. This can be done in any number of fields but some of the most common include anatomy, biology, chemistry, and physics. Not only will a bachelor’s degree teach essential knowledge in these subjects, it will also cover any prerequisites that may be necessary in applying for a medical degree such as anatomy. After four years of undergraduate education, a prospective radiologist must then complete four years of medical school. This covers both book work and clinical experience. According to the Bureau of Labor Statistics, physicians and surgeons such as radiologists must also be licensed. This is done through the United States Medical Licensing Examination once the appropriate education is completed. After licensing, the next step in becoming a radiologist is completing a residency. A residency is a paid position in a specialised field of medicine where a physician works, receives additional training, and further develops specific skills after completing medical school. The length of residency can vary, but for radiologists it is typically six years. After completing a residency, radiologists also have the option of sub-specialising and completing a fellowship. A fellowship is a sort of analogy to a residency in that it is further specialisation in a particular field. These are also paid positions, typically last one to two years, and provide even greater knowledge and experience.
1.1. Obtain a Bachelor’s Degree
In most cases, aspiring radiologists earn a bachelor’s degree before moving on to a medical degree. Students can choose from a range of undergraduate majors; however, they may need to think about concentrating in a science-related field, such as biology or chemistry. These programs typically incorporate classes like organic science, physics, science, and mathematics. Guideline 5. Next: Take the Medical College Admissions Test (MCAT). Students finish their junior year of college are qualified to sit for the Medical College Admissions Test, or MCAT. Exceeding expectations on this test is crucial. Combined with a strong academic performance, a good MCAT score is one of the single most important indicators for admission to medical school. A prospective applicant’s scholastic and extracurricular experiences are something else to take into account when applying to medical school. These can include standout academic performance, as well as volunteer work, leadership and research activities. It is very important for students aspiring to become radiologists to choose a finding your doctor specialized in diagnosing and treating diseases and injuries using medical imaging techniques such as x-rays, computed tomography (CT), magnetic resonance imaging (MRI), nuclear medicine, positron emission tomography (PET) and ultrasound. Every one of these areas of sub-strength requires medical school graduates to finish a five-year residency where they will practice in the area and get particular training in these sorts of imaging. So for example, if you know you are interested in CTs or MRIs, scanning or ultrasound choose select projects and training programs that emphasize that particular specialty.
1.2. Attend Medical School
Once you get your undergraduate degree, you will need to attend medical school in order to become a radiologist. First, you will need to submit an application to the American Medical College Application Service and provide your transcripts, your Medical College Admission Test (MCAT) scores, and letters of recommendation. Personal interviews are also part of the application process. Second, medical school lasts four years. Students take classes on the foundational principles of medicine and typically spend the latter half of the program gaining hands-on experience with patients. Experience in the form of clinical rotations is very important to a student’s education and is usually a big part of the third and fourth years of medical school. You will also need to pass all parts of the United States Medical Licensing Examination at the end of the second year and throughout the third and fourth years. After graduating from medical school, you will need to complete a residency program, which will take four years. Residents “train to practice in a field of medicine…and may focus on patients in a specific age group or for a specific organ system”. Also, experience in the form of new and varied clinical experiences is key to becoming a good radiologist. Because technology is always improving, radiologists must stay up-to-date on the latest methods and instruments for diagnoses and treatments. Therefore, radiologists need to complete 13 years of education and training after graduating from high school.
1.3. Complete a Residency Program
To become a licensed radiologist in the US, you must complete an accredited residency program. In addition to completing licensing exams, certain states may also require you to complete a fellowship program after your residency. By the time you finish your residency, you should be ready to pass both parts of the United States Medical Licensing Exam (USMLE), which is required to become a licensed physician. Your residency training will also give you the experience you need to perform well on this exam. As a medical student in the US, you can start your residency in the field of diagnostic radiology. These programs take four years to complete. If you want to become a radiation oncologist, you can also do your initial training in diagnostic radiology. This training usually takes four years to complete. After completing one of these programs and passing the USMLE, future radiologists can move on to becoming board certified. Residents are trained to practice in all areas of radiology: X-ray, computed tomography, magnetic resonance imaging, and ultrasound. Your experience will encompass these areas. The first year of residency consists of clinical training in a wide variety of areas such as surgery, internal medicine, pediatrics and other sub-specialties. Work as a resident is complemented by frequent lectures, conferences and case review sessions. Residents also benefit from close ties with faculty, abundant research opportunities and access to modern medical equipment and facilities. By the time you are in your second, in depth year of radiology, you will start to feel comfortable interpreting images and using the different forms of radiological technology. However, continuous faculty close supervision means that you can always confer with an experienced radiologist if required. Over the three years of residency, the level of responsibility increases. Residents learn not just about the different radiology subspecialties, but also about quality control, administration of imaging departments and compliance with regulations. Residents will also work through a range of body systems such as chest, abdomen and pelvis, musculoskeletal and so on, to gain a comprehensive knowledge of the precision and the anatomical detail required. By the time of completion, you should be able to qualify for board certification in radiology. Board certification is normally an entry requirement to the vast majority of radiologist positions in the US.
2. Licensing and Certification
After graduation from medical school, the graduate must complete a one-year medical or surgical internship. Training and coursework in radiologic technology must be completed and documented as well. Upon completion of the educational and medical requirements, applicants must attain and then pass a comprehensive exam specific to diagnostic radiology. This could be the United States Medical Licensing Examination (USMLE), the Comprehensive Osteopathic Medical Licensing Examination (COMLEX), or a similar state examination or board certification. Such examinations are recognized and accepted by the American Board of Medical Specialties. Students must apply for and take the first of the three steps of a medical licensing exam, typically after the second year of medical school. After they pass this part of the exam, students become eligible to apply for a student-in-training permit and can begin clinical clerkship. The second and third steps of the examination are usually taken during the first two years of residency; residents must pass the exam in order to obtain a full medical license. Residents are appointed to their program as full physician members of the faculty and are required to get an official Medical Doctor (M.D.) or Doctor of Osteopathy (D.O.) license in the state where they are doing their training. Every state requires physicians to be licensed, and the usual method to do so is to graduate from an accredited medical school, complete graduate medical education, and pass the licensing exam. After obtaining a license, those wishing to practice radiology must generally also become certified by the American Board of Radiology (ABR). Certifications from other boards may be accepted, but each state has a different set of requirements. There are several steps to becoming board certified in diagnostic radiology but the first step is to complete the full ACGME approved residency in diagnostic radiology. Residency lasts for four years and is a time of medical training—and of education, patient care and research—during which a licensed physician studies a chosen field of medical specialty. Residency has a heavy emphasis on direct patient care and this is where one begins to bridge the gap between textbook learning and real-life experiences in the practice of radiology.
2.1. Obtain Medical License
All physicians are required to complete and pass the United States Medical Licensing Examination, also known as the USMLE. The USMLE is broken up into three steps. Both Step 1 and Step 2 of the USMLE are available to take before you graduate from medical school. Step 3 of the USMLE can only be taken after a doctor graduates from medical school. Also, it is mandatory for physicians to complete all three steps of the USMLE to obtain their medical license. It is advised to complete Step 1 of the USMLE after the second year in medical school, or after successfully passing the Anatomy course of medical school, to assure that the bases of medicine is well understood and can be applied when taking the test. Also, after passing Step 1 of the USMLE, you can then take Step 2 of the USMLE. Step 2 of the USMLE has two parts: Clinical Knowledge (CK) which is a multiple-choice examination and Clinical Skills (CS) which helps test your ability to gather information from patients, perform physical examinations, and communicate findings to patients and how to apply scientific and medical principles to a diagnosis and treatment. All steps of the USMLE must be completed within seven years from the date when the candidate first passed any step. Culturally competent and patient-centered care is one of the main goals in modern medicine and CS helps to reflect the establishment of such practice. After completing and passing all of the steps of the USMLE and obtaining a medical license, the journey of becoming a new physician continues with the next step, which is to apply for a residency program.
2.2. Pass the USMLE
The United States Medical Licensing Examination (USMLE) is a three-step examination for medical licensure in the United States and is sponsored by the Federation of State Medical Boards and the National Board of Medical Examiners. If you’re an aspiring radiologist in the United States, you will need to write and pass all three steps of the USMLE. The USMLE is a significant milestone in the professional life of any doctor, and although the process of preparing for and taking the exam may seem daunting, the reality is that with effective preparation and a systematic approach, success is very achievable. However, passing the exam will require extensive study and revising the basic and social concepts of medicine. The USMLE isn’t just multiple-choice questions; it’s a comprehensive examination of the examinees’ knowledge of different relevant areas. Therefore, before you can start sitting the USMLE tests, you must have an ECFMG certification and for you to start preparing for the steps and eventually sit and pass them all, you will need to diligently work through your medical education.
Specialization
There are a number of possible areas within radiology where a practitioner might choose to specialize, and the kind of option that you would have would depend on where you were located but would also to some degree be influenced by the kind of technology that you would enjoy working with and the type of people or medical cases that you would prefer to work on. Cancer, which is a very wide-ranging medical area to work in, can be split up into a number of different specializations within the field of radiology. These might include finding out about the early diagnosis and the treatment of cancer, which is often something that is explored under the wing of pathology. If doctors are learning about the breaking down and the spreading of cancer, then this is classified as a specialization within the world of oncology, and therefore doctors who specialize in that will learn how to read and interpret radiological images of patients who have cancer in the body. Neuroradiology is another example of a kind of specialty within the field of radiology. This area involves the study of the diagnosis of brain and spine conditions by using different pieces of technology. The type of work that someone who specializes in neuroradiology might take up could involve anything from doing regular daily clinic work to researching new and innovative modes of treatment. Students will focus on the fundamentals and physics of relevant imaging techniques, such as MRI and CT scans, from an early stage in their training to become a radiologist, so it is likely that those who want to work in the field of neuroradiology will make sure that they become experts in these kinds of techniques. Last but not least, there is the option of studying for a specialization in diagnostic radiology, or radiodiagnosis. This specialization is considered to be more for those who are interested in the practical side of work and in using imaging technology in a more hands-on kind of way; students on this particular training program will learn how to become efficient in performing and reporting on the various different types of diagnostic imaging procedures that are used in hospitals and clinical settings. This type of specialization is attractive to many because it can lead to a variety of job prospects and opportunities for further training because diagnostic radiologists are always needed and the field is constantly expanding with new research and new technology that is being developed.
Choose a Radiology Subspecialty
Once you become a licensed radiologist, you can pursue different practice opportunities. An attractive aspect of radiology is that it is highly specialized, and you can choose a subspecialty that is of the greatest interest to you. In order to gain admission to a radiology subspecialty fellowship program, you will have to compete with other students who have also completed their first year of general medical residency. Some factors that could help you choose which subspecialty to go into include the type of work that you would like to do, the patient population that you would like to serve, and the expected salary that you would like to earn. Most subspecialties tend to focus not only on the anatomy of the different body systems, but also the physiology and the way that these organs and body systems interact. For example, a neuroradiologist studies abnormalities of the brain, spine and head and neck using different imaging modalities. On the other hand, a musculoskeletal radiologist studies the various pathologies and injuries that affect the bones, joints and soft tissues of the body, and the relevant procedures in which images are used to help guide such treatments. Diagnostic radiologists are doctors that specialize in diagnosing medical and health conditions through the use of imaging techniques. On the other hand, a therapeutic radiologist, commonly known as a radiation oncologist, is responsible for planning and administering treatments that seek to manage or cure cancers and other benign conditions by using radiation.
3.2. Complete Fellowship Training
Once you have finished your residency, your fellowship training will enable you to concentrate on a particular area of radiology. You can expect to undertake up to 18 months of further training in areas such as chest and cardiac imaging, nuclear medicine, neuroradiology or interventional radiology. This part of your training is an exciting opportunity to develop new skills and focus on an area that particularly interests you, where you can expand your knowledge and really become an expert in your chosen field. You will also start to get involved with more complex cases and procedures, which can be very rewarding. As with the residency, during your fellowship an educational program has to be implemented and continued, and there will always be new methods, techniques and developments to learn about and to incorporate into your practice. At the end of your training period, it is usual to be awarded with a certificate evidencing your successful fellowship. Well done – you are nearly there! After completing both your residency and your fellowship, the next step (finally) is undertaking the exams to become board-certified.
3.3. Obtain Board Certification
Obtaining board certification in radiology is highly recommended. Certification is offered by the American Board of Radiology. To become board certified, you have to first pass the Core Exam which can be taken after 36 months of diagnostic radiology. However you might want to consider taking the exam after 24 months just in case you don’t pass. As of 2020, the first exam is offered in the late spring/early summer, usually around the beginning of June. After passing the Core Exam, you have to pass another exam given by the American Board of Radiology in a form of an online, long-hour examination known as Radiology Certifying Exam which is offered once every year. Secondly, it is also necessary to obtain a medical license in the state which you would practice radiology. Specific requirements for licenses vary by state but all states require that candidates graduate from an accredited medical school and complete U.S. Medical Licensing Examination (USMLE). Furthermore, candidates must have completed one year of standard internship. Internship generally means that a freshly graduated medical student works in a hospital under a supervising doctor’s care to gain more experience. After completion of USMLE and internship, candidates can further apply for the medical license. The final step towards board certification is to obtain hospital privileges which allow doctors to admit and treat patients in a particular hospital. In order to obtain privileges, you must first pass required credentialing and background checks, and sometimes go through interviews and paperwork. This process varies in length but may take a few months. Once you become board certified and obtain both the medical license and hospital privileges, you can start working as a licensed radiologist. Board certification is not mandatory to practice radiology but it is certainly recommended. Board certified radiologists usually enjoy better employment opportunities due to their credential. Also, board certification allows medical professionals to build a high level of confidence from the public.
