Entering radiologyBMJ 2010; 341 doi: https://doi.org/10.1136/bmj.c5235 (Published 29 September 2010) Cite this as: BMJ 2010;341:c5235
- Marianna Thomas, specialty trainee year 4 in radiology
Marianna Thomas gives her take on getting into specialty training in radiology straight from the foundation programme
Radiology is one of the most competitive specialties at specialty trainee (ST) 1 level, with 18 applicants per post. Entry to training has traditionally followed completion of postgraduate medical or surgical examinations. After the introduction of Modernising Medical Careers, however, a small but rising number of individuals have successfully applied directly from the two year foundation programme.
Applying for run-through training
Entering your specialty of choice directly from the foundation programme carries a number of challenges. Limited clinical exposure and lack of postgraduate exam membership may count against you at the shortlisting phase and in the day to day job. The short postgraduate period means less time to embellish your curriculum vitae compared with more senior candidates. Successful application requires a planned targeted approach to address these issues.
How to get shortlisted for interview
Try to think ahead—emergency medicine and intensive care medicine are acute cross specialty disciplines, so experience in either of these specialties will stand you in good stead when you are on call. Try to include these in foundation year 2 job choices.
Find ways to demonstrate commitment to the specialty, such as radiology based audit, research, and publications. Taster weeks provide an excellent opportunity to see the workings of your local department first hand. Attending radiology courses—for example, emergency radiograph interpretation and chest x ray courses—will enhance your clinical practice and demonstrate your interest in the subject. The Society of Radiologists in Training provides an opportunity for non-radiologists to attend and present audit and research. Don’t be afraid to talk to your local radiology department about getting involved with ongoing audits and research.
Points are awarded at shortlisting for postgraduate clinical examinations, even part 1 of the membership of the Royal College of Surgeons (MRCS) or membership of the Royal College of Physicians (MRCP) exams. Having taken these examinations might lead to questions about your commitment to radiology in an interview situation, although most training programmes will appreciate evidence of additional clinical knowledge. Nevertheless, the anatomy component of the MRCS examination will be invaluable for the part 1 fellowship of the Royal College of Radiologists exam, and solid medical knowledge is particularly helpful for part 2a. Either way, you will need to make up ground when starting in radiology so it is important to pick which area you are most interested in, and also consider the fallback options if you do not make it into radiology training at this stage.
There is increasing emphasis on interventional radiology, which has recently been formally approved as a subspecialty. Competency at basic procedures such as chest drain insertion will set you apart from other applicants. Look for local practical procedure training courses and keep a record of the number and details of your cases. Advanced life support is an important part of any medical job, and management of anaphylactic reactions to intravenous contrast is particularly relevant in radiology.
Finally, try to address in your application all points on the person specification, which is freely available from the Modernising Medical Careers website.
How to impress at interview
Addressing the above points will give you a great head start. It is crucial, however, to do your homework about the career structure, exam format, and current issues in radiology. The websites of the Royal College of Radiologists and the Society of Radiologists in Training, and the relevant doctors.net forum, will equip you with most of the information you will need.
Objective structured clinical examination stations are increasingly common at interview (for example, role play encounters with clinicians and patients; basic x ray interpretation; and management of emergencies). Try to think up likely scenarios and consider how you would approach these.
Interview practice is crucial—ask a senior colleague or radiologist for feedback. On the day, arrive early and dress smartly. If you have not already looked around the department, there may now be an opportunity to do so.
And if it all falls through?
Be prepared to accept other clinical posts before entering radiology if you are unsuccessful at the first attempt. This provides an opportunity to complete postgraduate exams in other specialties, and also enables a short time out of training between shortlisting the following year and the start of radiology specialty training, if desired.
Starting run-through training
The first few months of training represent a steep learning curve and are not representative of the five year programme. You will quickly need to build up your knowledge of physics and anatomy for the part 1 exam and spend time observing and learning techniques. This may feel restrictive at first but improves dramatically through the first year.
Be keen and look for opportunities to learn. Read up on cases, make full use of study leave for plain film interpretation courses, and attend regular teaching sessions.
Competing interests: None declared.