Becoming a Radiologist Careers & Salary Outlook

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What is a Radiologist?

A radiologist is a medical doctor who interprets the results of medical imaging tests performed in a clinic or hospital by a radiological technician. For example, a radiologist will interpret the test results of an X-ray scan. After looking at the results of the imaging tests, the radiologist will inform the primary caregiver what would be the best treatment plan. Also, within this field are radiologists who utilize radiation in order to treat diseases like cancer.

Radiologists are licensed medical doctors that have gone through medical school. They do sometimes specialize in a certain field of radiology, such as breast radiology, emergency radiology, or cardiovascular radiology. Medical imaging results that radiologists interpret include X-rays, fluoroscopy, MRIs, ultrasound, computerized tomography, PET scans, and nuclear imaging.

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Steps to Take to Become a Licensed Radiologist

To become a radiologist, you will need a medical degree in order to practice in the field. Thus, the educational path to a radiology career begins with a bachelor's degree in radiology. Then, the student will need to attend medical school, followed by a medical residency in order to apply the skills the student has learned. There may be an optional fellowship to pursue medical specialties in radiology. The entire training path to full licensure and become a radiologist takes 13 to 15 years after high school graduation and includes medical school.

  • Step 1: Earn a Bachelor’s Degree

  • Step 2: Medical School

  • Step 3: Internship and Residency

  • Step 4: Fellowship

  • Step 5: Licensure and Certifications

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Step 1: Earn a Bachelor's Degree

Students who are pursuing a path to an M.D. will first need to earn their bachelor's degree. They need to take the courses that will be prerequisites for medical school, such as physics, biology, general and organic chemistry, and English. It is a good idea for the undergraduate student to obtain part-time employment or volunteer work in the medical field in order to gain some experience.

Students who plan on attending medical school must take the Medical College Admissions Test, or MCAT, in their undergraduate years. Applying to different medical schools actually begins in the junior year of one's bachelor's program. Students apply to schools, armed with great letters of recommendation that they hopefully received from work in the medical field while attending college, and are interviewed by the prospective schools. Besides great letters of recommendation, students need to have a high GPA and MCAT scores that are above average.

The American Association of Medical Colleges is a great source of information for students who will be attending medical school.

The biggest decision that a student must make during their undergraduate years is what type of medical school they would like to attend. There are two different types. Either one will lead to licensure in radiology. One type of medical school is allopathic. Allopathic medical schools train future doctors to use medications and surgery to treat medical conditions. Osteopathic medical schools teach future physicians to help patients prevent diseases and illnesses through a more holistic philosophy.

Step 2: Medical School

Radiologists must have an M.D. degree. Medical school will take four years. The first two years will be in the classroom, learning pathology, pathophysiology, anatomy, pharmacology, embryology, human behavior, and biochemistry. In anatomy class, students will be working hands-on with human cadavers.

After the classroom portion of medical school, the student will begin the second half of their program, called “clinical rotations.” In this portion of medical school, the student is working in all of the different parts of the medical field, so they will be doing hands-on work under experienced doctors in all of the sub-fields of medicine such as surgery, internal medicine, osteopathy, and pediatrics. They will be working both in hospitals and in clinics and with in- and out-patients.

There is a large, national examination that all medical students must pass in order to complete the program and receive their M.D. degree. It is called the United States Medical Licensing Examination, or USMLE. If one intends to go into a radiology career, one must get an above-average score on the USMLE.

Also, because internships and residencies, which are the next step in full licensure, are so competitive (as is the entire field of radiology) the aspiring radiologist must stay near the top of his or her medical schools class and get good recommendations from the experienced doctors they work with during clinical rotations.

Step 3: Internship and Residency

At this point, the student has their M.D., but they cannot fully practice medicine. They are in the next four-year phase of their training. The next full year of education is called an internship. This part of their education is paid. The new doctor will work in either surgery or general medicine. They will work with patients in emergency rooms as well as in hospitals and clinics in order to get a well-rounded, general training as a new physician.

After the first year of their residency, the interns are able to begin to work in radiology. Besides receiving more training, the interns will interpret medical imaging tests, speak with patients, provide diagnoses, and create treatment plans. The resident will move between classroom time and clinical practice time throughout each day. Residents will often need to be available nights and weekends as well.

Then, the residents must take more examinations to demonstrate their thorough understanding of radiology.

Step 4: Fellowship

Most radiologists do not end their training after their four-year residency program. They continue into a fellowship program that allows them to receive training in a sub-field of radiology. These fellowship programs work quite a bit like residencies, with lectures and training to attend, as well as hands-on work using the information they are learning with patients. Fellowship programs tend to last for a year or two. About 90% of all radiologists do at least one fellowship program. Some do two programs.

Step 5: Licensure and Certifications

At this point, the radiologist will be able to receive full state licensure to practice in their field. Most radiologists will also opt to take radiology board certification exams because most employers will require their radiologists to be board certified.

Board-certified radiologists need their M.D. and state licensure. They need to have completed their residency, and will need to pass the board's exams, which are both written and oral. Once the radiologist has their initial radiology careers certification and has completed a fellowship, they can pass an additional exam in order to receive certification in specialties within the radiological field.

There are two radiological certification boards in the U.S., the American Board of Radiology and the American Osteopathic Board of Radiology.

What Does a Radiologist Do?

Radiologists interpret the results of medical imaging tests. They have to create plans for treatment of the patient based upon the results of the tests. They will explain their findings to other doctors, family members, and/or patients. They are responsible for writing reports about test results and treatment plans and explaining to patients their proposed treatment plan and alternatives in order to obtain approval from the patient.

Radiologists usually are in a supervisory capacity over radiological technicians and other medical assistants who perform the imaging tests. As in any profession, radiologists are responsible for receiving continuing education in their field. They can work in a clinic or a hospital. Radiologists who work in hospitals tend to work any shift, while those in clinics usually work a day shift.

Today, many radiologists are able to transmit their imaging results easily to other caregivers, even around the world, so there is a trend toward radiologists having less patient contact than other types of doctors.

Skills to Acquire

Because of the degree of difficulty in your work, you’ll need to have several specialized skills. Some you may already have, so they just need further development. You will learn other skills in your electrical engineering classes.

  • Academic excellence – Radiology is a highly competitive field. Those who are able to garner the coveted radiological residencies are those who have the very top grades in their medical school class, top scores on their medical school exam, the best letters of recommendation, and some good experience in radiology. Without the all-important skill of academic excellence along with high motivation, the student will not be able to survive through each of the steps to achieve this career path.
  • Detail-oriented – The issues in this field can be life or death for the patient. A radiologist must be able to focus and not miss any detail in the imaging results.
  • A thorough understanding of human anatomy.
  • A thorough understanding of the wide array of medical imaging devices, their use, and how to interpret their results.
  • A thorough understanding of medical diagnosis and treatment procedures and plans.
  • A highly analytical mind.
  • Teamwork – From clinical rotations, residencies, to practice, the prospective radiologist must always be able to work on teams of other doctors in a positive manner that supports the patient's progress.
  • Great communication skills with other doctors and patients.
  • The ability to stay abreast of the latest new information in the field.

Alternative Paths

Not all radiologists in the U.S. follow the path through an American medical school in order to become a radiologist in this country. According to the American Board of Radiology, one path to certification is open to radiologists from other countries. Candidates must demonstrate to the board of radiology that they have received equivalent training in their own country and are licensed to be a radiologist there.

Another alternative path to a career in radiology is only open for those candidates who seek to obtain certification in diagnostic radiology. This path allows the candidate to simultaneously train in diagnostic radiology and conduct research. This path still requires the candidate to receive their M.D., but it reduces the time to receive a diagnostic radiological certification down to four years from five. This path was created because there is a shortage of radiologists in the research arena.

The final alternative pathway to a career in radiology is for those doctors who complete their residencies in osteopathic hospitals in the U.S. and Canada. There is no shortening of time in program completion. It is simply a means of allowing doctors trained in osteopathic methods to receive the same certification as allopathic-trained doctors.

Radiologist Career & Salary

Where Might You Work?

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Some radiologists work in hospitals or clinics. Others work in private firms that supply radiological services to hospitals and clinics. In the past, there were radiologists who were partners in radiological firms, but this practice is becoming rare because new radiologists to the field often do not like the idea of having to fund the cost of the radiological firm. New radiologists prefer employment. There are also radiologists engaged in research and in teaching.

Radiologists might work in a small, rural town and be the only game in town, commanding a larger salary, or they might be a specialist who works in an urban or suburban area.

According to Modern Medicine Network, there is a trend for hospitals and clinics in rural areas to prefer to hire radiologists who are willing to make a five or more year commitment to stay in the area. For this reason, such rural facilities are more likely to hire a radiologist who is more experienced. The belief is that an experienced radiologist will know what they want, so they will more likely stay in the area. New radiologists tend to have specialty certifications and work in metropolitan areas.

Potential Career Paths

There are many different sub-fields of radiology, so there are a variety of different career paths a radiologist may choose. This will depend upon what type of specialization the radiologist pursued in their fellowship. With more training and education, though, an experienced radiologist can break into other specializations and career paths.

Breast Imaging Radiology
This includes reading and diagnosing mammograms, breast ultrasounds, biopsies, and breast MRIs.

Cardiovascular Radiology
Medical imaging and diagnosing heart, vascular, or circulatory issues using x-ray, CT, ultrasound, and MRI scanning procedures.

Chest Radiology
X-ray, CT, ultrasound, and MRI imaging and diagnosis of heart and lung diseases and other issues.

Emergency Radiology
X-ray, CT, ultrasound, and MRI imaging and diagnosis of emergency conditions that may be traumatic injuries.

Gastrointestinal Radiology
Fluoroscopy, x-ray, CT, ultrasound, MRI, and gastrointestinal imaging and diagnosis of problems in the gastrointestinal and digestive tract.

Genitourinary Radiology
X-rays, CT, MRI, biopsy, kidney stone and uterine stone removal medical imaging and diagnosis.

Head and Neck Radiology
X-rays, CT, ultrasound, and MRI medical imaging and diagnosis of diseases that afflict the head and neck.

Interventional Radiology
X-rays, fluoroscopy, CT, ultrasound, and MRI imaging and diagnosis of interventional medical techniques, such as angioplasty and stenting, biopsies, removal of uterine fibroid tumors, and draining of excess fluids and abscesses.

Musculoskeletal Radiology
X-ray, CT, ultrasound, and MRI medical imaging and diagnosis of problems affecting the muscles and skeletal system.

Neuroradiology
X-rays, CT, ultrasound, and MRI imaging and diagnosis of problems afflicting the brain and nervous system.

Nuclear Radiology
Gamma imaging, PET, and PET/CT to diagnose and treat patients by using small amounts of radioactive substances. Treatment of thyroid cancer and hyperactive thyroid conditions are part of this specialty radiology practice.

Pediatric Radiology
X-rays, CT, ultrasound, MRI, and fluoroscopy imaging and biopsy, or drainage of excess fluid on tissues in diseases afflicting children.

Radiation Oncology
This sub-field within the radiology practice actually uses radiation from x-rays or radiation that is placed or injected in the body in order to treat cancer.

Radiologist Career Salaries

Occupation Entry-Level Mid-Career Late-Career
Radiologists $99,000 $313,000 $462,000
Radiologic Technologists $40,000 $54,000 $77,000
Radiation Therapists $53,000 $74,000 $99,000
Diagnostic Medical Sonographers $40,000 $62,000 $96,000
Magnetic Resonance Imaging Technologists $50,000 $69,000 $95,000
Cardiovascular Technologists and Technicians $40,000 $60,000 $82,000
Nuclear Medicine Technologists $55,000 $70,000 $92,000

**Salary info provided by PayScale

Career Outlook

According to the ModernMedicine Network, newly licensed and certified radiologists prior to 2015 were forced to complete a fellowship in a specialization, since there were few new jobs being created in the field. That has changed in the last few years due to the rise of a new type of work for radiologists called “teleradiology.”

Teleradiology is where the medical imaging test result is transmitted electronically to a radiologist in another location for diagnosis and prescription of treatment plan. This helps rural areas that may only have one radiologist in the community get coverage 24/7 from a teleradiology firm located in a metropolitan area with both general and specialist radiologists available. Such radiologists at teleradiology firms may not be salaried employees, instead being paid per reading and diagnosis, although more teleradiology firms are providing salaries for their radiologists as of 2017. Teleradiology has created more work for newly licensed radiologists.

There is still more demand for general practitioners than there are for radiologists, but more job opportunities are being created in the field. The ModernMedicine Network states that there is a 14% greater demand for radiologists and that radiologists are now the 10th most requested specialty physician category. Regardless, radiology remains a highly competitive job market.

Pay in the field was declining before 2015, but that trend has reversed course. The average yearly income for a general radiologist is now around $297,000.

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Advancing From Here

Radiologists can advance as they obtain more training. Radiological specialists can earn higher salaries. Also, some radiologists choose to go into the research field after being in practice for a time, while other radiologists, who are experienced and at the top of their field, may choose to go into education or become healthcare administrators. In some cases, specialization and more expertise can help a radiologist move from the hospital setting to better pay and a day shift in a clinic or radiology provider firm.

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