Most medical students have relatively little exposure to radiology until they’re completing med school clinical rotations during their third and fourth years. It’s not until this point that they may realize the field entails more than just sitting in a dark room.
So what do radiologists do aside from analyzing x-rays? What do radiologists do?
Radiologists are consultants to clinical colleagues, sometimes referred to as a “doctor’s doctor,” and are experts in using medical imaging technologies such as x-ray, ultrasound, computed tomography, and magnetic resonance imaging and uniquely trained at interpreting the results. They can even perform such interpretation remotely, helping to fuel the recent growth in telehealth. In many cases, radiologists are able to provide a concrete diagnosis to a clinical question and recommend next steps such as additional tests or treatments.
“Until there is a final report by a board-certified radiologist, not a single thing gets done—surgery, starting someone on medication, beginning chemotherapy, and so on,” explains Dr. George Bolotin, a St. George’s University (SGU) graduate and director of interventional radiology at Wyckoff Heights Medical Center. “Radiologists play a crucial role.”
What are some radiology specialties and subspecialties?
The American Board of Radiology (ABR) awards certification in four primary areas. These include medical physics (a nonphysician role) and radiation oncology, but there are really two primary radiology specialties:
Diagnostic radiology: Physicians who practice this type of radiology leverage imaging like x-rays, ultrasound, and electromagnetic radiation to diagnose and treat diseases. Diagnostic radiologists often detect problems early on by interpreting results and correlating their findings with clinical information and other relevant tests.
Interventional radiology: These radiologists similarly leverage imaging, but they’re also experts in performing image-guided, minimally invasive procedures, such as embolization, angioplasty, and stent placement. “You get extra training in a completely different clinical sense because you're performing procedures,” Dr. Bolotin explains. He adds that interventional radiologists are truly responsible for overseeing the patient’s care from first visit in the clinic all the way through providing postoperative care, something today’s integrated interventional residency programs emphasize. Dr. Bolotin also notes the field really began to branch out from diagnostic radiology when Dr. Charles Dotter pioneered a number of techniques in the 1950s and 1960s.
There are also many radiology subspecialties that require fellowship training. These subspecialties include:
- Abdominal/body imaging
- Breast imaging
- Cardiovascular radiology
- Chest imaging
- Emergency radiology
- Musculoskeletal radiology
- Nuclear radiology
- Oncologic imaging
- Pain medicine
- Pediatric radiology
- Vascular and interventional radiology
In addition, some fellowship training offers expertise in a particular modality such as a fellowship in MRI with training in multiple subspecialties listed above (i.e., body, musculoskeletal, and neuro). According to Dr. Bolotin, pursuing a subspecialty is often the best choice for radiologists today given how much imaging has advanced over time. He says that fellowship experience truly matters to employers.
What are some common radiologist duties?
Because there are so many options for specializing, there’s no universal radiologist job description. That said, there are a number of responsibilities that are typical for most physicians in this field. According to the Fellowship and Residency Electronic Interactive Database (FREIDA) from the American Medical Association (AMA), both interventional radiologists and diagnostic radiologists are responsible for the following:
- Interpreting x-rays and plain film
- Reading MRIs
- Performing diagnostic and therapeutic procedures using catheters
- Interpreting CT scans
- Providing diagnoses to referring physicians
- Training radiologic technologists on how to perform procedures
What are the most important skills for radiologists?
Good radiologists need an extensive knowledge base as well as skills like time management, critical thinking, and complex problem-solving. Dr. Bolotin notes it’s also important to be able to recall an extensive amount of information.
“I think what attracted me to radiology is the fact that you have to retain pretty much all your knowledge from medical school,” he explains. “You have to be aware of all organ systems, and you need to be able to recognize the pathology of anything from the toe all the way to the brain.”
While having an innate knack for interpreting imaging is also useful, it’s something that can be developed over time through residency training.
“I think that comes with experience,” Dr. Bolotin explains. “There's a certain threshold you hit during your first or second year into the residency when you really start to get it. Before then, you’re still learning and just trying to determine what ‘normal’ is.”
How do you become a radiologist?
Aspiring radiologists need to attend a four-year program to obtain a medical degree. The first two years focus on building a foundation in the basic sciences through lectures and labs. The final two years of medical school will entail beginning the three-part United States Medical Licensing Examination (USMLE) series and gaining applicable experience through clinical rotations, which can help you learn more about radiology.
“I would encourage you to do a rotation in radiology to see if it’s for you,” Dr. Bolotin suggests, adding that it’s often a good field for those who aren’t as focused on spending a substantial amount of time working directly with patients.
Students will then need to apply for residency positions and complete their postgraduate training. For radiology residents, this entails a preliminary surgical, medical, or transitional intern year. They’ll then focus on radiology (or radiation oncology) for four years. Upon completing residency, radiologists are able to obtain board certification. They can also pursue additional fellowship training to further specialize.
Ready yourself for a career in radiology
What do radiologists do aside from reading x-ray after x-ray? There’s a lot of variety, so radiology can be a great choice for those who really want to shape their careers. To pursue this technologically advanced specialty, you first need to gain acceptance to and attend medical school.
Make sure you’re prepared for the admissions process by reading “8 Questions You Should Be Asking the Medical School Admissions Team.”
Find out if medical school is right for you.Learn More