Well before they finish their training program, residents must decide on whether to proceed directly into private practice or add to their formal training through a fellowship and choose a career path afterwards. At this time, it is no secret that private-practice radiology jobs are plentiful, starting salaries are high, and years to partnership are low or non-existent.
Dr. Mirvis is the Editor-in-Chief of this journal and a
Professor of Radiology in the Diagnostic Imaging Department,
University of Maryland Medical Center, Baltimore, MD.
Well before they finish their training program, residents must
decide on whether to proceed directly into private practice or add
to their formal training through a fellowship and choose a career
path afterwards. At this time, it is no secret that
private-practice radiology jobs are plentiful, starting salaries
are high, and years to partnership are low or non-existent. This is
an ideal circumstance for radiologists just starting out. It is a
difficult time for private practices that are forced to compete
aggressively for new members and it is murder on the financially
less competitive academic radiology community.
A relatively small percentage of radiologists choose to start
their careers in academics, with the majority opting instead for
private-practice "big bucks," among other incentives. In many
academic radiology centers, one sees steadily increasing workloads,
more limited research and teaching time, fewer opportunities to
interact intellectually with fellow faculty, and decreasing time
for nonprofessional life. A lot of creativity and forbearance will
be required to navigate the current (perhaps quite lengthy)
manpower shortage. Seeing so many residents, and occasionally
colleagues, jump to private practice, I have reflected upon some of
the reasons I selected an academic career (although ambivalently at
the outset) as well as upon comments from conversations with past
and current faculty associates.
Teaching can be great fun. Good-quality research is difficult
but very satisfying when successful and acknowledged. Working with
equipment vendors is interesting and can enhance the creation or
direct improvement of imaging devices or methods. Traveling to
lecture is usually an outstanding personal growth experience.
Mentoring and assisting a less "seasoned" junior associate to
develop his or her career is as, or more, satisfying than coveting
one's own successes. Working collaboratively with colleagues near
and far and developing long-standing relationships is a source of
daily pleasure. Writing and researching and learning more about
your specialty maintains and enhances your practice abilities. Many
of these qualities can be found in private practice to varying
degrees, and some will be tough to obtain in a given academic
environment.
In our department, we encourage our residents and fellows to
participate at some level in the academic experience: develop
research ideas; write papers, case reports, or current reviews; or
make a major meeting presentation. It is important that residents
experience some aspects of an academic career directly before
choosing their path. These comments are not meant to ultimately
recommend one course over another. This is a very personal
decision, occurring in a relatively turbulent medical care
environment. The lines of distinction between the private and
academic world are becoming blurred in some settings. However, the
bottom line is that the next generation of radiology researchers
and teachers will come from among our current residents and
fellows. Will there be a sufficient quantity of sufficient quality
to do the job? Only time will tell. What we can do now in our
training programs is to make sure we give our residents a solid
opportunity to see what is behind the academic curtain (both
positive and negative). We should give them a chance to see if they
just might like it.
As a partial incentive toward this goal,
Applied Radiology
will henceforth sponsor an annual resident article writing contest.
Our editorial board will review articles that are submitted by
resident authors. Official journal recognition and a financial
reward will be offered for the three highest ranked submissions,
which will subsequently appear in the journal. Details are found in
this issue (page 33). The long-term strength of the specialty of
diagnostic imaging is directly related to the quality and vigor of
its academic arm.