Tuesday, January 1, 2019

Why Radiology is an Outstanding Specialty for Women: Perspectives from a Former Surgical Resident

There has been tremendous, laudable efforts about radiology women leaders to increase diversity in Radiology. The effort is in part due to increasing women representation but I argue for the betterment of the society and patient care because diversity in groups brings new insights and innovation which are necessary for adaptation and improvement. Recent RadioGraphics article by Spalluto et al on "Addressing Needs of Women Radiologists: Opportunities for Practice Leaders to Facilitate Change" and invited commentary by Dr. Canon became an impetus for this blog. Dr Canon writes

“Given my expertise in this area,” I have been asked to provide commentary on the article, “Other than being a woman, I have no expertise here and, in fact, have failed miserably in moving the needle for women in radiology. I am in good company, and Spalluto et al are challenging us with a call to arms. Why? Because despite the ample literature assessing the lack of gender diversity in radiology, the countless plenary session discussions, and the formation of national organizational task forces, the number of women in our field has not changed. “Women are, and have always been, underrepresented in radiology”. This is a powerful absolute."

I empathized with this statement because although I've listened, heard and supported these efforts, I've done little to contribute to "moving the needle for women in radiology". The following chart from Spatullo et al article is a telling story of the representation of women. Even though equal number of women and men graduate medical school, there are diminishing numbers as the ladder rises up to the C-suite. This is partially time-related because most of the leaders are Baby Boomers (the youngest Baby Boomers are now in their mid-50's) and the Gen X are transitioning to the leadership positions. Despite that, there are invisible forces including subconscious/implicit bias which make it harder for women to rise.

"Trend of diminishing numbers of women in radiology with advancing academic status. Left to right: Pictographs show the percentages of women medical students, women radiology residency applicants, women radiology residents, women practicing radiologists, and women radiology leaders." Spatullo et al.

My goal is to give my perspective on why Radiology is a great sub-specialty for men and women:
  • People: I love all the radiologists I trained under and radiology colleagues I work with. Radiologists are humble and intelligent individuals. As a former surgical resident, the M&M for surgery felt so punitive. We all make mistakes. In radiology, people understand that and there is a culture of humility which is less apparent in the surgical field.
  • Control and flexibility: As a diagnostic radiologist (not IR), you have control over your schedule and have flexibility. When I was a surgical resident, I felt the majority of my time was low-yield. I was following up orders, exams, etc; maybe about 20% of my time was doing doctor activities (consultations, clinic, cases). In radiology, 80% of the time is spent doing high-level work. You are independent and can dictate your own pace.
  • Cerebral: Most of the radiology depends on knowledge, which is entirely up to the individual. You are not dependent on exposure or seeing specific cases to learn the information. So, how good you are is entirely up to you and your willingness to train your eyes, master pattern recognition and develop your fund of knowledge. There are constantly new developments so it's great to constantly learn information that is immediately applicable to your practice. I love it. 
  • Technology-driven: Radiology was founded by the discovery of X-rays and continues to be driven by technological developments. It's the most rapidly evolving specialty in medicine. Thus, the efficiency and effectiveness of radiologists evolve with tech advancements. The image quality and our work processes are incredibly optimized. The tech aspect allows me to take call from home which is helpful for my personal needs. Some of my colleagues work entirely from home which is a unique opportunity for doctors.

  • With increasing volume, there is more pressure to read faster and more studies. This is an increasing problem in radiology primarily due to information overload from all the images we now generate (from 50-100 images a decade ago to now >300-500 images per CT/MR). But with AI and machine learning, hopefully, we'll be able to bridge the gap with image interpretation, workflow dynamics and many others by increasing accuracy, improving efficiency and access to care.
  • Radiology is a competitive specialty. But, don't be discouraged if your scores are not 95%tile. With careful planning and effective strategy, most dedicated students can match into the specialty. 
Do you have a question? Feel free to email me or submit your question below.

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