How to become a radiologist

If you are interested in being a radiologist, here are things you can do while in high school:

• Take advanced science classes in anatomy, biology, chemistry, physiology, and physics
• Take math classes to facilitate the calculation the reading of graphs
• Study Latin to help you understand unfamiliar medical terms that often have Latin roots
• Study a foreign language to increase your capacity to communicate with the segment of the population that does not speak English
• Research which colleges offer the best radiology programs
• Interview a practising radiologist

During an informational interview, ask questions such as:
- What made you become interested in radiology?
- Can you tell me about an average day at your job, from beginning to end?
- What do you like about your job? What do you dislike?
- What is the most challenging part of being a radiologist?
- What advice would you give to someone who wants to become a radiologist?
- If you could start over, would you still choose to be a radiologist? Why?

Like every medical discipline, radiology demands a commitment to a lengthy and rigorous educational track, multiple levels of examinations and licensing, an arduous residency, and career-long learning and dedication.

While there is not a specific degree required for undergraduate study, aspiring radiologists tend to concentrate their coursework in advanced biological sciences to meet admission requirements for medical school.

Students must graduate from an accredited bachelor's degree program with pre-med prerequisite courses, such as microbiology, biochemistry, and human anatomy. Also recommended are classes in English, advanced mathematics, and statistics. Most medical schools require a grade point average of at least 3.5 and may choose only those candidates who rank at the top of their graduating class.

During undergraduate study it is also important for students to gain experience that will set them apart from other medical school applicants and prepare them for their chosen career. This experience may include volunteering at a hospital, performing community service, and research work. Especially valuable are job shadowing programs, which allow students to follow radiologists and other doctors throughout a workday.

All of these activities demonstrate work ethic and dedication to the medical field. Whenever possible, these experiences should be documented on letters of recommendation, which can be submitted with medical school applications.

Prospective radiologists must sit for the Medical College Admissions Test (MCAT) administered by the Association of American Medical Colleges (AAMC) and the American Association of Colleges of Osteopathic Medicine (AACOM). Most students take the MCAT at least a year before they wish to begin medical school.

Through a set of multiple-choice questions, this standardized exam allows medical schools to evaluate a candidate’s training and skill set. Many schools share their incoming student MCAT score average on their website to inform undergraduates of how well they need to score to compete with other applicants.

To achieve their highest possible MCAT score, students are encouraged to take advantage of assistance available to them. This includes study materials, pre-tests, practice tests, and online and in-person tutoring. These resources are designed to ensure that students attain the best possible score, which will open doors to medical schools.

Radiologists obtain either a Doctor of Medicine (MD) degree or a Doctor of Osteopathic Medicine (DO) degree.

Medical school is a very challenging four years of study that is divided into two parts. The first part, comprising the first two years of the schooling, is focused on course and lab work that prepares students intellectually for patient interaction. This training is in the biological and natural sciences, physiology, chemistry, medical ethics, and the art and practice of medicine.

To test their grasp of this portion of training, in the second year of medical school students pursuing an MD must take and pass the United States Medical Licensing Examination (USMLE) – Step 1. Those pursuing a DO must take and pass the United States Comprehensive Osteopathic Medical Licensing Examination (COMLEX-USA) – Level 1. A passing score on the USMLE or COMLEX-USA indicates that students are ready to begin supervised patient visits and gain clinical experience.

The second part of medical school (the last two years) is called Rotations. During this time, students have the opportunity to experience a variety of medical specialties and a variety of medical settings under the supervision of experienced physicians. Rotations further students’ understanding of patient care, situations, scenarios, and the teams that come together to help those that are sick.

As they complete rotations, students tend to find out that they gravitate towards certain specialties or environments that fit their particular interests and skill sets. It is important that this time inform their decision of specialty or subspecialty, so that they find complete satisfaction as a physician.

After part two of medical school, students take the United States Medical Licensing Exam (USMLE) – Step 2 or the United States Comprehensive Osteopathic Medical Licensing Examination (COMLEX-USA) – Level 2. The objective of these exams is to test whether or not students have developed the clinical knowledge and skills that they will need to transition into unsupervised medical practice.

After completing medical school, postgraduates begin a five- to seven- year radiological internship (year one of residency) accredited by the Accreditation Council for Graduate Medical Education.

During this time, radiology residents spend many hours, both day and night, in the hospital interpreting imaging studies, counseling patients on their results, consulting with other clinicians, and performing image-guided procedures and interventions.

A ‘fellow’ is a physician who elects to complete further training or a ‘fellowship’ in a specialty or subspecialty, after or near the end of residency.

Some radiologists choose to focus their practice in one of the two areas of radiology: diagnostic radiology or interventional radiology (also known as ‘vascular and interventional’ radiology). Others opt for a dual diagnostic/interventional concentration.

Diagnostic Radiology (DR)
Diagnostic radiology allows health care professionals to see structures inside the body. Diagnostic radiologists specialize in the interpretation of these images, allowing them to diagnose the cause of symptoms, monitor how the body is responding to a treatment, and screen for different illnesses such as breast cancer, colon cancer, or heart disease.

The most common types of diagnostic radiology exams include:
- Computed tomography (CT)
- Fluoroscopy
- Magnetic resonance imaging (MRI)
- Magnetic resonance angiography (MRA)
- Mammography
- Nuclear medicine (bone scan, thyroid scan, thallium cardiac stress test)
- X-rays
- Positron emission topography (PET)
- Ultrasound

Interventional Radiology (IR)
Once considered a subspecialty, interventional radiology is now a specialty with its own distinct residency program. Interventional radiologists use imaging techniques to help with medical procedures. The imaging guides doctors when inserting catheters, wires, and other small instruments into the body.

The technology facilitates smaller incisions and allows doctors to diagnose or treat conditions in almost any part of the body without performing open surgery. It is used in treating cancers, tumors, blockages in the arteries and veins, fibroids in the uterus, back pain, liver problems, and kidney problems.

These are examples of interventional radiology procedures:
- Angiography, angioplasty, and stent placement
- Embolization to control bleeding
- Cancer treatments including tumor embolization
- Tumor ablation with radiofrequency/cryoablation/microwave ablation
- Vertebroplasty/Kyphoplasty
- Needle biopsies of different organs, such as the lungs and thyroid gland
- Breast biopsy, guided either by stereotactic or ultrasound techniques
- Uterine artery embolization
- Feeding tube placement
- Venous access catheter placement

The American Board of Radiology (ABR) lists the following as the primary radiology subspecialties. Although included in this list, vascular and interventional radiology – as noted above – has been elevated to ‘specialty’ level.

• Hospice and Palliative Medicine
• Neuroradiology
• Nuclear Radiology
• Pain Medicine
• Pediatric Radiology
• Vascular and Interventional Radiology

All physicians in the U.S. need to be state licensed. Licensing requirements may vary from state to state. Generally, candidates must have earned an undergraduate degree, graduated from medical school, completed a residency, and passed all necessary examinations.

Often, the examination component is satisfied by passing the USMLE or the COMLEX-USA exam. States may further require periodic license renewal and mandate continuing education.

Though not mandatory, most employers seek certified candidates. Board certification is offered by the American Board of Radiology (ABR). Passing Board examinations and earning ABR credentials establishes a radiologist’s commitment to excellence in the field and increases credibility and marketability in the medical community.

Additional Resources
- American Association for Women Radiologists
- American College of Radiology
- American College of Nuclear Medicine
- American College of Nuclear Physicians

Due to the complexity and the demands of radiology, as well as to the ongoing advances made in the field, radiologists undergo training and learn throughout their career. This continuing education takes place at annual meetings and conferences, through research, and via study of scientific journals.