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What is Radiology and What Does a Radiologist Do?

If you’ve ever broken a bone, chances are you’ve been treated by a radiologist. The field of radiology is dynamic as doctors are increasingly using evolving technology in the form of computer-enhanced imaging to diagnose and treat disease. If you’ve ever wondered “What does a radiologist do?”, read on to learn more about this career path and the opportunities available for radiologists after medical school.

What is Radiology and What is Radiology Used For?

Radiology is the field of medicine in which doctors use medical imaging scans to diagnose injuries and treat disease. The doctors who read and interpret these scans are called radiologists, and they are highly trained in their fields – most radiologists complete 13 years of training before entering a regular practice.
Physicians use radiology to help treat diseases and injuries where they would otherwise be unable to make a proper diagnosis. For example, if a patient experienced a fall, the treating physician wouldn’t know for sure if there were broken bones without the aid of x-rays and a trained radiologist to read them. If the treating physician assumed there were no broken bones, a misdiagnosis could result in life-long issues from broken bones that didn’t heal properly. On the other hand, if the treating physician assumed there were broken bones, a misdiagnosis would result in unnecessary costly treatments and potential weakening of the extremity due to needless immobilization. Radiology helps doctors see inside the patient and provide a more definitive diagnosis and treatment plan.

What does a radiologist do?

Radiologists are primarily involved in the diagnosis and treatment of disease, but they often review medical imaging reports of patients who they never meet. However, in some specializations, such as interventional radiology, the doctor will be directly involved in performing procedures. Radiologists can become involved in patient healthcare in a variety of ways, including consulting with other physicians, monitoring and administering radiological safety procedures, developing treatment plans for cancer and other major diseases, and using medical imaging in combination with other tests and procedures to determine complex diagnoses.

How do I become a radiologist?

Since radiologists are performing a variety of procedures that all involve radiation, they must be highly trained to handle the equipment and perform these procedures safely. As such, this career path requires extensive training beyond medical school, and a radiologist must also be highly specialized – there is little demand for a radiology generalist. Aspiring radiologists should gain exposure to different specializations as early as possible in training so they can be prepared to follow a specialization pathway when the time comes. Once properly trained, a radiologist is a key partner on any medical treatment team.

Education and Training

To become a radiologist, a student must complete 4 years of undergraduate work followed by 4 years of medical school. After graduating medical school, the student must complete a 4-year residency program, and most radiologists also complete a 1- or 2-year fellowship in the radiology specialization of their choosing. In many other medical disciplines, a fellowship is viewed as optional, but in radiology, over 90% of physicians complete a fellowship and it is viewed as expected training for the field.

Radiology Specializations

Since radiology is such a highly specialized field, there are several specializations and subspecializations available to carve out a niche career path. In medical school, students can search for a residency program that prepares them for one of four primary specializations. After residency, the fellowship program available within a primary specialty can help radiologists to further niche down and hone their skills.

Diagnostic Radiology

This specialization focuses on using x-rays, ultrasounds, and other medical imaging to diagnose and treat disease. Students are trained on using these tools to find cancers, blood clots, heart conditions, and other issues. In addition to finding these conditions, diagnostic radiologists use their tools to monitor patients who are actively on a treatment plan to track the recovery process and determine if changes are needed.

Doctors who specialize in diagnostic radiology can go on to sub-specialize in any of the following areas:
• Hospice and palliative medicine
• Neuro-radiology
• Nuclear radiology
• Pain medicine
• Pediatric radiology
• Vascular and interventional radiology

Interventional Radiology/Diagnostic Radiology

Students who choose this pathway can expect to take at least 3 years of diagnostic radiology training and two years of interventional radiology training. Interventional radiology focuses on using medical imaging to guide minimally invasive procedures in the moment. For example, a radiologist may insert a stent while watching a fluoroscope to make sure it is placed properly. This field provides patients an alternative to inpatient surgeries that can be costly and have a longer recovery process.
Doctors who specialize in interventional radiology/diagnostic radiology can go on to subspecialize in any of the following areas:
• Hospice and palliative medicine
• Neuroradiology
• Nuclear radiology
• Pain medicine
• Pediatric radiology

Radiation Oncology

Radiation oncology is sometime referred to as “cancer therapy”, since these radiologists specialize in finding and treating cancer cells. These doctors also help with pain management during the course of cancer treatments and routine monitoring to check for cancer resurgence once a patient is considered cured. Since it may be unclear whether a tumor is benign (non-cancerous) or malignant (cancerous) until after it is removed and tested, radiation oncologists may spend some time treating patients with non-cancerous tumors and other conditions that require radiological imaging as well.

Doctors who specialize in radiation oncology can go on to sub-specialize in any of the following areas:
• Hospice and palliative medicine
• Pain medicine

Medical Physics

Medical physicists combine expertise in the fields of radiology and physics to ensure safe and accurate patient treatment. Medical physics is considered an interdisciplinary field that brings together the knowledge of medical imaging with the knowledge of applied physics in computer modeling and data analysis to further develop the science behind healthcare delivery. While these doctors may work primarily in a research capacity, they can also act as consultants, educators, hospital administrators, and government regulators to ensure that radiological procedures are performed safely and with patients’ best interests at heart. When choosing medical physics as a specialty, doctors must choose at least one subspecialty area and may hold certification in multiple sub-specialties.

Doctors who specialize in medical physics can go on to sub-specialize in any of the following areas:
• Diagnostic medical physics
• Nuclear medical physics
• Therapeutic medical physics

Salary Expectations

According to Medscape’s 2019 Physician Compensation Report, radiologists make on average $419,000 per year. Salary can vary based on location, experience, and specialization, but radiologists earn more on average than their physician counterparts in nearly every other specialty. The only specialty fields that earned more in 2019, according to Medscape, were cardiology, plastic surgery, orthopedics, and otolaryngology.

The average annual salary for radiologists also increased 4% from Medscape’s 2018 figures, and salary and career opportunities are projected to continue growing over the next 10 years. As technology continues to develop, there will be an increasing need for radiologists who understand how to incorporate computer-based imaging and modeling into traditional healthcare and treatment practices, so radiologists who work to understand this growing field can expect ample career opportunities after finishing medical school.

Frequently Asked Questions

What is diagnostic imaging?

Diagnostic imaging is the use of medical imaging, such as X-rays, CT scans, or MRIs, to aid in the diagnosis and treatment of patients. Medical imaging allows trained doctors to see inside the body and make better diagnostic decisions and treatment plans that improve rehabilitation time and overall quality of life for patients.

What is a radiology technician?

Radiology technicians take x-rays of patients and aid in patient education. This role is different from a radiologist in several ways:
• Individuals can become a radiology technician with a 2-year associates degree; radiologists require 13 years or more of schooling.
• Radiology technicians primarily perform x-rays and do not perform more advanced medical imaging procedures. Radiology technicians are also not involved in diagnosis – they still pass the x-rays off to a radiologist to read and interpret the results.
• Radiology technicians make a much lower salary. The average salary for radiology technicians is $59,601 per year according to Salary.com.

How much does a radiologist make?

According to the 2019 Medscape Physician Compensation Report, radiologists make an average of $419,000 per year. Radiologists make, on average, over $100,000 more per year than the average physician and almost double the salary of primary care physicians.

How has the radiology profession been impacted by the COVID-19 pandemic?

Although the true impact of the COVID-19 pandemic is still unfolding, radiologists have proven to be a key partner in diagnosing and treating patients with the Coronavirus. While it is true that many routine imaging procedures, such as annual mammograms, have been halted since lockdowns and extreme social distancing measure were initiated, those measures are temporary. As with many industries, the field of radiology is adapting to a “new normal” in the wake of the pandemic, and radiologists are incorporating new approaches, such as remote readouts, that will help the field regain momentum quickly.