My CV would tell you that I am a stock market trained body imager, but you might not know that from the jobs I have had.
Sure, a good chunk of my 16.5-year-old case volume would fall under “body”, but it’s a big tent. I’ve written before about my feeling that body imagery really has too much of a topic. It’s as if body imaging pulls together all the radiology not covered by the other scholarships, then encroaches a bit on their territory for good measure. I guess that sounds better than saying you are sub-specializing in “everything else”.
Even with that in mind, the four places I worked made me wear very different hats. An employer asked me to do general stuff that didn’t fit someone else’s niche. In another facility, I was the guy from nucs and mammo. Almost as an afterthought, I was mostly tasked with the ultrasound too, probably less because of my body imaging credentials and more because my office was right next to the sonographer’s room.
My next employers didn’t tell me so much what they wanted me to do, but created conditions in which reading certain types of imagery was more rewarding for me. Some reviews were worth more per click, for example, or generated more political capital within the group.
In other words, the less you have to say things like “No, I can’t / don’t want to do X,” the more doors open for you. A fraternity degree is fine, but I have found that you get the best range of opportunities if you focus on what is needed / wanted and adapt to it. Like the man said, “Don’t ask what your rad group can do for you …”
Sometimes things fit together well. This nucs / mammo / sono job put me in the position of having constant interruptions, so I made a habit of cleaning up all of their XRs and other low value stuff. It was easier to put small cases in between other things than to try to have a whole body scan. As a result, I became particularly effective in what I called “bite-sized” studies, preparing for a daytime teleradiology concert years later which depended on the ability to read books. XR and the United States at high volume.
Whenever I find myself in a position to talk about aspects of rads that I can do, it reminds me of one of the assistants in my residence. A guy from private practice, he also recognized the value of never saying “no” to a particular type of imagery. He quipped: “I have read everything.
I can’t say he didn’t. He has done well enough, at least, that the management of his group does not find fault with his performance to impose limits on his scope of practice. But even though he was a superstar genius for everything presented to him, “I read it all” seemed creepy to me, somehow belittling his work.
I don’t think I would be alone in this perception. Imagine a rad applying for a job and the employer asking the candidate what roles he or she could fill there. Then the rad just says, “I read it all. Maybe the potential employer has a lot of use for such a plug-n-play team member, but I don’t see the interviewer being impressed by this exchange.
As impressive as it may be to consider that a rad has gone through years of practice without losing skill / confidence in any aspect of the field, the phrase “jack of all trades, master of nothing” comes to mind. Maybe a given interviewer would continue with the topic, “It’s good that you read everything, but what would you say you’re particularly good at or are interested in?” “
At this point, if the rad redoubles the ‘I’m reading everything’ feeling and doesn’t restrict attention at all, it can set off a wake-up call in the interviewer’s mind. Is this rad really oblivious to his own strengths or, more importantly, his weaknesses? Does the rad lavish readings in the name of “everything” when there may be things that it is not so good at that it is best to leave it to others? Most rads sub-specialize or beg for certain types of imaging. Is this rad a self-centered person who thinks he or she is better than all of them?
Even without asking twice, an interviewer who hears an “I read it all” flip or its equivalent might have such concerns. This is a lost opportunity for the applicant. There was an engraved invitation to say something great, or at least something memorable, and the candidate verbally shrugged as if his work was nothing special. Instead, the claimant looked as generic as it gets.
Going through a laundry list (“Well I read XR, US, CT, NM, MR, mammo, dexa and do some light IR”) compromises the rads. Yes, more words can be used with this approach, but it conveys the same not very exciting idea. So how do you get across the idea that you are versatile and can serve a group in many capacities?
Your mileage may vary, but here is a “sweet spot” that I have found for myself. I’m referring to how my decade of Telerad kept me comfortable with most types of imagery. Then, I specify a few areas of particular strength and / or types of work that I find the most satisfying. I particularly emphasize things that I know my audience wants / needs from me or that other rads generally avoid like PET, for example, or Arterial Doppler.
Also, do you remember when I said I avoid saying I can’t / won’t do this or that? Well, that wasn’t a hard and fast rule. I include such “relevant negatives” in my shpiel, but just a hint or two. It shows that I recognize my limitations and prevents others from leaving the conversation with the wrong ideas about what I could do for them.
It is never a flat negative statement, à la “I don’t make windows”. It may seem closed-minded and demanding. Instead, I mention it with an explanation and leave the door open slightly if there’s any chance I can change my position.
An example might be: “I’m avoiding MSK MRI. I haven’t read much since training and it’s best to leave it to others who are more comfortable with it. I read the thorns, of course. Another example could be: “I am not currently doing mammos. Yes, I was the Senior Breast Imager for my second job after training, but my MQSA credentials expired when I switched to Telerad. Of course, I could recertify if that’s of interest.