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So you want to be a Radiologist

So you want to be a Radiologist

Radiology is attracting a high number of applicants for its Higher Specialist Training (HST) programme and the Dean of the Faculty of Radiologists, Dr Adrian Brady, said that very strong candidates are applying for the available posts.
Clinical and diagnostic radiology is one of the few specialties where a background in a specific area is not required. There is no Basic Specialist Training (BST) scheme in radiology and Dr Brady explained that the Faculty does not target surgeons or physicians in particular, but the typical doctor accepted on to the programme will have a few years in medical, surgical or paediatric training, a membership or fellowship from another specialty, and will have been published in peer reviewed journals.

At present there are 86 posts on the HST scheme and the Faculty accepts about 15 or 16 new trainees each year. Specialist registrars (SpRs) take on five years of accredited training and sit the final exit exam, the Fellowship (FFR RCSI), in the fourth year. The scheme often incorporates a final year abroad. Basic sciences relevant to clinical radiology are taught in the first year. In addition, the trainee is introduced to interpretative reporting, practical procedures and communication skills. In the fifth and final year, some trainees opt to stay in Ireland while others undertake fellowships in Britain or North America, but only in centres approved for specialist registration that the Faculty would have knowledge of and where the centre has defined sub-specialties.

Training abroad

Usually, training abroad focuses on areas such as neuro-radiology, interventional radiology, breast radiology, and cross sectional imaging CT or MRI. While some SpRs pursue training in a particular interest such as cross sectional imaging, it is not formally considered a sub-specialty. The Medical Council only recognises paediatric radiology and neuro-radiology as sub-specialities. At present specialisation in other aspects of radiology is mentioned only as an interest in a particular area for the purpose of consultant posts.

Competition for the HST posts is intense and there are between 40 and 60 applications for the scheme each year. It is estimated that the Faculty receives applications from two suitable candidates for each training post. Dr Brady believes NCHDs vote with their feet and considers radiology as more competitive than ever as the development of modalities such as interventional therapies, has moved the specialty into a central position in- patient care “and that is one of the attractions”. Sub-specialty The fifth year and final 12 months of training allows for training in one sub-specialty for those who wish to declare a special interest or a year devoted to a mixture of two or more sub-specialties. This 12-month period is usually undertaken in the fifth year, but the Faculty can schedule the period in a modular fashion during the fourth and fifth years of training.

Additional years of sub-specialty training may be required in, for example, neuro-radiology or interventional radiology. The HST programme is designed to prepare doctors to acquire the final Fellowship of the Faculty of Radiologists of the RCSI, which consists of two parts. Trainees on the scheme are paid at approved rates with credit for previous hospital service, i.e. a registrar will retain his or her registrar salary if accepted onto the scheme.

Doctors who complete five years’ accredited training can apply to the Medical Council to be included on the specialist register. The Faculty does not issue a certificate of completion of training; under the new registration arrangements, the Faculty of Radiologists of the RCSI assesses applications referred to it by the Medical Council. The remit of the Faculty is “to compare the knowledge, skill and experience of the applicant to that of a radiologist eligible for inclusion on the register following training by the Faculty in Ireland”. “An appropriate level of knowledge, demonstrated by passing the Fellowship of the Faculty of Radiologists (FFRRCSI) or the equivalent qualifications in the UK, USA or Canada” is required for registration. 

The Faculty also offers an alternative pathway for people who have qualified in radiology but do not meet all the standard criteria. In recent years, the profile of the specialty has changed significantly and many radiologists have developed interests in interventional radiology, which is considered an active component of treatment in a number of specialties such as vascular (e.g. aortic stenting, DVT), oncologic (chemotherapy, RF ablation), and gynaecology (fibroid embolisation).

And the job prospects?

The number of trainees is relatively small and over the last 10 or 15 years, Dr Brady feels that the numbers qualifying have been well matched to the needs of the system but in its latest workload report, the Faculty has identified that there is a pressing need for more consultants.

Factfile: Posts and Salaries 

Higher Specialist Training posts: 86 posts 
Annual Higher Specialist Training intake: 15/16 posts 
Number of approved HSE consultant posts: 239 includes: neuro-radiology: 6 paediatric radiology: 3 general radiology: 148 Posts with a special interest (e.g. breast, vascular, interventional): 65  Number of part-time posts: 5 
Specialist registrar’s basic salary: starting at €60,403.78 - €76,071.94 
Consultant pay: New entrant’s salary – Type A contract starting at €184,455, Type B starting at €173,620

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Valarie Ryan: Medical Independent