Crush Your Radiology Rotation
Written by Jake Romm, MD
Your radiology rotation is going to be a blast.
Finally, you get to see what your life will look like as a rads resident and get a taste of what you can look forward to learning. Not only that, but you get a chance to flaunt that gigantic brain of yours. I mean, if you rotate at a target institution, it’s basically a four-week interview.
According to the 2021 NRMP survey of residency PDs, “performance in the clerkship of preferred specialty” received a mean importance rating of 4.1 out of 5. So, doing well may help you score more interviews. With that in mind, let’s talk through the resources to use and what to expect during the rotation.
With a smattering of tips to make a good impression, of course.
Resources to study
If you’re on a general radiology rotation, then you will need something that covers high-yield pathologies for each of the imaging modalities. Brush up on some of the relevant anatomy and check out some of these resources:
Learning Radiology: Recognizing the Basics: Honestly, this is the “go-to” resource for your rotation. It outlines high-yield points for all imaging modalities and covers the material any self-respecting radiology program could hope to teach an MS4. It is perfectly readable, and you can even find pre-made Anki decks to go with it. I created one myself during my rotation. I even have permission from Dr. Herring to share it. Reach out to me here if you’re interested!
LearningRadiology.com has extra content to review with practice cases and images to supplement the book.
Felson’s Principles of Chest Roentgenology: Classic text resource for getting very familiar with chest radiographs. Teaches you to read them like a pro. And you will be asked about chest radiographs. I guarantee it.
University of Virginia online tutorials, quizzes, and other resources: Encompasses all subspecialties. Geared towards MS4s interested in radiology and contains a ton of detail. Helpful if you find yourself bouncing around subspecialty sections like a pinball. I particularly enjoyed the “ICU Chest Radiograph” tutorial and have visited this site many times post-match.
I’m not too familiar with the ACR’s free (for med students) two-week online radiology curriculum. I wanted to mention it in case you need a structured plan to help you focus your review or find your rotation isn’t very organized. You just create an account to gain access.
What to expect
Delivering your best performance is easier when you know what you’re in for.
Lots of shadowing
Let’s be real. As an MS4 you have relatively little to offer in terms of radiological expertise. This means that you spend a lot of time learning by watching. But you will still have opportunities to shine. You can bet your priciest pair of Figs scrubs that if a CXR with pneumonia pops onto the list, that puppy has your name on it.
When the opportunity arises, walk through your search pattern and describe what you see. Even if you can’t arrive at a specific diagnosis, you can demonstrate your organized approach to evaluating a study.
A presentation
Because you won’t be contributing to the workload in the same way as you might on other rotations, you will most likely be graded on a presentation. Adhere strictly to the grading rubric in terms of time and content. Double check the radiology terms you are using with a willing resident beforehand. You want to be wielding those words like a seasoned darkroom warrior and avoid language that makes some radiologists’ skin crawl, ie. infiltrate.
Formal didactics, lectures, and practice cases
There is a ton to learn in radiology. You will have lectures and presentations that cover the basics as well as interesting cases. Participation in these lectures is greatly appreciated. Expect to be asked to “describe what you see” or “identify the abnormality”. More than likely this will be in a safe, nonjudgmental environment with other students. You may have some Aquifer cases to work through for practice as well.
Again, nobody expects you to know much of anything at this point. This just means that if you do know something, they will be impressed. So, prepare for lectures ahead of time!
Brief exposure to multiple preceptors
You can expect to be bounced around a little bit during your rotation. Having a learner inherently slows down the workflow in the fast-paced world of radiology. Think of it as a chance to get facetime with many potential members of the selection committee!
Be attentive and engaged, write down any questions you have, and figure out when it’s okay to ask them. People will be more willing to teach if you appear interested and engaged. Which is tough. Watching someone else “do radiology” is painfully boring.
If your goal is to secure a letter of recommendation, then look for opportunities to work with attendings outside of the rotation. Such as research. You could work smarter and turn your presentation into an RSNA Case Collection submission. This online library is meant for student and resident education. They accept cases that show “classic” findings and are essentially a case report. It requires much less time and effort than a full-blown publication but still gets you a DOI number and facetime with an attending.
An assessment
This is variable. Some rotations may offer a test at the end to add to the objective data they use to give you a grade. Use any specific resources they recommend, otherwise, I think the Learning Radiology text will have you covered.
Final advice
Pay attention to how the residents and attendings interact. Watch the residents during conferences and try to get a sense of the program culture. Get to know the residents. My favorite resources for preparing for residency interviews were residents I had met during my radiology rotations.
Enjoy it! Radiology is the absolute best specialty in medicine. People are super nice and the work is important. And that’s my totally unbiased opinion.
