How to Become a Radiologist

  • Aspiring radiologists must complete eight years of academic training and seven years of clinical practice, for a total of 15 years.
  • Aspiring radiologists must pass a medical licensing exam to become a licensed physician. They should earn certification from accredited institutions.
  • There are three specializations and numerous subspecialties in radiology, which may require additional training and certification.
  • Acquiring and maintaining certifications are crucial for career growth and advancement.
  • As of 2019, radiologists receive an average salary of $401,000 per year(1).

What is Radiology?

Radiology is a branch of medicine that utilizes radiant energy to form medical images, which doctors use to diagnose illnesses and deliver treatments. Radiology uses a variety of diagnostic imaging techniques, such as X-ray, computerized tomography (CT), magnetic resonance imaging (MRI), or positron emission tomography (PET), to produce the images used to make a diagnosis. In modern healthcare settings, radiology involves various healthcare professions working together as a team. The team is often composed of a radiologist, a registered radiologist assistant, a radiology nurse, a radiologic technologist or a radiographer, and an x-ray technician.

A Radiologist’s Job Description

Radiologists are licensed physicians who utilize diagnostic imaging procedures to analyze and diagnose patients’ health conditions. Radiologists work closely with fellow physicians to review a patient’s medical history and determine the right imaging procedure required to diagnose the patients properly. Radiologists also work closely with radiologic technologists. Radiologic technologists are in charge of operating the diagnostic imaging machines under the supervision of radiologists. Unlike general physicians, radiologists do not handle the patient’s general medical needs. Radiologists perform non-invasive interventional procedures to administer diagnosis or treatment to patients.

How to Become a Radiologist

To become a radiologist, one must first undergo about 15 years of academic and clinical training.

Educational Requirements

Education Requirements Number of Years(2)
Bachelor’s degree Four
Medical school Four
Residency Minimum of three years
Fellowship One to two years
Additional approved training  One to two years
After receiving a high school diploma, aspiring physicians must finish a four-year bachelor’s degree program. Any college major is acceptable in medical school However, experts state that having credits in general chemistry, organic chemistry, biology, and physics in one’s bachelor’s degree may be advantageous. General chemistry studies atoms and molecules and how they interact to form matter, both organic and inorganic. On the other hand, organic chemistry focuses on carbon-containing compounds. Biology delves into the properties and structures of living organisms. It tackles crucial subjects, such as anatomy and physiology. Meanwhile, physics concentrates on the mechanics and atomic structure of matter. Physics also delves into energy and radiation, which are essential concepts in radiology. Students with a bachelor’s or master’s degree may take the Medical College Admissions Test (MCAT)(3).   Undergraduates usually take the MCAT during their junior year. Passing the MCAT means one can gain admission to a medical school. One’s MCAT score can significantly influence one’s admission to medical school, as prestigious academic institutions only admit those who belong in the higher score percentile(4). The MCAT was developed and administered by the Association of American Medical Colleges (AMCAS). The organization also helps connect medical students to their preferred schools and provides resources on various med schools’ admission processes(5).

Entering Medical School

Upon finishing an undergraduate degree, aspiring physicians must complete four years of medical school, with the first two years focused on classroom learning. There are two types of medical schools in America: allopathic and osteopathic(6). Allopathic medical schools focus on diagnosing and treating illnesses through medications and surgeries. Necessary coursework in med school includes anatomy, pathology, pharmacology, biochemistry, and pathophysiology. Graduates from allopathic schools are called medical doctors or MD. On the other hand, osteopathic medical schools employ a holistic approach in health and wellness, focusing on sickness prevention and patients’ overall well-being.  A graduate from osteopathic medical schools is called a doctor of osteopathic medicine or DO. Medical students begin their clinical rotations by the end of their second year in med school. Clinical rotations, conducted in clinics or hospitals, allow students to do hands-on work under the supervision of capable and expert physicians in different medical specialties. These sub-fields include surgery, internal medicine, pediatrics, and radiology. Students must pass a critical licensing exam, called the United States Medical Licensing Examination (USMLE), to receive their medical degree(7).  On the other hand, osteopathic students must pass a different medical licensing exam, called the Comprehensive Osteopathic Medical Licensing Examination-USA (COMLEX-USA)(8). The next step for newly licensed doctors is to undergo a four-year residency program before practicing medicine. In their residency program, new physicians work with various patients both in and out of emergency rooms to acquire comprehensive general medicine training.  Aspiring radiologists also get further training and advanced instructions on radiology in their residency period. This training period involves taking scans, analyzing and interpreting medical images, and familiarizing protocols and safe practices. Upon concluding their residency training, doctors may opt to immediately apply for an employment or an additional one or two years of a fellowship program. Completing a fellowship program allows fellows to train in one radiology subspecialty.

Licensure and Certifications

Radiologists must first earn their medical license by passing their licensing exam before moving to their radiology residency and fellowship training. Radiologists can also take certification exams from accredited institutions, such as the American Board of Radiology (ABR) or the American Osteopathic Board of Radiology (AOBR)(9) State laws do not require radiologists to have certifications. However, the ABR explains that board certification is a great way to measure a radiologist’s knowledge, experience, and skills in providing quality patient care. Acquiring and maintaining certifications are also crucial for career growth as employers tend to evaluate radiologists through their credentials.  Board-certified physicians often receive higher wages and opportunities for career advancement.

Career Paths for Radiologists

Radiology Specializations

Radiology has three specializations: diagnostic radiology, interventional radiology, and radiation oncology. Diagnostic radiology utilizes imaging techniques, such as X-rays, ultrasound, electromagnetic radiation, and radionuclides, to diagnose and treat medical conditions.  Individuals looking to specialize in diagnostic radiology must have one year of clinical training and four radiology training years. An additional year of fellowship training is encouraged but not required. Interventional radiology combines imaging techniques with minimally invasive procedures and patient care to diagnose and treat benign and malignant medical conditions. Interventional radiologists must have a competent knowledge of minimally invasive surgical techniques, such as ablation, embolization, thrombus management, angioplasty, and stent placement. Aspiring interventional radiologists must complete three years of training in diagnostic radiology and two years in interventional radiology before earning a certification. Radiation oncology utilizes controlled radiation to treat or reduce the symptoms of cancer. This process is known as radiation therapy. Radiation oncologists may also use imaging techniques, such as CT scans, MRI, and ultrasound, to plan and deliver treatment.  One year of general clinical training and four years of radiation oncology training is mandatory for aspiring radiation oncologists.

Radiology Subspecialties

Radiology’s subspecialties include neuroradiology, nuclear radiology, pediatric radiology, vascular and interventional radiology, pain medicine, and hospice and palliative medicine. Neuroradiology focuses on diagnosing and characterizing abnormalities in the central nervous system, such as cancer, cerebrovascular diseases, stroke, trauma, seizure disorders, aging disorders, and degenerative disorders. An additional year in fellowship training and another in approved training are mandatory. Nuclear medicine utilizes radiopharmaceuticals to visualize and diagnose diseases, such as cancer, tumors, and hyperthyroidism.  This subspecialty also uses imaging technologies, such as positron emission tomography (PET) and single-photon emission computed tomography (SPECT) scans. Aspiring nuclear radiologists need an additional year in fellowship training. Pediatric radiology employs imaging and interventional methods to diagnose, treat, and manage congenital anomalies and diseases specific to infants, children, and adolescents. This subspecialty also addresses childhood diseases that can carry on to adulthood.  Pediatric radiology requires an additional two years’ worth of fellowship and approved training. Vascular and interventional radiology (VIR) uses a vast array of radiologic imaging techniques, such as CT, MRI, sonography, digital radiography, and fluoroscopy, to treat a wide range of cardiovascular conditions. VIR makes use of therapies, like angioplasty, embolization, thrombolysis, biliary, stent placement, abscess drainage, and genitourinary drainage. Additional fellowship and approved training are mandatory to earn a certificate in VIR. Breast imaging involves diagnosing potential medical conditions affecting the breasts. This subspecialty detects and characterizes any lump or abnormality in the breasts. Characterization is vital in diagnosing the abnormality as either benign or malignant. Breast imaging uses many diagnostic technologies, such as X-ray, MRI, ultrasound, diffuse optical mammography, and scintimammography. Pain medicine (algiatry) is a specialty that is concentrated on providing pain relief to patients with acute, chronic, or cancer-related pain.  Specialists in this field may work in either inpatient or outpatient settings and must work closely with other patient care specialists. A radiologist must complete one year of fellowship training to become a certified pain medicine specialist. Hospice and palliative medicine focuses on optimizing a patient’s quality of life by managing pain caused by life-limiting illnesses, such as cancer.  Specialists in this field work closely with a palliative care team and help address a patient’s physical, psychological, social, ethical, moral, and spiritual needs. A radiologist must complete one year of fellowship training to become a certified hospice and palliative medicine specialist.

Pros and Cons of Being a Radiologist

Pros 

  • Radiology is a dynamic and challenging yet rewarding career path that combines various medical and scientific disciplines.
  • Radiology makes use of one’s critical thinking, analysis, and communication skills. Radiologists must form a diagnosis based on the available visualization of a patient’s internal organs and clearly and concisely relay the diagnosis to patients.
  • There is a high chance for remote work as patient interaction is not an integral part of radiologists’ job description.
  • Based on recent data, radiologists may receive an annual average salary of $401,000(10).
  • The Bureau of Labor and Statistics reports that radiology has a faster-than-average job outlook over the next ten years(11).

Cons

  • An aspiring radiologist must spend about 15 years in academic, clinical, and additional training.
  • AAMC reported that from 2016 to 2017, the average yearly tuition for a public medical school is $34,592 for in-state students, while out-of-state students need to pay $58,668. The average cost for private high school for both in-state and out-of-state students is more than $50,000(12).

Job Outlook

The overall job outlook for a radiologist is positive. The United States Bureau of Labor Statistics (BLS) projected that surgeons and physicians’ overall employment rate, including radiologists, is to increase 7% from 2018 to 2028(13) According to the BLS, physicians are among the highest-paid professionals across all occupations in the USA. In 2017, the estimated average annual physician’s salary was $208,000(14) By 2019, collated data indicated that radiologists receive an average annual wage of $401,000(15). The BLS attributes this growth to the United States’ fast-growing and fast-aging population. As more people age, the rate of people with chronic illnesses is also likely to increase. However, the BLS notes that the demand for physicians is highly dependent on healthcare reimbursement policies.  Medical treatment is expensive, and consumers may seek fewer physician services should their medical insurance prove insufficient to cover the cost of treatments.

Conclusion

Radiology utilizes medical procedures, from non-invasive to minimally invasive, to form images of a patient’s internal organs. Doctors use these images in diagnosing illnesses and delivering treatments. Medical professionals who analyze and form diagnosis from the resulting medical images are radiologists. They work closely with other radiology specialists, such as radiographers and technologists, in producing medical images from different radiologic technologies. Radiologists also collaborate with general physicians, oncologists, and other specialized physicians to diagnose and treat a patient’s medical condition. To become a radiologist, one must finish about 15 years of training in academic and clinical settings. Aspiring radiologists must also pass a medical licensing exam to become a licensed physician. Continuing education and specialization is integral in a radiologist’s career. Much like other physicians in the medical field, radiologists are evaluated based on their level of specialization, the number of certifications, and years of experience.
  1. Kane, Leslie. “Medscape Radiologist Compensation Report 2019.” Latest Medical News, Clinical Trials, Guidelines – Today on Medscape. Medscape, April 29, 2019. https://www.medscape.com/slideshow/2019-compensation-radiologist-6011349.
  2. Colucci, Andrew. “How to Become a Radiologist: Requirements & Career Info.” Innerbody. Innerbody Research, December 14, 2018. https://www.innerbody.com/careers-in-health/how-to-become-a-radiologist.html.
  3. “Taking the MCAT® Exam.” AAMC Students, Applicants and Residents, December 14, 2016. https://students-residents.aamc.org/applying-medical-school/taking-mcat-exam/.
  4. MCAT Scores and Medical School Success: Do They Correlate?” American Medical Association, May 24, 2019. https://www.ama-assn.org/residents-students/preparing-medical-school/mcat-scores-and-medical-school-success-do-they.
  5. Ibid.
  6. Colucci, 2018., op cit
  7. “Everything You Need to Know about the USMLE Board Exam.” The Princeton Review. Accessed August 27, 2020. https://www.princetonreview.com/med-school-advice/usmle.
  8. “Examinations & Assessments.” NBOME. Accessed August 27, 2020. https://www.nbome.org/exams-assessments/.
  9. “ABR.” The American Board of Radiology, February 26, 2020. https://www.theabr.org/about; “AOA Osteopathic Board Certification in Radiology.” American Osteopathic Board of Radiology, June 23, 2020. https://certification.osteopathic.org/radiology/.
  10. Kane, 2019., op cit
  11. “Physicians and Surgeons : Occupational Outlook Handbook.” U.S. Bureau of Labor Statistics. U.S. Bureau of Labor Statistics, April 10, 2020. https://www.bls.gov/ooh/healthcare/physicians-and-surgeons.htm.
  12. “What’s the Real Cost of Medical School?” Kaplan Test Prep, November 8, 2019. https://www.kaptest.com/study/mcat/whats-the-real-cost-of-medical-school/.
  13. Physicians and Surgeons : Occupational Outlook Handbook. op cit.
  14. Ibid.
  15. Kane, 2019., op cit

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