How to Become a Radiologist – More than 13 years in the making

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So you want to become a radiologist? Curious as to what it takes? If so, read below….

Radiologists are physicians who use cutting-edge technology in medical imaging studies to diagnose disease. The training is lengthy, just like any other sub-specialty area in medicine. Lets start from the beginning (disclaimer: the below paragraphs will detail the most common pathway, taken by >95% of physicians and radiologists).

1. Undergraduate degree (4 years)

To pursue a career in medicine, the vast majority of doctors begin with an undergraduate bachelor’s degree, and the majority of these are in science related fields, with biology and chemistry being the most common. Although, in recent years, humanities related majors are becoming more common for pre-med students. I myself completed an undergraduate degree in Business in addition to completing the pre-med pre-requisite courses, which include core requirements of 1) 1 year of general chemistry 2) 1 year of general biology 3) 1 year of organic chemistry and 4) 1 year of physics. There are additional requirements for specific schools, such as Calculus 1 and 2, and upper level science classes such as molecular biology and gross anatomy; however, these depend on which school you apply to. Also, there are 6 year combined bachelors and MD programs; however, those are not the norm.

Before applying to medical school, a pre-med student will have to take the medical college admissions test (MCAT). I myself took the last written administration of the MCAT, which is all computer based now. This is likely the most important step in applying to medical school, and your score will likely dictate a large majority of which schools you will have a chance of being admitted to.

But don’t get too excited just yet. There is more that goes into getting into medical school than just getting a high GPA and high MCAT score. You have to do something else. “What something else?” you may ask. It almost doesn’t matter. You can almost do anything else. You have to be interesting. There’s going to be hundreds of other applicants that are 4.0 GPA biology majors with 95th percentile scores on the MCAT. The bottom line: medical school admissions committees want to know that you can do multiple things at one time, and be great at all of them.

Check out the American College Medical Admissions Service (AMCAS) to find out how to apply to medical school.

2. Medical school (4 years)

Some may say that this will be the most grueling part of your training, but that’s not always true. Sure, medical school is busy, but residency can be busier (read below). The first two years of medical school are traditionally spent learning the basic sciences, while the latter half of medical school are spent in clinical rotations. Medical students apply to residency in the fourth year medical school.

Without getting into the gritty details, the most important part of your application is undoubtedly the United States Medical Licensing Exam (USMLE) Step 1 score. Of course, as above, if you are shooting for the top residency programs, just having a good step 1 score is not enough. You have to do SOMETHING ELSE! Whether its publishing an article as a first author in a medical journal or starting a free medical clinic, these extracurricular activities go back to the bottom line: selection committees want to know that you can do multiple things at one time, and be great at all of them.

Applications to residency are handled through the Electronic Residency Application Service (ERAS).

3. Internship and Residency (5 years)

A diagnostic radiology residency must be proceeded by a one year clinical internship, which can be in any clinical specialty, but most typically is a year of general surgery, internal medicine, or a transitional year internship.

Then, four years of diagnostic radiology training must be completed. This typically consists of rotations covering all of the areas of diagnostic radiology and interventional radiology. Residents learn interpretation of plain x-rays, computed tomography (CT), magnetic resonance imaging (MRI), nuclear medicine, and how to perform and interpret fluoroscopy and angiography. Beyond interpretation and technical skills, residents need to understand the physics of medical imaging, which can be a grueling task.

Radiology residents go through multiple examinations given by the American Board of Radiology (ABR) to become board certified.

4. Fellowship (typically 1-2 years)

Finally, at least 90-95% of radiology residents will complete a fellowship, which is typically 1-2 years. Two fellowship sub-specialties use a matching service through the National Resident Matching Program (NRMP), including neuroradiology and interventional radiology. Other fellowships include body imaging, women’s imaging (including mammography), pediatric radiology, emergency radiology, nuclear medicine, and muskuloskeletal imaging, and these are filled in a traditional interview and offer process without a match. That completes the list of the most common areas of sub-specializing in radiology. Some residents will complete two fellowships, or do a two year neuroradiology fellowship, which can also be followed by an additional year in interventional neuroradiology. This is also sometimes done by pediatric radiology fellows who want to do an additional year in pediatric interventional radiology. 

After completing fellowship, the radiologist will usually sit for an exam to obtain a certificate of added qualifications (CAQ), and every 10 years will undergo maintenance of certification (MOC). 

There you have it! Overall, its a minimum of 13 years of training! Although, most residents do 14 and its becoming common to do 15 years of training! Good luck!