Clinical radiology is the use of imaging to diagnose, treat and monitor various disease processes. Rapid advances in technology and our understanding of the features of disease on diagnostic images allow imaging to be used at earlier and earlier stages of the diagnostic process. Similarly, changes in the characteristics of disease with treatment can be detected by imaging, which is frequently used to monitor progress.
With greater clarity of imaging comes the opportunity to offer image-guided treatment. Masses identified by radiology can also be biopsied with guidance of the needle path by imaging techniques and without recourse to a surgical procedure in most cases. Interventional radiologists use image guidance for a rapidly increasing array of minimally invasive procedures - from arterial to colonic stenting, from vascular embolisation for uncontrollable bleeding to image guided ablation of tumours.
The massive growth in applications of radiological imaging and image-guided treatments has resulted in a worldwide shortage of trained radiologists. The Royal College of Radiologists and the Department of Health have responded to the demand for increased radiologist numbers by increasing training opportunities, most recently by the introduction of the Integrated Training Initiative and the establishment of Radiological Academies at three training schemes. This is an innovative training design that combines traditional learning opportunities with an advanced e-learning platform designed to ensure that the radiologists of the future are properly informed and prepared to deliver clinical imaging to the highest possible standards.
If you are considering a career in clinical radiology, a good understanding of general medicine and surgery is paramount. In the past, a higher examination such as MRCP or MRCS was often needed to secure one of the highly competitive specialist registrar posts. With the establishment of Foundation Training and the implementation of Modernising Medical Careers, there is an increasing emphasis on student electives, audit/research projects in radiology, demonstrable links with imaging departments during Foundation Years, an intercalated BSc or some other mark of distinction. Above all you will need enthusiasm, good eyesight and the ability for hard work! The rewards are high with a career where your skills are valued both by your clinical colleagues and your patients.
Applicants may find the points below of assistance.
Get a good CV as a medical student (eg, anatomy prize)
Undertake a portfolio of mainstream acute care clinical posts in Foundation Years
Consider whether your clinical skills will be enhanced by spending a period of time in core training in acute care clinical specialties such as medicine, surgery or paediatrics. However, entry directly from FY2 is permissible.
Take or create any opportunity for audit/research in an imaging topic
Foster links with local radiology departments (eg sit in on reporting, attend relevant MDT meetings)
Consider an elective in radiology as a student or during Foundation Years
Most trainees embarking on a career in clinical radiology are not certain where their areas of special interest will lie and, therefore, benefit by an equal exposure to all areas of radiological practice. This is achieved by rotating through the areas of basic general radiology during the first years of training, followed in the latter years by more focussed training in areas of special interest. A small number of trainees identify their individual area of special interest at an early stage and their training can be structured with that in mind. The principal difference is that a rotation to their area of special interest is undertaken early in training and studied in a part-time fashion for the bulk of the remainder of their general training before returning to it in a more full-time manner in the latter years. The same total curriculum is covered and the total duration of training is unchanged.