Radiology residents push to complete their residency on a high note and begin building their careers.driven

What makes one person spend four hours studying for a test when another only studies for 30 minutes? Perhaps it's the desire to out-perform peers or a need to truly master the material.

Regardless, the drive to succeed can be particularly beneficial when it's applied to radiology residency or to launching a career in imaging. Drive is what helps residents survive overnight and other periods of taking call, limited reading time, and constant stress.

Focusing on Your Strengths

Drive is also what helps residents and young radiologists find opportunities to shine amid all of these challenges, provided they are motivated to act upon them. Just ask C. Matthew Hawkins, MD, chief resident at the University of Cincinnati, who was recently elected chair of the ACR Resident and Fellow Section (RFS) and is an expert in pinpointing problems and coming up with solutions. Such an aptitude helped him gain the spot of chief resident.

However, Hawkins isn't motivated by titles. "What drew me to medicine was that I could see what was coming down the pike — domestic policy changes, reimbursement issues — everything we're facing now," he says. "[Earning the position of chief resident] was more of a byproduct of me trying to identify problems and find ways to involve myself in situations where I can help solve them with other people in the profession."

Hawkins pursued his new role as RFS president because he had a desire to give back. "The ACR has excellent leadership; it's truly trying to advocate for the profession," he notes. His involvement with the College has also helped him become adept at networking, which he says "means a lot and may give me an edge career-wise."

Achieving Your Goals

And while Hawkins chases problems — and subsequent solutions — others seek different milestones along very specific career paths. Brian D. Midkiff, MD, MPH, radiologist, division director of ultrasound, and assistant residency director at St. Vincent Hospital in Worcester, Mass., finished residency in 2008. Back then, he saw many opportunities to be involved with teaching and training future generations of radiologists. He set his sights on becoming assistant residency director within three years of completing his fellowship.

Instead, he earned the spot after only one year in practice. "I wanted to work with residents to keep their passion ignited and motivation high as well as to help them stay in touch and why they went into radiology and medicine," he says. And Midkiff didn't stop there. His next goals were to reach partnership in his practice and become a division director within three years. He achieved both.

"All of these steps have been to create a solid foundation or launching pad," Midkiff adds. "Partnership offers stability; being division director helps me learn about the financial side of radiology; and serving as assistant residency director allows me to teach and train."

He also stays motivated by recognizing gaps in his knowledge about radiology. "Doctors are not taught nearly as much about things like budgets as they should be," he notes. "Looking over your first budget, you're trying to make decisions about equipment and staff, and so getting involved in an administrative role is helpful to learn about hospital infrastructure."

"The single best way to get ahead when first in practice is to build interpersonal relationships." —  Brian D. Midkiff, MD, MPH

Staying Motivated

However, Midkiff wouldn't have been able to accomplish so much so early in his career if he hadn't taken the opportunity to reconnect with his love of radiology in residency. "The third year was a real step up in terms of motivation," he says. "You've been taking all this call — lots of nights and weekends, and then comes the radiologic pathology correlation course. At that course, you get to focus on your learning and you realize that you're at the next level of training. You look at your books in a different way."

The third year has the added interest of completing fellowship applications. "Interviewing, visiting other institutions, and seeing new technology — you get a glimpse of your future," Midkiff says. "That was exciting."

Of course, other obvious milestones during residency give young physicians a reason to do more than just coast. Passing the oral boards is an accomplishment in and of itself, which requires more than the minimum amount of effort. Christina Cinelli, MD, fourth-year radiology resident at Johns Hopkins University in Baltimore, is a member of the last class of residents who will take the traditional oral boards before the ABR institutes the new computer-based assessments. "For me, this exam is a tremendous motivator to finish strongly," Cinelli says. "Just like it was in medical school, studying for a test is always a nice way to make your knowledge cohesive."

"For me, [the oral boards are] a tremendous motivator to finish strongly." — Christina Cinelli, MD

Importance of Mentors

If you hyperventilate when thinking about oral boards, you can gain some perspective — and plenty of fantastic advice — from mentors. These are the "really great people [who] make you feel that you, too, can become great," Mark Twain once said.

"Good mentors definitely provide that spark — they make you want to be a better radiologist and person," says Christopher P. Ho, MD, assistant professor of radiology and assistant program director for residency at Emory University in Atlanta. "I can't stress enough how much having a mentor during residency really facilitates your career. One of my former mentors recruited me from the University of Virginia and has been nothing but supportive and influential. I've been so lucky to have him watch my back ... and make sure that I was doing the right things."

Like Midkiff, Ho had aspirations in resident education, which led him to apply for assistant program director for residency only a year out of fellowship. "I was forewarned that it was possible I wouldn't get the position because I was early in my career," he says. After he got the position, he found out that one of his mentors had written a glowing letter of recommendation.

"My advice to residents is to try new opportunities and leadership roles you may not have thought you were interested in," says Ho. "But you also need to balance the activities you undertake from being a 'yes person' with projects and positions that are really appealing. Otherwise, you'll burn out and lose momentum."

Standing Out in Practice

Ho's recommendations aren't limited to residency. Applying his suggestions while in practice can also help you get noticed by colleagues and managers, which in turn, may motivate you to accomplish more.

But there is more than one way to stand out. "The single best way to get ahead when first in practice is to build interpersonal relationships," says Midkiff. "My boss once asked, 'If a radiologist falls in the forest, does he make a sound?' You don't want to be a silent, single radiologist in the forest. By developing relationships with clinicians, giving them personal service, and taking the time to answer their questions about cases and protocols, you become valuable and secure in your position."

No resident is truly alone in the forest of residency. That's why the ACR began the RFS and is also in the process of developing the Young and Early Career Physician Section following a resolution passed at AMCLC 2012. The new group will encourage ACR participation for members who are age 40 or younger or who are within the first eight years of practice after residency or fellowship. Leaders are in the midst of planning activities for the new section, and more information will be announced in future issues of the Bulletin.

The saying, "you get out of it what you put into it" has never been truer than in residency. As Ho, Cinelli, Midkiff, and Hawkins demonstrate, by being open to new opportunities, challenging yourself, and using available resources — such as mentors, colleagues, and ACR support — you can set high standards not only for yourself, but also for the generation of residents following in your footsteps.

By Raina Keefer
Raina Keefer (This email address is being protected from spambots. You need JavaScript enabled to view it.) is a freelance writer.

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