As a radiology registrar part way through my 5 year training program, there are good days and stressful days. We rotate among the North Shore, Middlemore and Auckland hospitals.

Depending on which hospital, and whether im on a particular specialty rotation or not, an average day goes as follows:

The day starts at 8 or 8.30am, rostered on to two half day sessions. For each session i will be rostered with a consultant, who will generally co-sign every report i write. There is often a morning conference, which might be just watching, or (for the more senior registrars) sitting up the front, talking through the cases and answering questions.

Lunch at 12ish. There is often teaching through lunchtime with one of the consulants. A bit of tidying up after the afternoon session formally finishes lets me go home at 5 or 5:30pm. There is half a day of protected teaching time every week. This is well respected, and a time when we get to see all the other radiology registrars in the auckland area (and some from hamilton and tauranga).

Call frequency varies between two longdays a week and one every two weeks, depending on the hospital – just like any registrar job.

One fun part of the job are the observations that can be made and how these can change patient managment.

An interesting case recently: A 40 year old lady with a two day history of left flank pain, and feeling off. No haematuria. Bloods show a mild leukocytosis. The assessing ED doc doesnt know whether to refer her to the urologists or the surgeons. A noncontrast CT of her abdomen shows a small pocket of fat anterior to the descending colon with surrounding inflammation: likely due to infarction of one of the little tags of fat that hangs off her colon. I call up her clinician: “She has epiploic appendagitis.” “She has what?” “Google it. She doesnt need an operation or antibiotics. Just pain relief.”

A lot of the interesting side of radiology is when things arent so clear-cut. We have a number of tools up our sleeve for when things are unclear, and a big part of the job is learning where to use them and when. Plain films techniques, ultrasound, fluoroscopy, CT… you would also be surprised on all the variations that can be achieved with contrast media - be it iodinated contrast material, air or water - by altering where it is given and the timing.

The acute medicine side is limited, and its usually not a place for heroic situations. A radiologist on their own isnt much good to anyone, and its only your part in a larger team of clinicians and allied health professionals that allows you to really help anyone.

Exams are one thing that have to be mentioned; Part 1 in first year, covering anatomy and radiation physics. Take about 4-5 months of study, though most people pass. Part 2 through 4th year. Take a good 12-18 months of study, and (at my stage, still approaching them) seem like quite a hurdle.

People do radiology for many reasons. One myth that seems to be heard less these days is that its for people who dont like people. Getting on with people – doctors and radiographers – is an essential part of the job and most of what we do is through discussion with others. There is also substantial patient contact – while performing an ultrasound scan i often have more time to talk to a patient than anyone else has had during the patients hospital stay.

Overall, I find being a radiology registrar a satisfying way of contributing to the care of patients. Check the college website for details about applying http://www.ranzcr.edu.au/ .

Sohrabh Memon