What Is a Radiologist?

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Like most physicians, radiologists spend much of their young lives in training. Four years of college and four more of medical school (some universities offer combined bachelor's and medical degrees in six year programs thus shaving off two years). After medical school come another five years of residency. Radiologists get tested all the way along, from college into medical school by the MCATS and from medical school into residency by the National Boards or other testing agency.

To be board certified in radiology, candidates must complete an accepted program and pass both written and oral exams. The multiple-choice written test is a daylong ordeal that covers all aspects of radiology, radiation physics, and safety. The oral exams, which are now given in Louisville, KY, every six months, are even more rigorous. Candidates meet with professors in hotel rooms and interpret films under their scrutiny. Each of the six to eight sections of the exam takes about 1/2 hour.

Like all physicians, radiologists are required to complete courses of continued medical education. In addition, radiologists can now become proficient in other areas such as neuroradiology, pediatric, and interventional radiology.

FAQs about Radiologists

1. Do the radiologists work for the hospital? Rarely. Usually, the radiologists do not work for the hospital, even though they work on the premises, use hospital equipment, and work with hospital-employed technologists.
2. Should I expect a bill from the radiologist that is separate from the hospital bill? Yes, generally the radiologist's practice is separate from the hospital, and they will bill you separately.
3. Do radiologists really have "bankers' hours" or is that just a lot of bunk? Sort of bunk. Compared to other physicians, their hours might be shorter, but they interpret images anytime of day, any day of the week, including nights, weekends, and holidays.
4. Can radiologists really interpret images from home? Yes. CT, ultrasound, nuclear medicine, and MR images can be transmitted from the imaging site to a computer in the home of the on-call radiologist. Very little information, if any, is lost in this transmission. X-rays are much more difficult to transmit because of the sheer quantity of information necessary (very large gray scale as compared to digital images). This technology is, however, improving rapidly.
5. Can I ask the radiologist to tell me what he or she thinks? The short answer to this question is "yes," but there are some caveats that are described in more detail elsewhere on this website, Your Rights as a Patient in an Imaging Department.
6. Is the radiologist responsible for the other employees in the hospital department? No, not really. Radiologists generally do not work for the hospital and do not have any sort of control over hospital employees. However, there are long-held health-care conventions that make the radiologist the "Captain of the ship." Most radiologists accept that function.
7. Why do I need a radiologist in the first place? Won't my own doctor look at the pictures? Don't expect that to to happen. Some PCPs can interpret chest and abdomen x-rays, orthopedists can read bone films and so on, but there are very, very few that have become savvy with the newer modalities of ultrasound, CT, and MRI. Most don't even try.
8. How do I find out if the radiologist is qualified and/or skilled? There are a couple of relatively easy things you can do, like ask your primary care physician. Also, many states allow the public to view information about state-licensed physicians. This information includes a physician's training and malpractice history and is often located on an easily accessible website. Unfortunately, though, there's just not a whole lot of information out there, and you'll have to hope that a good hospital will have a good x-ray department with good radiologists. Ask around.

Radiology has evolved. In the 1960s, a "general radiologist" was a physician who did both diagnostic and therapeutic radiology. In the 70s, both fields grew significantly to encompass such vast amounts of information that radiology residents decided to restrict their focus to one or the other, but not both. So diagnostic and therapeutic radiologists went their separate ways. A general radiologist became a physician who does all sorts of diagnostic radiology. As the field grew even larger with the newer imaging studies, radiologists became even more specialized. Now there are neuroradiologists, ultrasound, MRI and CT specialists, mammographers, GI radiologists, and on and on.

Two subspecialities are worth noting. Radiologists often interpret nuclear medicine tests such as bone and lung scans. Other specialists, who have passed an additional nuclear medicine board exam, may interpret radionuclide scans in some hospitals. In other words, the turf is unclear. Secondly, there is the new and very important emerging field of interventional radiology that places specially trained radiologists in a position that is close to being a surgeon.

These radiologists not only study the body, but also do all sorts of procedures, such as dilate blocked arteries, drain fluid collections, and biopsy tumors with needles.

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