Clinical radiologist

Clinical radiologists are medically qualified doctors specialising in the use of imaging to investigate, diagnose and treat a range of clinical conditions and diseases

You'll use a variety of imaging techniques, such as:

• computed tomography (CT) scans
• fluoroscopy
• magnetic resonance imaging (MRI)
• molecular imaging
• nuclear imaging
• positron emission tomography (PET)
• ultrasound
• x-rays.

You will also perform many of the interventional procedures and may run patient clinics, prepare patients for surgery, take biopsy samples and perform minimally invasive surgery (interventional radiology).

You'll work closely as part of a multidisciplinary team that includes radiographers, other doctors and medical staff from a range of specialties and will provide expert guidance and advice.

Types of radiology

Interventional radiology is the only sub-specialty of clinical radiology that is officially recognised by the General Medical Council (GMC). Interventional radiology uses image-guided pin-hole surgery to treat a variety of conditions - from life threatening aneurysms and haemorrhages to joint, tendon and muscle injuries - in the least invasive way.

You can, however, specialise in a particular area of interest, including:

• breast
• cardiac
• chest
• emergency
• gastrointestinal
• genitourinary
• head and neck
• musculoskeletal
• neuroradiology
• oncology
• paediatric
• radionuclide radiology
• vascular.

Many radiologists will specialise, but you can also work as a generalist in all types of imaging and can also perform some interventional work.

Responsibilities

As a clinical radiologist, you'll need to:

• use images to diagnose, treat and manage a variety of medical conditions and diseases
• offer specialist expertise and guidance to other doctors and staff from a range of medical specialties
• liaise with other medical and non-medical staff in hospital settings to ensure quality treatment
• examine patient anatomy, pathology, clinical history and previous imaging
• select appropriate radiology techniques for patient diagnosis
• assess and support patients through various diagnostic and interventional radiology procedures
• undertake minimally invasive techniques to guide and direct a variety of interventional treatments throughout the body
• manage the health and safety of your patients and the radiology team by minimising radiation exposure
• write up imaging reports and report on cases to multidisciplinary team meetings
• carry out teaching of junior staff, auditing and research.

Salary

• The basic starting salary for junior hospital doctor trainees at Foundation Training level is £29,384 to £34,012. As a trainee doctor you'll receive a basic salary plus pay for any hours over 40 per week, a salary enhancement for working nights, a weekend allowance and an availability allowance if you're on-call.
• As a trainee at specialty level you can earn between £40,257 and £53,398. If you're working as a specialty doctor, you'll earn a basic salary of £50,373 to £78,759. As a specialist grade doctor you'll earn a basic salary of £80,693 to £91,584.
• Salaries for newly qualified consultants start at £88,364, rising to £119,133 for consultants with ten to 19 years' experience.

Beyond trainee level, you'll receive allowances for working nights, weekends and being on call. You'll automatically be enrolled in the NHS pension scheme but are able to opt out.

Consultants may apply for local and national Clinical Excellence Awards and are also able to supplement their salary by working in private practice.

Figures relate to the pay and conditions of medical doctors within the NHS - the largest employer of radiologists in the UK.

Income data from NHS Health Careers. Figures are intended as a guide only.

Working hours

Junior radiologists often work long and unsocial hours, including weekends and nights (usually on a rota basis). As a consultant, on-call or out-of-hours work varies depending on the type of hospital you're working at, especially if there's a limited number of specialty trainees. However, most clinical radiologists find that a good work/life balance is possible.

Part-time work is also an option, and you'll find opportunities to train on a less than full-time basis.

What to expect

• You'll spend a large part of your time writing and reporting on imaging procedures, including follow up with a range of healthcare professionals. The amount of contact you have with patients varies depending on the role you specialise in. If you work in ultrasound, musculoskeletal or breast imaging, for example, you're likely to work with patients more regularly. This also applies to interventional radiography.
• On-call work is regarded as a key part of training in radiology and may increase at consultant level, depending on the type and size of the employing hospital.
• Jobs are available at NHS and private hospitals throughout the UK.
• The work can be challenging, especially with the increase in the number of interventions and evolving imaging techniques. However, being able to diagnose and treat illnesses is incredibly rewarding.

Qualifications

To become a clinical radiologist, you'll need to first complete a degree in medicine recognised by the GMC, which usually takes five to six years. If you've already got a degree in a subject other than medicine (usually a 2:1 or above in a science-related subject) you can apply for a four-year accelerated graduate entry medicine programme (also known as a graduate entry programme). For a list of medical schools, see the Medical Schools Council.

You'll then need to complete a two-year Foundation Training programme, common to all medical graduates, where you'll work in hospitals as a junior doctor on a rotational basis in different departments that may include radiology. After successful completion of the first year of Foundation Training, you can apply for full registration as a doctor with the GMC. On successful completion of the programme, you'll be awarded a Foundation Programme Certificate of Completion (FPCC). For full details, see the UK Foundation Programme.

The next stage of training is the radiology specialty training programme, which takes five years to complete (stages S1-S5). There is a further year of training (ST6) if you want to specialise in interventional radiology.

The first three years of speciality training are in general radiology, followed by two years of special interest training (or three if you're following the interventional radiology path).

During your specialty radiology training you'll also take examinations leading to Fellowship of The Royal College of Radiologists (FRCR). At the end of your training, you'll receive a Certificate of Completion of Training (CCT) and will be eligible for entry onto the GMC Register. You can then apply for consultant posts.

For full details on radiology training, see RCR Careers and recruitment.

For details on the qualifications and training required to be a doctor, see hospital doctor.

Skills

You'll need to have:

• an analytical mind
• a keen interest in anatomy, physiology and pathology
• a good understanding of general medicine and surgery
• manual dexterity for certain roles
• an eye for detail and good observational skills
• good clinical knowledge across all specialties
• problem-solving skills
• the ability to multitask and work under pressure
• the capacity to work well in a team and to manage others effectively
• excellent verbal communication skills to engage with patients and to collaborate with and advise colleagues and other clinicians
• strong written communication skills for accurate report writing
• a flexible approach to work with the ability to adapt quickly to changing situations.

Work experience

Before applying to do a medical degree, you're expected to undertake work experience, either paid or voluntary, in areas relevant to medicine. This could be through work experience at your local hospital, GP surgery or nursing home, or through work shadowing a doctor. This experience shows your commitment to becoming a radiologist and provides insight into the physical and emotional demands of working in medicine.

Consider becoming a student member of the British Society of Interventional Radiology, as well as joining your university's radiology student society, to keep informed about developments in the field. You could also take a student-selected module, project and elective in radiology as part of your undergraduate medical degree.

During your two-year Foundation Training as a junior doctor, you'll need to choose a radiology placement to gain an insight into the work.

For free mentoring resources and experiences designed to support aspiring healthcare and legal professionals - including virtual work experience that is accepted by medical schools, see Medic Mentor.

Find out more about the different kinds of work experience and internships that are available.

Employers

The NHS is the largest employer of clinical radiologists. There are also opportunities to work in the private sector, as well as setting up a private practice.

Look for job vacancies at:

• BMJ Careers
• NHS Jobs - England and Wales
• NHSScotland Jobs
• Jobs.hscni.net - health and social care jobs in Northern Ireland.

Professional development

Continuing professional development (CPD) is essential if you want to remain on the GMC register, and as a radiologist you'll be expected to continue learning throughout your career. In particular, you'll continue to develop your knowledge in your area of special interest/clinical area or explore new intervention techniques.

CPD activities include attending courses, conferences, meetings and workshops, as well as undertaking research and peer-reviewing journal papers. For more information, see the RCR CPD Scheme.

There are excellent opportunities for research up to PhD level. Research areas range from the effectiveness and application of resources and techniques to supporting the evaluation of drug trials.

There is also a range of postgraduate teaching qualifications available if you want to integrate more formal teaching into your work. See, for example, the Postgraduate Certificate in Medical Education (PGCME) for Radiology, aimed at trainee and consultant radiologists with an interest in developing their careers in medical education. Search postgraduate courses in radiology.

You can also develop your management skills by taking a variety of courses through the Royal College of Radiologists and the national NHS Leadership Academy programmes.

Career prospects

As a consultant you'll gradually gain more clinical experience and take on more managerial responsibilities. You may then move on to a senior consultant role or, in larger departments, you could take on responsibility for your own subspecialty or imaging technique.

It's not unusual for clinical radiologists to be recruited to higher management levels such as medical director, chief executive or dean. This is primarily due to the fact that radiology interacts with so many areas of service and provides a broad overview of medicine.

There are also opportunities to work in the private sector and government agencies, as well as directing professional and scientific societies.

If you wish to take up scientific research and an academic career, you'll need to start early during your Foundation Training as this field is highly competitive.

If you're interested in teaching future doctors you may become a director of medical education, training programme director or associate dean in charge of the entire training programme.