_{Published August 5, 2022}

Every year, medical students, early in their educational journeys, are encouraged by deans and other high-ranking medical school administrators to consider primary care (internal medicine, family medicine, or pediatrics) as a career choice. Most of us chose a different, more specialized route and wound up in radiology.

Now, I would like to encourage you to be a primary radiologist. By saying primary radiologist, I am not encouraging you to go into primary care, but rather to be the best radiologist that you can be. Primary radiologists are leading radiologists—working at a very high level, communicating clearly and effectively with referring physicians and patients, and keeping up to date with new developments in imaging and medicine. Most practices or groups have a primary radiologist—the highly accurate radiologist who is consulted on the most difficult cases and who is always available to help.

The primary radiologist’s role is based heavily on earning the respect of others. A primary radiologist is the one you and others turn to when you need an expert opinion. Oftentimes, a colleague will ask, did you show the case to Dr. _____? Alternatively, one may want an opinion on how Dr. _____ would approach a difficult procedure.

It is difficult to be a primary radiologist. There are ongoing global stressors, like the COVID-19 pandemic, and stressors affecting radiologists, including high burnout rates and an ever-increasing workload. Bhargavan et al. noted that when 2006–2007 data was compared to 2002–2003 data, the annual workload per full-time equivalent radiologist increased by 7%. When 2006–2007 data was compared to data from 1991–1992, the annual workload per full-time equivalent radiologist increased by 70.3%! Now, 2006–2007 seems like a long time ago, and, undoubtedly, workloads have continued to rise over the last 15 years. 

How do we become primary radiologists in the current milieu? When we think of doing a great job, we need to define success. Success may be defined differently by deans, hospital administrators, chairs, section heads, and individual radiologists. As many of us are working very hard these days, it makes sense to think about what success means. John Wooden served as the basketball coach at the University of California, Los Angeles (UCLA) from 1948 to 1975. During that time, he led the UCLA Bruins to 10 National Collegiate Athletic Association (NCAA) basketball championships. I like John Wooden’s definition of success. Coach Wooden stated that “success is peace of mind which is a direct result of self-satisfaction in knowing you did your best to become the best that you are capable of becoming.”

In Coach Wooden’s Pyramid of Success, industriousness and enthusiasm are major cornerstones. Regarding industriousness, I don’t see radiologists’ workloads diminishing any time soon.  In our current world of radiology, I agree with Coach Wooden, who noted that “there is no substitute for work. Worthwhile results come from hard work and careful planning.” When discussing planning and preparation, Coach Wooden stated that “failing to prepare is preparation for failure.” This important maxim applies to individual cases and procedures, as well as to our overall growth and development.

As we strive to be primary radiologists, our continued growth and development is based on self-assessment and identifying educational opportunities to rectify our perceived deficiencies. As we head into a new academic year and try to find top-notch educational content to fill our gaps, I suggest looking into the vast portfolio of educational offerings from our American Roentgen Ray Society. On ARRS.org, you will find information on the 2023 ARRS Annual Meeting in Honolulu, Hawaii, upcoming Live Symposia, Online Courses, Web Lectures, Quick Bytes, and Global Partner Education, including American Journal of Roentgenology (AJR) articles with credit, AJR Webinars, Author Videos, Podcasts, Tweetchats, Visual Abstracts, and much more. Whatever you are looking for, it is very likely that you will find it on the ARRS website and various social media channels.

In our quest to become primary radiologists, a key ingredient is enthusiasm. Coach Wooden noted that enthusiasm “brushes off upon those with whom you come in contact.” He continued, noting that “you must truly enjoy what you are doing.” Being enthusiastic about an unrelenting onslaught of work can be challenging, but we should try to be enthusiastic toward those who really need our services—our patients and our referring providers—and our team members. In general, our teams will function at a higher level if we treat everyone with enthusiastic, professional respect.

In addition to enthusiasm and industriousness, I think that in today’s topsy-turvy world, adaptability is critical. If we are going to be at the top of our game and really be the primary radiologists that we are capable of becoming, we must be able to adapt to new and sometimes unforeseen situations. Coach Wooden defined adaptability as “being able to adjust to any situation at any given time.”  Just think of how different October 2019 (pre-COVID) was compared to March 2020 (early in the COVID-19 pandemic). The first COVID-19 outbreak was reported in Wuhan, Hubei, China in November of 2019, and by March 11, 2020, we were involved in a major pandemic with 118,465 confirmed cases of COVID-19 and 4,295 deaths worldwide. As we enter a new academic year, I want to encourage you to be the best radiologist that you can be—to be your best version of a primary radiologist. It won’t be easy, but with industriousness, enthusiasm, and a lot of adaptability, I think that we can do it and enjoy the journey!