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Four Challenges Many Early-Career Radiologists Underestimate—and the Solution I Discovered

As radiologists, we make it through the difficulties of residency and fellowship on the idea that if we can just hang in there, we’ll be rewarded on the other side with a successful career helping patients. “Only a few more months and life will be good!” 

However, what traditionally comes after training isn't any easier. The early years of private practice include the same long hours and strict schedules with a vague promise of stability one day.  

I think this reality is often underappreciated among early-career radiologists. I know it was for me and a few of my colleagues. With this article we hope to cast light on these issues and share our experience with a solution that is often overlooked—the alternative career path of teleradiology. 

Practicing independently can be daunting 

Following training, the idea of signing final reports without anyone else’s oversight can be intimidating. As early-career radiologists, we want to continue learning alongside more experienced colleagues.  

The breadth of anatomy and pathology that radiologists come across daily is vast, making assistance from other doctors at times invaluable. Sadly, the idea of mentoring in traditional radiology jobs is disappearing. As imaging volume increases, there's less time to collaborate with colleagues. Those would-be mentors are busy clearing their worklists so they can get home to their families, too.  

Another reality is that new radiologists often work after-hours shifts alone without access to their veteran colleagues. I know radiologists who selected an in-person position specifically for the benefits of having a team and mentorship. They ended up surprisingly isolated and very frustrated.  

While radiologists in traditional settings are becoming more isolated and production-driven, our radiologists have access to an amazing support network on a single platform with built-in consult tools.  

Since my first day at vRad, I have received overwhelming support with all the tasks that seemed overwhelming and was assigned a more experienced radiologist as my mentor. Moreover, if I ever get a case that I haven’t seen before or just want that extra reassurance of looking at it with a colleague, I simply reach out using the consults tool on our reading platform. No matter the time of day, dozens of subspecialty-trained radiologists are always online and willing to assist. Many radiologists love to help—especially since they’re not pressured to get through the worklist. In fact, each year our CMO presents a fun award for the most consults.   

Even though we are physically separated, we never work alone.  


Busy lives require more time than private practice can give 

We know the first several years of a radiology career are going to be busy—but they often collide with the busiest part of our personal lives as well. Many radiologists get a new job and perhaps move to a new location. Others might be buying homes, getting married, or are starting families.  

All these things require time and attention, but a traditional radiology position doesn't allow for that. Early-career rads are paying their dues, so to speak. They have less seniority, with little control over their time off and schedule. And since many feel pressure to prove themselves, they'll take on more shifts or increase the volume of cases they read daily.  

My colleagues have talked about how they completely missed out on personal events in their previous positions. Birthdays, date nights, kid events and the like should be a time for celebration. Missing them adds stress and pressure to overworked radiologists, compounding the problem.  

vRad's flexibility and sheer size of 500 radiologists allowed me to set a work schedule that fits with my personal life. My job doesn’t compete with my personal life, it complements it. This lifts a significant amount of pressure off of me so that when I work, I do so efficiently.


Practicing medicine vs. the administrative duties of practice partnership

Many early career rads choose traditional career paths so they can become partner one day. We are led to believe that landing partner is the ultimate goal, so we must sacrifice personal comforts to get there.  

It is true that teleradiology generally doesn't lead to a partner position. But for me, that's more than okay.  

Becoming partner means shifting your focus away from radiology and toward business management. While this may be ideal for some radiologists, it's not a fit for everyone. Most radiologists complete years of training to help others—not make decisions about new hires or the yearly budget. While vRad has opportunities for leadership and administrative roles, I am more than happy to forgo these or a partnership track if it means I can focus on what I was trained to do: read imaging studies. 

Focusing too much on advancement and securing a partner position can also affect your work-life balance. I touched on this in the previous point, but it stands repeating. Working traditional radiology positions in pursuit of partnership can absorb years of your life.

Beware of mundane casework  

Just like most other radiologists, I pursued this career because I love the work. However, what can put a damper on that passion is getting stuck in a routine of reading similar or otherwise unfulfilling cases, which is quite common in private practice settings. vRad, on the other hand, offers an intriguing mix of case types.  

I routinely read images from a wide range of settings from large well-known university medical centers in urban settings to very small rural clinics. We receive diverse cases (>60% CT) covering a breadth of pathology, including everything from level-one trauma to bread-and-butter emergency radiology cases.   

I must say that it's quite gratifying to help small towns and rural communities that have limited resources or may not have a subspecialty radiologist after hours. The case diversity also makes the work anything but routine so my passion for radiology still burns bright. 

It’s a shame teleradiology isn’t discussed in training  

It’s rare that radiologists in training learn much, if anything, about the career path of teleradiology. I suspect some still view the industry as a competitive threat. Many believe that remote work is unsuitable for early-career radiologists while others think this career is for rads nearing retirement. As a result, people tend to ignore teleradiology and push more traditional paths that tend to be hospital or group-based.  

This is unfortunate because teleradiology can actually be a much better choice for radiologists, especially those just beginning their careers, due to the flexibility, work-life balance, and support services offered. I've experienced benefits I never thought possible so early in my career, and more radiologists should consider this career path.

Consider a career in teleradiology   

As you begin your radiology career, take the time to evaluate your priorities. Consider your professional and personal goals and how your current trajectory can impact them. Keep in mind that there's no reason to sacrifice your personal life and aspirations for a career in radiology.  

That elusive work-life balance that so many people seek can become your reality with a career in teleradiology. As you explore your options, keep in mind that not all teleradiology practices are the same. Don’t miss the story from my colleague Dr. Jaime Salvatore, Being a teleradiologist was a nightmare at first, but now it’s my dream job.  

I hope you consider working with vRad. Each radiologist works at their own pace with no worklist pressure, which helps you balance productivity and quality patient care. Working from home also removes the distractions and inefficiencies that exist in a traditional workplace. 

If you would like to talk to me more about the teleradiology experience, you can request to be contacted here and mention my name. I'd be more than happy to share my experience and answer your questions.  

Thank you to my colleagues Mary Huff, MD; Jaime Salvatore, DO; and John Krol, MD for their contributions to this article.

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Author Teresa McQueen, MD

vRad Radiologist



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