January 18, 2023

Managing Workflow While Striving for Growth as a First-Year Resident

Blake H. Salisbury, MD

Blake H. Salisbury, MDThe time had come when I finally finished my transitional year and was ready to move on to diagnostic radiology, the field that felt so far away for the past 12 months. While my transitional year program included diagnostic and interventional radiology for one month each, the exposure was limited and only offered a chance to dip my toes into the radiology waters. I was nervous, excited and a tad scared, but I was ready to start working and learning.

My first rotation was GI fluoroscopy. I knew of several GI studies and had ordered multiple the year before but had never performed or interpreted any of the exams. I wasn’t quite sure what most of the examinations entailed or where to begin.

What contrast do you use? Why is surgery calling me about a gastrografin enema on a constipated patient? What do the buttons on the fluoroscopy machine do?

I had five procedures the first day, mostly esophagrams and upper GI studies. Between looking up patient histories and how to perform the procedures, I may have read an additional chest X-ray or two. I survived the day, less enthused than when I started. I was frustrated that I felt clueless and worried that I would never have a strong understanding of radiology.

Day-to-day work did get better, not just in GI, but in all the rotations throughout my first few months. I was fortunate to have multiple strong senior residents show me the ropes and guide me so that I wasn’t completely overwhelmed. Gradually the workflow and general cluelessness became more manageable and exciting. As I look back, now being more than six months into my first year, I still know little. However, I am excited about my work and studies, and less intimidated by the phone ringing, procedures and long list of stat studies to be read on PACS.

Radiology is a hard specialty, but it is extremely rewarding intrinsically. I have a long way to go in my residency, but I feel more and more excited for the future as I keep working towards my goals of becoming a radiologist.