Blake H. Salisbury, MD
Managing Workflow While Striving for Growth as a First-Year Resident

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.