If you're a natural problem-solver with a keen eye for detail and enjoy working with cutting-edge technology, then a career in clinical radiology may be for you
Clinical radiologists are medically qualified doctors specialising in the investigation and diagnosis of a range of clinical conditions and diseases, using a variety of imaging techniques such as:
- computed tomography (CT) scans
- magnetic resonance imaging (MRI)
As a clinical radiologist, you'll be responsible for reporting most imaging procedures and will also perform many of the interventional procedures. 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
As a clinical radiologist you may focus on either diagnostic radiology or interventional radiology (the only sub-specialty recognised by the General Medical Council (GMC)), or on a mixture of the two:
- diagnostic radiology - involves finding out what is clinically wrong with patients using a range of imaging techniques. You can develop a special interest in a variety of clinical areas including paediatric, musculoskeletal or cardiac.
- interventional radiology - concerned with 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.
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.
- The basic starting salary for junior hospital doctor trainees at Foundation Training level is £26,614 in the first year, rising to £30,805 in the second year. As a trainee doctor you'll receive a basic salary plus salary enhancements for any hours which fall into the unsocial hour periods.
- As a trainee at specialty level you can earn between £36,461 and £46,208. Salaries for specialty doctors (staff grade) range from £37,923 to £70,718.
- The salary for newly qualified consultants starts at £76,761, rising to £103,490 for consultants with 10 to 19 years' experience.
Allowances are paid for working nights, weekends and being on call. You will automatically be enrolled in the NHS pension scheme but you can 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, which is the largest employer of radiologists in the UK.
Income data from NHS Health Careers. Figures are intended as a guide only.
Junior radiologists often work long and unsocial hours, including weekends and nights (usually on a rota basis). On-call or out-of-hours work for consultants can vary depending on the type of hospital you're working at, especially if there are 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 there are opportunities to train on a less than full-time basis. Currently, around one-fifth of clinical radiologists work part time.
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, fluoroscopy 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, it can also be rewarding as you're able to diagnose and treat illnesses more quickly than in the past. On-call work can be particularly pressured, especially if you need to travel between hospital sites.
- Currently, 39% of trainee radiologists are women, compared with 61% of men (Clinical Radiology UK Workforce Report 2015).
To become a clinical radiologist, you'll need to start by taking a degree in medicine recognised by the General Medical Council (GMC), which usually takes five to six years to complete. 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 medical graduate entry programme (GEP).
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. On successful completion, you'll be awarded a Foundation Achievement of Competency Document (FACD.)
The next stage of training is the radiology specialty training programme, which takes five or six years to complete depending on whether you wish to follow a diagnostic or interventional radiology career path.
The first three years of speciality training are in general radiology and are common to both diagnostic and interventional training paths.
If you're continuing with a diagnostic training path you will then undertake two years of special interest training covering a variety of areas such as paediatric, musculoskeletal and cardiac radiology. However, if you elect to follow the sub-specialty interventional training path you will undertake a further three years of interventional radiology training to develop techniques such as inserting stents to blocked blood vessels, performing biopsies and treating joint, tendon and ligament lesions, while still maintaining core radiology competencies.
During your specialty radiology training you will also take examinations leading to Fellowship of The Royal College of Radiologists (FRCR.) At the end of your diagnostic or interventional radiology training you'll receive a Certificate of Completion of Training (CCT) and will be eligible for entry on to 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.
You will need to have:
- an analytical mind, an eye for detail and good observational skills
- a keen interest in anatomy, physiology and pathology
- a good understanding of general medicine and surgery
- manual dexterity for certain roles
- good clinical knowledge across all specialties
- 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 deal with patients and colleagues
- strong written communication skills for accurate report-writing.
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 radiology. 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 that will give you a good insight into the work.
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. There are currently plenty of opportunities available for radiologists.
Look for job vacancies at:
- BMJ Careers
- NHS jobs - England and Wales.
- NHS Scotland Recruitment
- Northern Ireland Health and Social Care Jobs
Look for training posts at:
- National Radiology Recruitment (England, Wales and Scotland) - national radiology recruitment coordinated by Health Education England (London and South East), for speciality clinical radiology training posts.
- Northern Ireland Medical and Dental Training Agency (NIMDTA)
There is a good demand for radiologists, with an increase in training numbers planned. The competition ratio (applications per post) for training places is currently just under four to one.
Continuing professional development (CPD) is essential if you want to remain on the GMC register, and as a radiologist you will 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. The Royal College of Radiologists provides guidance on undertaking CPD.
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.
If you wish to integrate more formal teaching into your work, there is a range of postgraduate teaching qualifications available. The Postgraduate Certificate in Medical Education (PGCME) for Radiology, for example, is aimed at trainee and consultant radiologists with an interest in developing their careers in medical education. Search for 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 programme.
As a consultant you will 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.
Radiologists interested in teaching future doctors may become a director of medical education, training programme director or associate dean in charge of the entire training programme.