Applying to Radiology

Radiology is a very exciting and innovative field of medicine. Radiologists have such an important role in the investigation of a patient’s condition and the field is becoming increasingly popular. In this article, we discuss what is great about radiology, how you can apply and how to put in a competitive application.

Why Radiology?

Now more than ever, patients almost always undergo some sort of imaging investigation, and this imaging is integral to shaping the decisions that clinicians make around diagnosis and management. Therefore, the importance of Radiology as a specialty cannot be underestimated. When undertaking a Radiology placement as a final year medical student, I was fascinated by the work carried out by the consultants. Their level of knowledge and understanding of anatomy, physiology and pathology was so detailed, and they had to apply this knowledge to help answer important clinical questions.

Radiologists don’t just look for pathology – they have to work out the clinical significance of the finding and relay that to the clinician in a way that allows them to understand what next steps they need to take. If you want to have that kind of role in shaping patient care, then Radiology is for you.

As simple as it sounds, another reason I like Radiology is because it is just so cool. Many a patient has expressed how interesting it is to be able to see “inside” a person, and I can’t help but agree. In real-time, I can look at someone’s aorta, or watch them swallow contrast and see it go through the oesophagus into the stomach. You learn about the physics of medical imaging which can be very tough but also very interesting (I now actually understand the difference between T1 and T2-weighted MRI imaging – that was a tough physics lesson!) I am constantly being pulled away by colleagues to look at an interesting finding CT or MRI, and no two days in work are ever the same. 

This is a specialty in which doctors have a notoriously good work-life balance, although this is beginning to change for consultants dealing with an ever-increasing workload. Every consultant and trainee I met on my taster week told me how happy they were and how they would highly recommend Radiology, and nationally it is one of the highest-ranking specialties for clinician satisfaction. 

What is the training programme like?

Radiology is understandably competitive to get into. Trainees undergo a five-year run through programme and will often start with no nights or on-call shifts, and will always be heavily supervised, allowing plenty of time to focus on learning.

Training Pathway

Clinical Radiology has a 5-year run-through training programme (ST1-5), however, you may choose to specialise in interventional radiology in which case there is an ST6 year. There is no application process for ST3 post as this is a run-through programme. You can find out more about the training pathway for clinical radiology here.

Clinical Radiology pathway

Image from here

Life as a Radiologist

Most patients will make contact with the radiology department when seeking help for a health issue, so contrary to popular opinion, Radiology trainees end up with quite a lot of patient contact. I currently have two ultrasound clinics, one breast clinic and one fluoroscopy list per week. This means I have contact with patients every day, and instead of standing behind a consultant writing notes, running off to write discharge summaries or sending off referrals, I get to spend one-on-one time with patients. I really love being in the breast unit because I get to be part of a fantastic team who are not just performing important investigations, but also supporting patients as they go through a daunting and emotional process. It also means I get to be involved with a variety of image reporting, ultrasound and biopsy. 

The application process

To help build your portfolio you should understand the application process for Clinical Radiology. Look at the RCR’s website for more information: 

November - Applications open on Oriel (the same website you'll have used for F1/F2)
This part of the application is simple. You must ensure that you meet the Person Specification which includes:
– Medical degree
– GMC license to practice
– Completed (or due to complete) Foundation Training within 3.5 years of the start date
– Eligible to work in the UK
– 18 months or less experience in Radiology by the time of the interview date
December - Bookings for the Multi-Specialty Recruitment Assessment (MSRA) open
If you meet the eligibility criteria (see above), you will be asked to book an MSRA slot. This is an online exam that taken in a Pearson Vue Computer Testing Centres which are dotted around the UK. The booking process is first come first served so book quickly! There is a minimum cut-off score that you must meet to be invited to interview. The MSRA score also contributes to a third of your final application score, so you must do as well as you can in this exam.

The MSRA test is split into 2 sections:

Section 1: Professional Dilemmas (Situational Judgement Test)

Time: 110 mins
What it covers:
1) Professional integrity
2) Coping with pressure
3) Empathy and sensitivity

Question Types:
1) 29 Ranking Questions: Rank all responses in order of appropriateness, as discrete actions
2) 29 Multiple Choice Questions (MCQs): Choose the 3 best responses out of 8. Taken together, the 3 responses should fully resolve the situation.

Section 2: Clinical Problem Solving
Time: 75 mins

What it covers:
1) Cardiology
2) Dermatology/ENT/Ophthalmology
3) Endocrinology/Metabolic
4) Gastroenterology/Nutrition
5) Infectious disease/Haematology/Immunology/Allergies/Genetics
6) Musculoskeletal
7) Paediatrics
8) Pharmacology & Therapeutics
9) Psychiatry/Neurology
10) Renal/Urology
11) Reproductive
12) Respiratory

Question Types:
1) 43 Extended Matching Questions (EMQs)
Presented with 7-10 response options, followed by multiple questions linked to this response set. Select the 1 most appropriate response for each question. Each response can be selected once, more than once or not at all.
2) 43 Single Best Answer Questions (SBAs)
Given a scenario: Select the single most likely answer/diagnosis out of 5-8 response options
3) A few Multiple Best Answer Questions (MBAs)
Given a scenario: Select the 2 or 3 most likely answers out of 6-8 response options

Early January – Sit the MSRA

How to prepare for the MSRA
I advise you start revising 2 months before the exam date. Use at least one or two online question banks (e.g. Passmedicine, MCQ Bank, etc.) The old Oxford Handbook practice SJT questions are useful also for revision. Complete the MSRA sample questions which are available on the GP recruitment website and take the Pearson VUE generic tutorial to familiarise yourself with the controls and screen layouts (you will receive an email about this prior to the exam). 

Tuesday 20th February – Invitation to interview

March 12th – 15th – Interview

Interviews will be held online vitually

You will have two stations: previously there was a portfolio station however this will now be done before the interview as candiates will submit evidence which will then be assessed and verified. An overall breakdown of the scoring system below.

1) MSRA
MSRA will make up 20% of candidates overall score and will be used for shortlisting for interview
2) Interview station - Contributes to one third of your overall score
Interview will make up 50% of candidates overall score.
Practice, practice practice. There are loads of useful resources to prepare for interview but the most important thing to do is ask Radiology trainees what questions they got and learn from this. Be as honest and relaxed as you can. You will only get 3 or 4 questions so learn to answer questions in a way that drops in all of your qualities and achievements. The Society of Radiologists in Training has a fantastic example of this (see resources below). Be prepared for a range of questions and not just the usual “Why Radiology”.
3) Portfolio self assessment
This will involve evidence submitted before the interview which will then be verifed by assessors. You will have to score yourself and be careful not to overscore yourself as you may be deducted points. Equally don’t undersell yourself!

The scoring of the portfolio can be found here.

A few days post-interview – Submission of job preferences

26th March – Offers!

How to build your portfolio

Building a Radiology portfolio is not too challenging but it is worth bearing in mind there are a few things that you will only score on if you have completed them within a year before your interview (normally held in February). It is really important to read carefully through the scoring criteria. You should also read the RCR’s website for information on what they are looking for as the point scoring system is based on this (see below).

For 2024 a breakdown of the points below:

  • Research into a career in Imaging through a taster week (multiple experiences will count for more)
  • Clinical Governance, audit and quality improvement (radiology themed)
    • This is important. For full marks, you must have presented two quality improvement or closed-loop audits at national conferences for two points within the last year.  
  • Teaching and training experience
    • PGCERT and Masters in teaching qualification
    • Leading a national teaching programme
  • Research activity and Publications (rdaiology themed for maximum points)
    • First-author publication in a peer-reviewed journal will get you two points for this.
  • National leadership positions (A radiology position will score maximum points)
  • Prizes
    • Radiology prizes and national prizes will score maximum points 

When I applied there were no points for leadership roles or prizes, however, I put these in my portfolio and showed them off at the interview. Be aware that the assessment can change yearly, so while I don’t think you should overfill your portfolio, I do believe it is important to prepare to show off important achievements don’t expect to come up. 

Useful Resources

  • The SRT has a popular Youtube video (recommended by the RCR) on how to get into Radiology, as well as many other interesting resources and conferences.
  • Radiology cafe provides a fantastic in-depth guide for Radiology applicants
  • For MSRA information here is a useful link
  • The Radiology Person Specification is a vital read
  • The RCR has more information about the Radiology application process

By Dr Lara Jehanli BMBS, The SRT Secretary

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