Clinical radiologist

Clinical radiologists are medically qualified doctors specialising in the use of imaging to investigate, diagnose and treat a range of clinical conditions and diseases

You'll use a variety of imaging techniques, such as:

• computed tomography (CT) scans
• fluoroscopy
• magnetic resonance imaging (MRI)
• molecular imaging
• nuclear imaging
• positron emission tomography (PET)
• ultrasound
• x-rays.

You will also perform many of the interventional procedures and may run patient clinics, prepare patients for surgery, take biopsy samples and perform minimally invasive surgery (interventional radiology).

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

Interventional radiology is the only sub-specialty of clinical radiology that is officially recognised by the General Medical Council (GMC). Interventional radiology uses 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.

You can, however, specialise in a particular area of interest, including:

• breast
• cardiac
• chest
• emergency
• gastrointestinal
• genitourinary
• head and neck
• musculoskeletal
• neuroradiology
• oncology
• paediatric
• radionuclide radiology
• vascular.

Many radiologists will specialise, but you can also work as a generalist in all types of imaging and can also perform some interventional work.

Responsibilities

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.

Salary

• The basic salary during foundation training in England is £36,616 to £42,008. Salaries for doctors starting their specialist training range from £49,909 to £70,425.
• As a speciality doctor, you'll earn between £59,175 and £95,400. Salaries for specialist grade doctors range from £96,990 to £107,155.
• Salaries for newly qualified consultants start at £105,504, rising to £139,882 depending on the length of your service.

Resident doctors (formerly known as junior doctors) will earn a basic salary, plus pay for any hours over 40 per week, a pay enhancement for working nights, a weekend allowance and an allowance if you're on call.

High-cost supplements are available to clinical radiologists working in London. You'll automatically be enrolled in the NHS pension scheme, but you can opt out.

Consultants in England and Wales may apply for local Clinical Excellence Awards and national Clinical Impact Awards. You should also be paid more if you take on extra responsibilities in, for example, management or education. In Scotland, you can apply for discretionary points. Consultants 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 clinical radiologists in the UK.

Salary bands differ across the four countries of the UK. Pay negotiation happens annually at different times, so salaries will change when each country agrees their new pay award. Check your country's pay scales for doctors for the most up-to-date NHS salary information.

Income data from NHS Health Careers. Figures are intended as a guide only.

Working hours

Junior radiologists often work long and unsocial hours, including weekends and nights (usually on a rota basis). As a consultant, on-call or out-of-hours work varies depending on the type of hospital you're working at, especially if there's 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 you'll find opportunities to train on a less than full-time basis.

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, musculoskeletal 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 continue 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, being able to diagnose and treat illnesses is incredibly rewarding.

Qualifications

To become a clinical radiologist, you must complete:

• a degree in medicine recognised by the General Medical Council (GMC)
• a two-year foundation training programme of general training
• specialist training in clinical radiology, which lasts five years (or six if you want to specialise in interventional radiology).

Medical degrees usually take five years to complete, although 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). For a list of medical schools, see the Medical Schools Council.

This is followed by two years of paid work-based foundation training common to all medical graduates that allows you to develop your clinical and professional skills in the workplace. You must apply for a foundation training place via the Oriel website. During this training, you'll undertake a series of work placements in different departments that may include radiology. For full details, see the UK Foundation Programme.

The next stage of training is the radiology specialty training programme, which takes five years to complete (stages ST1-ST5). There is a further year of training (ST6) if you want to specialise in interventional radiology. You will need to apply via Oriel for specialty training.

The first three years of speciality training are in general radiology, followed by two years of special interest training (or three if you're following the interventional radiology path).

During your specialty radiology training you'll also take examinations leading to Fellowship of The Royal College of Radiologists (FRCR). On successful completion of your training, you'll be awarded the Certificate of Completion of Training (CCT), which allows you to join the GMC Specialist Register and to apply for radiology consultant positions.

There's an increasingly large number of doctors who are neither trainees nor consultants. They take up posts as specialty and specialist grade doctors (SAS). However, according to the RCR, only a very small percentage of the radiology workforce are SAS doctors, much lower than in other medical specialties.

For full details on radiology training, see RCR Career development.

Find out more about the qualifications and training required to be a hospital doctor.

Skills

You'll need to have:

• clinical expertise in radiology, with a good understanding of general medicine and surgery
• manual dexterity, particularly for image-guided procedures and interventional radiology
• excellent analytical and problem-solving skills to interpret complex imaging data
• keen observational skills and strong attention to detail
• the ability to remain calm under pressure and make informed, evidence-based decisions
• leadership skills with the ability to organise, train and motivate others
• empathy, sensitivity and respect when interacting with patients and colleagues
• the ability to work flexibly and collaboratively as part of a multidisciplinary team
• excellent interpersonal and verbal communication skills to liaise with clinical teams and explain findings
• strong written communication skills for clear and accurate report writing
• a flexible approach to work with the ability to adapt quickly to changing situations and new challenges
• an innovative and imaginative approach to work
• emotional resilience to work in challenging situations
• self-motivation, initiative and a commitment to continuous learning
• the ability to manage clinical complexity and uncertainty
• awareness of current trends, research and innovations in clinical radiology
• knowledge of relevant legal, ethical and professional requirements.

Work experience

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 doctor and provides insight into the physical and emotional demands of working in medicine.

Once you're at medical school, try to choose modules in radiology. You could also consider an elective placement. Contact your local radiology department to see if they can help you organise a student selected clinical placement, elective or clinical audit, for example.

It's also a good idea to join and get involved in your university's radiology student society to keep informed about developments in the field. You could also consider becoming a student member of the British Society of Interventional Radiology.

During your two-year Foundation Training as a resident doctor, you'll need to choose a radiology placement to gain an insight into the work. Make the most of networking opportunities by attending conferences and events.

For free mentoring resources and experiences designed to support aspiring doctors, including virtual work experience that is accepted by medical schools, see Medic Mentor.

Find out more about the different kinds of work experience and internships that are available.

Employers

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.

Look for job vacancies at:

• BMJ Careers
• NHS Jobs - England and Wales.
• NHSScotland Jobs
• Jobs.hscni.net - health and social care jobs in Northern Ireland.
• RCR Jobs Board (Clinical Radiology)

Professional development

As a clinical radiologist, you'll be expected to continue learning throughout your career. Continuing professional development (CPD) is essential if you want to remain on the GMC register. In particular, you'll continue to develop your knowledge in your area of special interest/clinical area or explore new intervention techniques.

CPD activities can include attending courses, conferences, meetings and workshops, as well as undertaking research and peer-reviewing journal papers. Membership of the Royal College of Radiologists (RCR) provides access to a range of courses, events, resources, advice and networking opportunities. For more information, see RCR CPD and events.

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.

There is also a range of postgraduate teaching qualifications available if you want to integrate more formal teaching into your work. See, for example, the Postgraduate Certificate in Medical Education for Radiology, aimed at trainee and consultant radiologists with an interest in developing their careers in medical education.

You can also develop your management skills by taking a variety of courses through the RCR and the national NHS Leadership Academy programmes.

Career prospects

As a consultant you'll 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.

If you're working as a specialty doctor, you'll spend most of your working day on patient care and are responsible to a named consultant clinical radiologist. There is some scope for leadership and management roles, and you may also have the opportunity for teaching, research, committee work and more. 

It's not unusual for clinical radiologists to be recruited to higher management levels such as medical director, chief executive or dean. This is partly 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.

If you're interested in teaching future doctors you may become a director of medical education, training programme director or associate dean in charge of the entire training programme.