Introduction 

Most people assume that a Radiologist is a doctor who spends large amounts of time in a dark room looking at black and white scans of the body. Although this stereotype does have some truth to it, the role of the radiolist goes far beyond this. 

An overall description of a radiologist is a specialist doctor who is involved in the diagnosis and treatment of a variety of medical conditions through the use of medical imaging techniques which include X-rays, computed tomography (CT), nuclear medicine, magnetic resonance imaging (MRI),ultrasound, and positron emission tomography (PET).

They have an extensive training pathway and expertise that makes them a vital component in modern medicine.^1,2  

Roles and Responsibilities of a Radiologist

The important thing to understand about a radiologist is their roles and responsibilities. Although varied can be split into the four categories of

• Interpreting images
• Collaboration
• Performing procedures
• Advising³

Interpreting medical images

• Using their expertise and knowledge of anatomy and pathology to interpret medical images produced by X- ray, CT, MRI, PET, fluoroscopy, molecular imaging and nuclear medicine imaging.⁴
• Summarise the large amount of data produced by imaging tests, and identify the clinically relevant information. This must be processed into a diagnostic, and treatment, report which can be understood by the doctor communicating the results to the patient. 
• Making use of previous medical exams and tests to support their findings.⁵ 

Collaboration 

• Communicating results in the form of clear and structured reports making sure information is actionable for the receiving doctor.³
• Working in partnership with other medical teams and acting as a point of referral. 
• Patient contact and communication especially in hands-on imaging like breast imaging, ultrasound and fluoroscopy. adiologists play a important role in the patient-centred care, making sure that they are involved in all decisions including radiology. The communication can be directly face-to-face or via patient access to digital reports.⁶
• Collaboration is also important in enhancing education to those referring a patient for a radiology scan as well as students, patients and the general population.³

Performing procedures

• Radiologists often carry out image-guided procedures, which could be for treatment or diagnosis. This part of radiology is known as interventional radiology and procedures performed by a radiologist include:
  • Biopsies,
  • Injections and drainages
  • Methods used to keep arteries open like stenting and angioplasty
  • Targeted injection treatments for anti clotting or dye injections to visualise blood vessels known as angiography.⁶ 
  • Scans can be used to pinpoint exact treatment locations.⁷

Advising 

• A radiologist is able to recommend to other professionals the best type of exam to choose for each condition.¹
• They can act to advise and protect patients against the ionising radiation that a patient may be exposed to. This is done by making use of protocols and dose reference levels. 
• Act as advisors and teachers, making use of new emerging AI (artificial intelligence) applications in the field of radiology.³

What does a week as a Radiologist look like? 

A typical week as a Radiologist involves around 40-60 hours of work. This can typically take place in hospitals and private diagnostic imaging sites. They may even have the opportunity to work remotely from home. 

Generally, the workload is a mixture of writing up imaging reports, providing follow up consultations, teaching, involvement in patient case team meetings, and depending on the specialty performing interventional radiology procedures. 

A radiologist may also take night calls. This more common in interventional radiology as there are cases of emergency life threatening procedures that may need to take place.⁶

Types of Radiologists

Although there are several subspecialities of radiology such as cardiac, respiratory etc, the two main categories are diagnostic Radiologists and interventional Radiologists.⁵ 

Diagnostic Radiologists 

This is the most common type of radiology which involves using images as a means of diagnosis and visualisation of organs. The radiologist is part of the medical pathway for interpreting scans and relaying the results to other physicians. They recommend the type of image scans, treatment and additional tests. 

Radiologists can either be generalists or work in specific areas including chest, gastrointestinal, cardiovascular, Genitourinary, breast, respiratory, musculoskeletal, Head and neck, and Neuroradiology. Additionally they may also work with specific patient populations like Emergency, forensic, nuclear medicine and oncology radiologists.² These types of radiologists can also be therapeutic in the treatment of cancer through the use of radiology. They use targeted oncology treatment to the tumour whilst sparing surrounding tissue.⁸

Interventional Radiologists 

The other main type of radiologist are interventional radiologists who use techniques like X-rays or MRI in order to guide them during various surgeries. The surgeries often require a small incision so that they can reach the target area and deliver the treatment or perform procedures for diagnosis. 

The use of imaging helps the doctor to reach this area with minimal damage. Examples include 

• Biopsies which is the removal of small samples of tissue for diagnosis
• Embolisation which involves cutting off abnormal blood supply to tissues
• Angioplasty and stents to widen blood vessels
• Ablation which uses the heat or cold to remove diseased tissue²

The branches of this type of radiology are vascular and nonvascular interventional radiologists and neurology based interventional radiologists.⁵ 

Education and Training

The pathway to becoming a Radiologist in the UK in general involves: 

• Required degree in Medicine 
• Two year foundation programme in six different specialities 
• Radiology speciality training which takes 5 years, which is three years of general training and then two years of speciality training. 
• Additional sub-specialisation in a area of interest⁹

The process to becoming a Radiologist in the UK is competitive and so here are some tips that can help with this process if you are interested in pursuing this career: 

• Join radiology based medical societies and conferences in your undergraduate education. 
• As a foundation year doctor, reach out to radiology departments for experience and get involved in audits and courses. 
• Due to the academic component of radiology, you may want to apply for the academic foundation programme in order to increase chances of getting into the training programme.^6,10

Skills and Qualities of a Radiologist

In order to become a Radiologists certain skills and qualities are favourable examples of these include: 

• Good communication and interpersonal skills with colleagues, patients and families. 
• Be able to time-manage and work well under pressure 
• Strong problem- solving and diagnostic ability 
• Be able to pay attention to detail. 
• Recognition and knowledge of all imaging techniques¹

Earnings 

On average in the UK, radiology consultants earn  between £62,400 to £93,658 per year. This value can vary based on experience, speciality and whether they work in the private sector who often earn more. 

Summary 

From reading this article, the question of ‘What is a Radiologist’ has been answered by providing details on the roles, responsibilities, types, skills, earning and a general overview of a working week in life of a Radiologist. A Radiologist plays an important part in diagnosis, treatment and monitoring of a patient and there are many benefits to this role including a high income, fascinating work with modernisation through the use of artificial intelligence, and opportunities to teach and progress in their roles. 

Some people may also consider the cons of radiology which include less gratification and ability to miss subtle or significant details in scans.⁴ Although there are both pros and cons to this role, from a patient perspective the work of a radiologist is fundamental to clinical practice and making sure that they receive the correct diagnosis and treatment through their expertise and knowledge. As well as in interventional radiology their ability to perform procedures such as biopsies, embolisations, angioplasty, stents and ablations.

 Radiology is a constantly evolving field and the role of radiologists will soon work in collaboration with advancing technology and modern imaging techniques that further ensure the most efficient and correct diagnosis and treatment for a patient.^1,2