A guide to medical etiquette: radiology

At your interview for medical school (if you were interviewed) when you said why you wanted to be a doctor (if you were asked) it may be that you said, "I want to work in dark rooms away from patients starting at bright shiny boxes." However, I guess that few of you said any such thing. None the less, people change, aspirations grow, and no doubt some of you will become radiologists.

Radiology is a modern specialty. Modern in that it crosses geographical boundaries. Surgery, medicine, and most of the various subspecialties are confined to a particular mode of treatment and therefore to a body of patients who are housed together. Herein lies their power. They have territory and a line in the sand at which they say, "This far and no further."

This is not the case for radiologists. This, and their long hours in darkness, means that they have a certain insecurity. Indeed, the only time that a radiologist has any real power is in the radiology meeting. This is why you must be especially careful on their territory.

There is certainly a protocol to be observed in a meeting. The supplicant clinician says, "I have a film (never an x ray). The radiologist replies, "I will see the film." They then make seemingly supernatural comments on, say, a chest x ray film. For example, "The patient has red hair," or "his parents are Scandinavian." Everyone will say, "Aaah" in awe, and you must do the same. An American study showed that radiologists came by this information by secretly spying on patients. However, you must not try to expose this practice for your own safety.

An ability that radiologists do not fake is their talent for finding out that a medical student is in their radiology meeting. It does not matter how old you look or how close to the back you sit. Suddenly they will stop in mid-sentence, their noses will go up and after a sniff or two they will declare, "Medical student!" All eyes will be on you and you will then be required to go and present a film to the assembled group. Remember that you are not expected to have the same talent as a radiologist, and you will come off well if you put the film the right way round.

David McAllister, intercalated medical student, University of Glasgow
Email: david_mcallister@yahoo.co.uk


studentBMJ 2001;09:129-170 May ISSN 0966-6494