To Rank Or Not To Rank, That Is The Question (2023 Edition)
Our top tips on how to rank your radiology jobs (updated for 2023)
Happy Sunday RadCastees,
As the dust settles from this year’s interviews, there is one final thing to discuss: the dreaded ranking of jobs. At first the process may seem totally random but trust us, there is a method to the madness. Now since so many of you have asked for help, we thought we’d focus this entire newsletter on dealing with the topic directly. So grab yourself a beverage, put your feet up (you deserve it) and enjoy!
Please note, the information below is taken from a prior newsletter we sent back in the 2021-2022 application cycle but updated wherever required.
Beauty Is In The Eye Of The Beholder
The first thing we need to discuss is how you rank. Now, we don’t mean the actual physical process of ranking but rather, the art of ranking. Yes, you heard that right. Ranking is an art. Why? Because it’s all about your own perception of the matter. Like we’ve never understood modern art, Uzoma goes so far to even call them an eye-sore, but others think they are masterpieces. Who’s right? Both are. It’s just about your perception. The same applies to how you rank. Craving the boujee London life? Then rank it higher-up. Want to pursue the academy life? Put it higher in the rankings. Thinking to yourself that ‘ain’t nobody got time for that’ and you just want to enjoy the finest Sunday home roast for the next 5 years of training then guess what, rank the jobs closer to home higher up; this higher and lower business is making us sound like we’re on Bruce Forsyth’s ‘The Price Is Right’ gameshow (man, we’re getting old)! Genuinely, there is no wrong way to rank and it is a simple case of ‘whatever floats your boat’. But, and this comes onto my next point, you must rank according to your priorities.
Prioritise Your Priorities
Candidates often complicate the ranking process due to one simple reason. They apply multiple priorities at once. Now you may be asking, what do you mean by this? Let me explain through candidate A and candidate B.
Meet candidate A who we’ll call Godfrey. Godfrey is a particularly clever chap, which is of course why he’s pursuing radiology, but he’s also a bit spoilt. After smashing his application, with the help of RadCast of course, he’s now faced with the prospect of ranking all the radiology jobs across England, Scotland and Wales. As I said, Godfrey is a bit spoilt (a bit like Veruca Salt from Charlie and the Chocolate Factory) so he wants it all. Specifically, he wants to be near home AND close to London AND near a tertiary referral centre doing cutting edge research in radiomics and A.I (the buzzwords of the modern day radiology applicant). So what happens when Godfrey goes to rank the radiology jobs? Well, he realises not a single one of the advertised jobs matches all the filters he applied at once. All this will do is cause unnecessary anxiety and panic.
Now let’s meet candidate B who we’ll call Wilhelm. Like Godfrey, Wilhelm’s a clever chap but unlike Godfrey, Wilhelm also has had street smarts (a bit like Charlie from Charlie and the Chocolate Factory). When it came to ranking the radiology jobs available, Wilhelm decided to prioritise his priorities. He sat there and asked himself a simple yet profound question, ‘what matters to me the most’? He scratched his head: was it being close to home? Was it working in a large city? Do I want more research opportunities? All these thoughts came to him at once but Wilhelm anchored his thoughts once more. ‘No, whilst I may want ALL of this, what is the MOST important’? After spending some moments soul searching, it came to him like a flash. Using this new found wisdom, Wilhelm then applied this most pressing priority to the list of jobs to get his ‘first rankings’. But Wilhelm was not done, far from it in fact. He then went one step further, ‘now what is the NEXT most important priority for me’? Wilhelm continued this methodical, stepwise manner until his heart was at peace knowing all of his priorities were accounted for.
Ultimately, it comes down to the age old saying of ‘you can’t have your cake and eat it’. When you rank, you can’t apply all your priorities at once. It just won’t work and will leave you feeling frustrated and restricted as to where you can train. Rather, you need to prioritise your priorities. Apply your ranking filters in a systematic and consecutive manner with your most important priorities being taken into account first. As to what those priorities are, that is entirely up to you and there are no ‘correct’ priorities.
Academies Vs. Non-Academies - Should I Even Care?
This is a recurring question we get year in, year out. “I’ve heard academies are better in terms of training”, “I heard you get to do simulation in the academies”, “I heard you get free coffee in academies”. Whilst the last one definitely isn’t true, well we don’t think so anyhow, the first two points are reasons that candidates have used in the past to justify ranking academies over non-academies. Now in the last section, we just made a point that frankly it doesn’t matter what priorities you use when you rank. But we want to use this opportunity to make a few things clear about academies that may help you in your decision making process.
Before we do however, let’s get the story straight about academies. Unless you’ve been living under a rock, you’re probably familiar with what we’re about to say (especially for those of you who have been on CRAC…our course that is). Simply put, the academies were set up to address the workforce shortage that has been plaguing radiology for years now. By having these large, external institutes (academies) that weren’t tied down to a single hospital, it could facilitate a larger number of trainees. Basically, think of it as like a university campus but just for the cool radiology trainees. Because these academies had a larger space to work with, they could be innovative and integrate things like simulation suites.
But things have changed since then, quite a lot in fact. Since the workforce crisis isn’t going away anytime soon, there has been a growing push to recruit more and more trainees into radiology. Whilst that’s awesome, and we definitely welcome this, there must always be a balance between the number of trainees to the opportunities for training. As the number of trainees goes up, you have to remember that there is a delay of 5 years before they’ll become consultants. That means in the interim, the number of trainees per consultant is going up which makes it challenging to provide a standardised level of training to everybody across the board. This is particularly true for the practical elements of radiology such as ultrasound, interventional and fluoroscopy which require a high level of input (especially in the initial stages of training). Whilst academies had already prepared for this, meaning they can tolerate the increase in trainees to a point, the non-academies have been impacted by this as they often thrived on providing 1-to-1 teaching to their trainees.
Now it isn’t all doom and gloom for non-academies. In terms of the tech side of things, non-academies have caught up, especially as a result of the corona, with a large boom in virtual remote teaching. So what does the future hold? Without a crystal ball, it’s quite hard to tell but one can speculate. So, word of warning, these are our personal opinions. Will your training be jeopardised by going to a non-academy vs. academy? Probably not since this is post-graduate training after all. Nobody is going to spoon feed you and it’ll be up to you to put in the hours. But, truth be told, we have no hard evidence to back this up and a comparison of outcomes between academies and non-academies would make for a very interesting research study! Will training shift towards more an academy style? In our honest opinion, yes. We think due to the current crushing needs from the radiology department, it’s the only viable solution long-term from an infrastructural perspective as an academy can facilitate a larger number of trainees.
TLDR: does it matter going to an academy vs. non-academy? No, unlikely. Will there likely be more academies in the future? Yes, to address capacity issues.
The Quest For IR
Once again trainees will be able to enter an IR themed track from ST1. But what does this actually mean and will this prevent trainees who get a taste for IR later on in their training but weren’t on the IR themed track?
From speaking to trainees on this new IR track, it’s more for capacity planning purposes than anything else. Yes, you may get an additional IR session during your normal week but it isn’t anything ground-breaking; remember, your first 3 years of radiology training are the ‘core’ years where you get a grip on the entirety of the RCR radiology curriculum. Rather, it seems to be used by the higher ups in your training deanery to plan how many IR slots they need based off the number of interested trainees. In a nutshell, they want to make sure there is space to cater to all the trainees.
But RadCast, I’m unsure right now about IR. What if I want to do it later on but I wasn’t on this fancy IR track from ST1? Honestly, we highly doubt it matters. The workforce crisis in radiology is not just for diagnostic but also in interventional radiology too. This is only going to get compounded as there is a push for critical services such as a 24 hour stroke thrombectomy service. So, we don’t think it’ll be of any detriment not getting the IR themed post in the region you want to work.
Do I Have To Rank EVERYTHING?
Nope. Not at all. In fact, it’s encouraged you only rank the deaneries you actually want to work in. Obviously, leaving some deaneries not ranked induces fear amongst medics since we think we’re ‘throwing opportunities away’. But there is a real risk to ranking deaneries you genuinely don’t want to work in and I’ll explain why through a not so uncommon scenario.
Marie is a budding radiologist and has applied directly from FY2. Due to her personal preferences, she wants to live near home in England. When it came to ranking the deaneries, she couldn’t resist and cheekily included the Scottish deaneries in her ranking. But Marie thought ‘as if I’ll get ranked there, I put it so low in my list’ and went on her way. So you can just imagine the shock on Marie’s face when guess what, she ended up with an offer for a training post in a Scottish deanery! So what does she do? Reject it on the basis that it’s so far from home which after all, was her most important priority. Or accept it? Since that means she won’t have to do the bulls**t MSRA exam again. But on the flip side, she’ll be so far away from home. But she shouldn’t be stupid and throw away a training number right? Decisions, decisions, decisions. Honestly, this is a horrible place to be in. You’re torn between two extremes with no real middle ground. But, there’s an easy way to rectify this. Simply don’t rank all the deaneries unless you’re prepared to work in them!
The CountDown Clock - Offers & Upgrades
Once the offers start pouring in, you have a few decisions to be aware of. The first is taking an offer. If this was your first ranked deanery then it’s a no-brainer. Accept, celebrate and send us a thank you card.
The second is an offer in your not-top ranked deaneries. Now, you can ‘accept’ or ‘accept with upgrades’. To be honest, if it isn’t your top ranked deanery then there’s no harm in choosing the ‘accept with upgrades’. Like, if you don’t get the upgraded offer i.e. a job closer to your top ranked choice then hey, you still got the initial offer. By the way, once you accept that’s it. Your application is done. Even if a vacancy opens up in a higher ranked deanery that you wanted to be in, it doesn’t matter. You’re not eligible to take it.
The third is to reject or be rejected. If you reject, you’re basically saying ‘I want out’ and want to exit the application process. That means you get no training post and your application has come to an end. On the other hand, if you’re rejected, it means you weren’t deemed appointable and did not reach a sufficiently high enough score to be put on the reserve list.
The fourth is that you’re placed on the reserve list. That means that based on your performance across the MSRA, portfolio and interview, you aren’t ranked high enough to get first dibs on the training posts. But you aren’t rejected either. Basically, you’re in limbo. If any of the vacant spots aren’t filled, candidates on the reserve list will then become eligible to select these vacant posts.
Final Remarks
The ranking process can be quite gruelling as you’re making quite significant life choices. We hope the points we’ve made above helps you take some stress out of the process, especially the point about prioritising your priorities. Whilst there are opportunities to do inter-deanery transfer, these aren’t always guaranteed so we don’t advise relying on this as a crutch. Of course, there are other avenues to change deaneries such as for sub-specialty training but once again, the criteria for this may change (please have a read of the Gold Guide about this).
So, as always, we wish you the best of luck in this final hurdle of the application process. As always, our inbox is open for any questions so please do send them in to hello@radcast.co.uk!
Till next time,
From your ‘prioritise your priorities’ friends,
Muhammad, Uzoma and Jamie
RadCast Co-Founders