• Dr Sally Ayesa

Why Radiology?

Unsurprisingly, I have a lot of conversations about the topic of medical imaging. I talk about radiology with medical students, junior doctors, prospective radiology trainees, accredited radiology trainees, consultants and the odd academic. And I talk about it a lot.


A big question I am asked (especially by interns, residents and radiology hopefuls) is why I got into medical imaging in the first place. A bigger question is whether I would do it all again - which on some days is harder to answer than others. Some spirited conversations on social media over the last few weeks have also driven a bit of introspection and I have been thinking again about the journey which landed me at this point.


Did I always want to be a radiologist? In short, no. In medical school I was going to be everything from a GP to a surgeon to a physician to a psychiatrist, but not for one second did I think I was going to be a radiologist. I was fairly average at anatomy. When I looked at radiologists, I pictured a dark room, away from the glitz and glory of the forefront of clinical medicine. Interestingly, I pictured a serious male doctor. I'm not sure why.


I considered communication a strength of mine, and as such never figured that I would be more comfortable in a role partially removed from patients. What I didn't know at the time was that I would be significantly affected by compassion fatigue. And then you threw in some well-disguised introversion and a bit of social anxiety. I wasn't built for working face-to-face with patients for the whole day, but I was definitely not ready to admit that.


I did know that I loved science and physics, and developed a passion for oncology. By intern year, I was sure that my future was in radiation oncology. I stacked my residency terms with oncology and palliative care, and got about working on my resume.


Over the course of a few months, however, some life altering moments occurred. These were small in isolation, but together they changed the trajectory of my career.


I was put in contact with one of the most inspirational doctors I have ever known, who granted me 10 minutes of her time to discuss my career. She was a talented and well respected radiation oncologist, formidable educator and overall nice person. We talked about my career and why I wanted to do radiation oncology, and we talked about my life outside of medicine. At this stage, I had a baby daughter at home. She took pause and warned me that radiation oncology was no longer a lifestyle choice. The jobs were slim and I would need to be prepared to move myself and possibly my family in pursuit of my career. Although she thought I would make an excellent oncologist, she didn't know if it was the right thing for me and my young family. I told her it was what I wanted and would do everything to make it work - but a seed of doubt was sewn.


As an intern working in a suburban hospital in Sydney, the radiologists were mostly middle aged men (fitting nicely with my erroneous stereotype from medical school). One day, I took myself down to ask for a scan and found a new radiologist - who was recently fellowed, and female. She was kind and knowledgable, welcoming me into her reporting room and treating me with respect.


During this time I applied for a grant to attend the RANZCR college meeting - serendipitously combining the colleges of radiology and radiation oncology into one conference. I was awarded the grant and took myself to Melbourne. I was going to meet my future colleagues and it was going to be great.


Spoiler - it was not great. I found myself lonely and disorientated, and when I tried to make conversation with the radiation oncologists I worked with as a medical student they shut down the conversation. I felt embarrassed, out of my depth and thoroughly an imposter. Who did I think I was anyway?


Thoroughly disenchanted I found myself in a large lecture hall, listening to a talk on head & neck radiology. May as well branch out I thought. Make the most of an otherwise thorough waste of time. The speaker was a powerhouse radiologist, and when she spoke she oozed knowledge and passion. I was captivated, and something clicked into place. I attended more radiology lectures and found myself falling swiftly and deeply in love with the specialty.


Less of a lightbulb moment, but more of a winding journey towards the dark side (or darkened room)

I called my husband who was a little shocked, but admitted that it actually seemed like a good fit. I was becoming more and more emotionally labile after hard days on the wards and he admitted the clinical distance might be good for me. We had a young family and radiology would allow me to stay in one location with reasonable job security and opportunity. It satisfied all fronts.


After my half-finished residency I applied for a nuclear medicine SRMO position as my first foray into medical imaging. On my first day, I walked in to find the inspirational radiologist from my intern hospital sitting at our shared desk. She had decided to go back to dual train in nuclear medicine. To this day I still look up to her, even more so after getting to know her.


As to the question of whether I would do it all again? I think the answer is yes. By no means has my road been easy. There have been extreme lows and extreme highs, and my journey is far from over. Given my current detour into nuclear medicine, I still have the better part of 18 months to keep honing my craft before I can truely appreciate some of the true benefits I am promised, including more flexible hours and part-time work. But I look forward to the future, and am excited by it. At the end of the day I get to spend my time helping patients, exploring my love of physics and oncology, teaching others and taking the role of perpetual problem solver. I guess I am pretty lucky.

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