Radiologist

What radiologists make

CIHI (Canadian Institute for Health Information) leaves imaging specialists out of its national pay tables, so there is no official Canada-wide average. Provincial billing data consistently put radiologists among the highest-billing doctors in medicine. After overhead most radiologists net roughly $450,000 to $700,000. Hospital radiologists have low overhead; clinic owners have high overhead but own the machines.

During residency

Paid employees with benefits and a union contract. Quebec pays the least, Alberta and Ontario the most.

Paid per scan

A fast, accurate reader earns more. Some provinces have cut imaging fees in recent years, so the top end is not guaranteed forever.

What it costs to get there

Undergrad degree (3 to 4 years)

$7,000 to $10,000 a year

Medical school, the MD (doctor of medicine), 3 to 4 years

$15,000 to $28,000 a year

MCAT (medical school admission test), applications, interviews

$2,000 to $5,000

Licensing exam (the MCCQE, the national medical exam) and the Royal College certification exam

$1,500 for the MCCQE, plus several thousand for the Royal College exam

Roughly, all in

$73,000 to $165,000

Tuition, fees, exams and kit. Not rent, food or travel

The low end is a three year undergraduate degree at roughly $7,000 a year, three years of medical school near $15,000 a year, and the exam and application bill including the MCAT (Medical College Admission Test). The high end is a four year undergraduate degree, four years of medical school approaching $28,000 a year, about $1,500 for the MCCQE (Medical Council of Canada Qualifying Examination) and several thousand more for the Royal College certification exam. Typical debt at graduation is $80,000 to $150,000, and the interest on the line of credit that funds it is not counted in these figures. The five year residency is paid, and radiologist income clears the debt quickly once you are in practice.

Typical debt at the end of medical school is $80,000 to $150,000. Radiologists clear it quickly once in practice.

Benefits

• Pension only if salaried

  Most are self-employed and save on their own. Ontario residents are in HOOPP (the Healthcare of Ontario Pension Plan) during training.

• Union contract during residency

  Provincial residents' associations negotiate pay, call limits and leave.

• Malpractice coverage

  Through the CMPA (Canadian Medical Protective Association), mostly reimbursed by the province.

• Work from home

  Reading scans from a home workstation is normal, especially for night and weekend cover.

The path

Same road as every doctor, then 5 years learning to see what others miss.

1. 1

   High school

   Grades 11 and 12

   Top marks in biology, chemistry, math and English. Physics helps, since imaging is physics applied to bodies.

2. 2

   Bachelor's degree

   3 to 4 years

   Any major works. Keep a GPA (grade point average) above 3.8, volunteer, do research. Write the MCAT (medical school admission test).

3. 3

   Medical school, the MD (doctor of medicine)

   3 to 4 years

   Acceptance rates are 5% to 15%. Classes, then clinical rotations. Radiology electives matter a lot for the match.

4. 4

   Diagnostic radiology residency

   5 years

   Matched through CaRMS (the residency matching service). X-ray, CT (computed tomography), MRI (magnetic resonance imaging), ultrasound, mammography and basic procedures.

5. 5

   Certification and licence

   End of residency

   Pass the Royal College exam to become FRCPC (Fellow of the Royal College of Physicians of Canada), then register with your provincial College of Physicians and Surgeons. Most add a 1-year fellowship.

High school courses that help

• Biology and chemistry

  Required for nearly every pre-med path.

• Physics

  X-rays, magnets and sound waves are the tools of the trade. Also on the MCAT (medical school admission test).

• Calculus and functions

• Visual arts or design

  Odd but true: pattern recognition is the core skill.

Time and money, at a glance

Years after high school

11 to 13

Med school acceptance rate

Roughly 5% to 15%

Residency match

Competitive, one of the harder specialties to get

Total tuition

$90,000 to $150,000

Paid while training?

Only during residency

Heavily regulated

You need a licence from your provincial College of Physicians and Surgeons to practise, and Royal College certification in diagnostic radiology. Imaging clinics are also licensed and inspected by the province. The Royal College credential is national, so moving provinces is mostly paperwork. Quebec requires working French.

Fellowships that change the job

Almost every radiologist does 1 to 2 years of fellowship after residency.

• Interventional radiology

  Treat through tiny incisions using imaging: unblock arteries, drain abscesses, stop bleeding. Procedure-heavy and on call.

• Neuroradiology

  Brain and spine imaging, stroke calls at 3 a.m.

• Breast imaging

  Mammography and biopsies. Regular hours, patient contact.

• Pediatric, musculoskeletal, body or chest imaging

  Pick an organ system and read it all day.

Nice-to-haves before med school

• Research experience

  Radiology programs like publications.

• Comfort with computers

  The whole job happens on screens.

• French

  Opens Ottawa, New Brunswick and Quebec programs.

• Attention to detail

  The finding that matters is often 3 millimetres wide.

Nuclear medicine is separate

Scans that use radioactive tracers, like PET (positron emission tomography), belong to nuclear medicine, a separate 5-year Royal College specialty. Some radiologists train in both. Ask about it if the idea of imaging how organs work, not just how they look, appeals to you.

A typical day

Most of the day is in a dim reading room with two or three large screens. You work through a list: chest X-rays in seconds, a CT (computed tomography) scan of the belly in minutes, a tricky MRI (magnetic resonance imaging) of the spine longer. You dictate a report for each. Between studies, surgeons and emergency doctors call to ask what you see. Some days include biopsies or ultrasound-guided procedures.

The honest trade-offs

Work life

Typical hours

45 to 55 a week, plus call

Remote work

Common for reading, not for procedures

Physical demand

Low, mostly seated

Unionized

Residents yes, attending doctors no

Similar paths

• Medical Radiation TechnologistTake the X-rays and scans, or deliver radiation treatment for cancer. Two to three years of school and a national exam.
• SonographerUltrasound scanning, from pregnancies to hearts. High demand and good pay, but hard to get into and hard on the body.
• PathologistThe doctor who looks at tissue under a microscope and says what the disease is. Every cancer diagnosis passes through one. Five years of residency, regular hours.

The first Nobel Prize in Physics

Wilhelm Röntgen discovered X-rays in 1895 and won the very first Nobel Prize in Physics in 1901. Within a year, hospitals in Canada were taking X-ray pictures.

Canada is short on scanners

Canada has fewer MRI (magnetic resonance imaging) and CT (computed tomography) machines per person than most wealthy countries, which is a big reason for long scan wait times. More scanners mean more radiologists needed.

AI is a tool, not a replacement

Software now flags possible strokes, bleeds and fractures before a human looks. Canadian radiology groups have written rules for how to use it. So far it has increased the number of scans, not reduced the number of radiologists.

You may never meet your patients

A hospital radiologist can read 100 or more studies in a day and speak to none of the people in them. The exception is interventional and breast radiologists, who see patients all day.