What to Expect in Each Year of Radiology Residency

Radiology residency is a journey that transforms a general medical graduate into a confident, decision-making imaging specialist. While each institute has its own structure, the overall progression tends to follow a three-year pattern in MD/DNB/DMRD programs. Here's what you should realistically expect and aim for in each year.

First Year: Foundations and Survival

Focus: Basics, Anatomy, Physics, Conventional Radiology, USG

• This is the most crucial year. You are expected to unlearn and relearn clinical medicine through the lens of imaging.

• Expect to spend a lot of time with X-rays, ultrasounds, barium studies, and basic reporting.

• Learn radiological anatomy thoroughly. Use atlases, anatomy modules, and teaching files.

• Understand the physics behind imaging. Start with Farr’s, Christensen’s, or MRI Made Easy.

• Build habits: maintain a logbook, attend departmental teaching rounds, ask for case follow-ups.

• Most of your learning will be observational. Watch how seniors report, communicate, and handle emergencies.

Milestones by end of Year 1:

• Confident chest X-ray reading

• Understanding of radiological signs

• Basic ultrasound reporting

• Physics preparation for theory exam (or FRCR 1)

Second Year: Expansion and Skill Building

Focus: CT, MRI, Case Presentation, Subspecialty Exposure

• You’ll be more involved in CT/MRI interpretation. Expect to report under supervision.

• Begin focused reading on systems: CNS, MSK, abdomen, thorax, pediatrics.

• Start attending interdepartmental meetings and tumor boards.

• Get involved in your thesis and start data collection early.

• Present seminars and case discussions. Teaching others is the best way to learn.

• Learn structured reporting. Build templates for CT chest, abdomen, brain, etc.

• Observe and assist in interventional procedures.

Milestones by end of Year 2:

• Confident basic CT/MRI reporting (under guidance)

• Seminar/case presentations done

• Research work underway

• Comfortable with basic IR terminology and workflow

Third Year: Independence and Exam Preparation

Focus: Final Exam, Spotters, Viva, Rapid Reporting, IR Basics

• You should now function as an almost-independent resident.

• Prepare intensively for your theory and practical exams. Use spotter sets, previous year questions, and oral viva practice.

• Build exam cases with labeled findings and practice under time limits.

• Do mock exams with faculty and peers.

• Be actively involved in all modalities, including IR.

• Continue follow-up of interesting cases and complete your thesis.

Milestones by end of Year 3:

• Theory and practical readiness

• Polished spotter and viva skills

• Final thesis submitted

• Capable of handling duty independently under indirect supervision

Key Tips for All Years:

• Always keep a radiology diary.

• Make your own checklists and mnemonics.

• Maintain humility. Ask for help. Admit what you don’t know.

• Practice reporting regularly—even if not asked.

• Join academic platforms (Radiopaedia, RSNA, IRIA, ESR) and learn continuously.

Radiology residency is a marathon, not a sprint. Build steadily. Stay curious. Stay committed.

These three years will define your confidence for the next thirty.