Your First Day:

A first time locum or first day hire will generally be scheduled on a daytime rotation at either Royal Jubilee Hospital or Victoria General Hospital. Our daytime shifts unless otherwise specified run from 8am – 4pm.

On your first day in the department please present yourself at our front desk in radiology, and ask our clerical staff to show you to the reading rooms and where you can find the other radiologists. One of the other radiologists on site will help orient you to the basic facility layout and introduce you to relevant clerical staff and technologists so you can get working.

On your first day in Island Health, our PACS IT staff will arrange a meeting with you to get you up and running on our PACS and dictation system usually around 8am or earlier (some locums choose to arrange this meeting in advance of their first day, but this is not expected). This usually takes 30 – 60 min depending on your level of familiarity with the local software setup.

There are multiple other radiologists scheduled at these sites. This will allow for backup in case you encounter procedures you are uncomfortable with. Please take the time to introduce yourself to any radiologist working at the site you haven’t yet met.

Our current weekly schedule is available here. Check this link the week of your locum if you want to find out who else is on site with you.

Rotation Expectations

In general, procedural rotations will have a defined list of procedures that are assigned to the radiologist on that rotation for the day. Ultrasound rotations have the expectation that you will be responsible to read all ultrasound cases at a particular site. Some rotations have added clerical expectations such as protocoling or are set as a point of contact for clinical inquiries for procedures relating to that rotation.

For a complete list of individual rotation responsibilities, click here.

Attempts will be made by bookings to make sure we don’t schedule locums to do any procedures outside their scope of practice, however last minute changes happen, so we recommend you review your procedure list early in the day. If there is anything you don’t feel comfortable doing, speak with one of the other radiologists on-site early in the day so we can arrange our day to back you up or take it over ourselves.

Work Productivity Expectations

Each rotation has set productivity goals in terms of the amount of CT, MRI, and Radiographs a radiologist is expected to read on the rotation. This is updated in a rotation specific quota that our productivity software displays on your screen and updates throughout the day.

Assigned Work

Ultrasound cases are assigned by site during daytime hours (i.e. RJH US radiologist is responsible for all ultrasounds performed at RJH from 8am-4pm). If there is a type of case you are unfamiliar with reporting as a locum (i.e. vascular work, MSK), please ask one of the rads on site for advice or assistance.

Procedural work (i.e. fluoroscopy, US and CT guided interventions), are assigned to specific rotations.

Nuclear Medicine work is assigned only to the NM rotation

Unassigned Work (i.e. The Open Worklist)

• X-rays are not assigned to a specific reader but open to anyone who is working. There is an expectation that priority be given to reading emergency cases (showing up in red and blue in PACS) or inpatient cases (showing up in yellow).
• CTs performed at Royal Jubilee Hospital, Victoria General Hospital, and Saanich Peninsula hospital are not generally assigned to a specific reader, but can be reported by anyone working at any site or at home.
• MRIs performed at Royal Jubilee Hospital or Victoria General Hospital can also be reported by anyone working at any site or at home.

General List Etiquette

• Read inpatient (yellow) or emergency cases (red or blue) for your local hospital site as a priority, or for other sites, provided:
  • You expect to have enough time to finish the case before your next procedure, meeting or other predictable interruption
  • The case falls within your scope of expertise
• When reading outpatient studies
  • Don’t read cases you aren’t credentialed to read (i.e. CT colonography, coronary CTA and cardiac MR, NM)
  • Don’t read studies you aren’t comfortable reading
  • It is appropriate to target some of your reading to cases relevant to your particular clinical interest or subspecialtly expertise
  • When reading within your subspecialty, generally read the oldest cases first
  • If there is a case suitable for a general radiology opinion you can read that has been on the list disproportionately longer than anything in your subspecialty (i.e more than a day older), read that first

Productivity Etiquette

You have a daily quota assigned for CR, CT, MRI for all rotations and US for some rotations.

Patient safety and clinical quality are more important than productivity. Productivity will generally be expected to be lower when first entering a new environment.

In general, a partner in our group is expected to meet quota on rotations the vast majority of the time, acknowledging that the occasional day may be derailed by procedural complications, patient emergencies, personal crises or administrative challenges. Most radiology partners are able to achieve quota within the scheduled time (i.e. 8H) for most of our scheduled shifts.

On day 1 for a locum, substantial IT delays are common and it is not unusual to fall well below productivity targets, so if PACS/IT took four hours to set you up, don’t stress about it. The rest of us will pick up the slack.

Locums transitioning from fellowship/residency to practice: Our main goal is to have you learn how we work and see if our practice is a mutual good fit. It is expected that you will be slow on your first locum. Your top priority should be the quality of your work at this stage. You do not have to stay 15 hours to make your quota. You will get tired and start making mistakes. New hires fresh out of training are generally advised to not worry about the quota for the first 6 months, and most are able to meet productivity expectations without staying late within one year of working with our group. Roughly 50% of our hires in the past decade have joined our group immediately after fellowship and all make this transition successfully.

Locums already established in practice: A new IT system and a change in scope from a different practice setting can be somewhat jarring for some, although usually this resolves within a few days or weeks depending on the radiologist, area of expertise, and familiarity with our PACS/IT setup. Some locums can easily meet or exceed quota expectations on day 1, while others sometimes struggle. If you are considering joining our practice, it would be advisable to attempt to meet productivity targets by the end of your first week of locum. It would generally be expected that a radiologist joining our group as an associate who is already 5-10 years into practice would be meeting productivity targets routinely within less than 3 months of joining our group. This has not posed a barrier in any hiring decision in the last decade.

Collegiality

We value our working relationships with each other, other physician groups, technologists, and other allied health professionals. We have an internal code of conduct, and additional policies exist within the health authority and medical staff association that will be distributed to you during the onboarding process.

Most of this is common sense, but institutional cultures vary, so in the interests of avoiding unnecessary conflict, be nice to your colleagues. If you are rude or aggressive with patients, clerical staff or technologists, they will quite likely tell us and we may not invite you back.

Likewise, if you find someone in our organization is not treating you well, let us know and we will do our best to address it.