Radiology is undoubtedly one of the most revolutionary and dynamic medical specialties. With latest advances in imaging and post processing, a career in radiology is far more challenging and interesting. Traditional role of radiology has expanded to offer a wide range of therapeutics as well. Interventional procedures, tumor localization techniques and advanced musculoskeletal imaging have upgraded ‘old radiology dark room’ to a state-of-the-art ‘workstations’ and ‘Interventional theatres’. It is not surprising that radiology training is attracting far more number of applications when compared to only few years ago.
It seems best to come to UK early in the career and apply for foundation year 1 or 2 training posts. Traditional IELTS (organized by British Council Libraries or their sister branches) and PLAB 1 & 2 remains the first hurdle to cross. Once in the UK, a clinical attachment gives one the first taste of NHS. It is important to organize one’s self and get a proper feel of the atmosphere. Some deaneries have what is known as a ‘clinical apprenticeship’ which is same as clinical attachment but with a personal portfolio to provide evidence of skills, achievements and capabilities. Things are really changing here; pen is going to be more powerful than sword. Selection into a job in many deaneries would be based on what you have put down in your portfolio!. Gone are the days of visiting the consultants and impressing them with your presence. The portfolio will be the weapon to sell yourself.
Going back to the days when I started, career of an overseas doctor would start with a clinical attachment or apprenticeship followed by house job or FY 1(traditional PRHO). If one succeeds in getting a one-year FY1 post, you are most certainly going to get an FY2 post (traditional SHO) in the same deanery. After completing foundation years, one can apply for training in Radiology run-through program. Since the advent of MMC (modernising medical careers), most deaneries will recruit only those candidates who have done FY1 and FY2 posts. Traditional specialist registrars (SpR’s) have been replaced by specialty registrar (StR). Your portfolio will decide whether you get short-listed or not. Even if you do not get a run-through in the same deanery; your chances of acquiring a radiology training post somewhere else are still high.
It is more difficult getting into training in Radiology in the UK at a later stage. The Royal College of Radiologists website has good advice regarding these options and regulations. You are more likely to get non-training SHO level posts (FTSTAs – Fixed term specialty training appointments) at first. You have play to your cards really well! The way out can have various forms. Traditionally, an eligibility criterion for radiology training was to complete MRCP or MRCS. Since the advent of MMC, it is not the case. MRCS or MRCP is not required anymore, but it still forms an excellent criterion for distinguishing applicants. Some deaneries still prefer taking people with an MRCS or MRCP degree. In summary, UK training in radiology is going through a phase where uncertainties are having the order of the day.
Things are difficult here, but they have always been. People who are here had to fight their way in, so be prepared to struggle. Few suggestions that I would personally make are:
Decide do you really want to come
Come as early as possible
Try getting into MMC
Clinical attachment in Radiology may help
For those who want to do a full 5 year training in Radiology in the UK (of course this may again be changed to 4 years soon!) FRCR 1 has no extra advantage
Most deaneries look for people with no experience in radiology
Wherever you are, start maintaining a proper portfolio
Radiology related audits, presentation, research and case-reports add excellent value to your CV
With the advent of portfolios, formal CV’s will loose their importance, but remember to keep these up-to-date and clean.
Things are changing faster than Shoaib’s yorker and you will be caught out if don’t adjust your bat-lift. Most of us feel that things will become clearer in a year or two, once the process shapes properly. Those, who are safe gamblers, may choose to wait a year or so before placing their punt. If you do so, utilize your time, make your portfolio and get yourself ready.
I will list some useful websites at the bottom, because ultimately it is your career and your life. You should make a proper informed and educated decision regarding your training.
Postgraduate Medical Education and Training Board PMETB
Postgraduate Medical Education and Training Board (PMETB) has taken over the guardianship of all medical training in the UK . For all queries regarding overseas training and there recognition www.pmetb.org.uk
Royal College of Radiologists, UK
For all Radiology specific queries including taking various FRCR exams www.rcr.ac.uk
Modernising Medical Careers
For current training queries including overseas training, recognition and to get an idea of the port-folio and the curriculum of the FY trainees, e.g. what is expected of them, what skills they are supposed to know etc. www.mmc.nhs.uk
Medical Training Application Service 
Post graduate training application process www.mtas.nhs.uk
List of UK deaneries
www.nosa.org.uk/contacts
(With thanks to Dr Farokh Jal SETNA, Consultant in Radiology)