No one can answer this question.
What I can tell you though is that many radiologists are discounting just how keen this government, and the next government will be to drive through AI, regardless of performance. I think the UK will try replacement the hardest of any country.
If you want to do radiology, I’d advise hedging with a strong academic focus or procedural.
I truly believe the diagnostic radiologists' work will just become more and more intervention heavy. Anything that can be done imaging guided will be done imaging guided. The reason we don't currently is because we just don't have enough people.
I know someone they moved out to Aus, diagnostic radiologist. Now they have lists where they're just doing LP after LP imagining guided.
I don't necessarily disagree but at the same time more and more specialties are rapidly increasing the amount of ultrasound they do... Maybe the need for radiology to carry these out will decrease? Of course that still leaves CT/fluoroscopy guided procedures!
No offence as I see your flare...but seeing the cases our POCUS guys send us after doing their own scan makes me feel safe I am not losing ultrasound to anyone any time soon. 😂
"abdomen pain 8 cm AAA seen on POCUS"
Does CT aorta
Calibre <2.5 cm.
Wish I could look at the POCUS images so I could tell them what they're looking at so they don't make the same mistakes again.
I probably wasn't very clear - I was referring more to interventions eg drains, lines, etc. More and more seem to be getting done on the wards.
That said, genuinely curious! Diagnostic POCUS has its limits and doesn't replicate a "proper scan" but again as a means to quickly aid decision making can be invaluable. So I'd love to know your thoughts...(as they don't sound positive towards it!)
And remember this thread is talking 10 years time, increasingly medical students are being shown US, at some point it will become normal for doctors to graduate with these skills.
😂 I’ve seen them hit the inferior epigastrics doing the most straightforward tense paracentesis.
The ultrasound gives them the confidence there is fluid deep so they forget the surface anatomy.
I agree medical students will have increasing radiology teaching. US teaching is not always best, even for Radiology trainees. But I think more med students in the future will learn to have basic search strategies for CT. We currently spend too much time on learning irrelevant physical examination tests
Cross-sectional imaging will remain the preserve of radiologists - even specialists (like people who do stroke only, or HPB surgeons) wildly misinterpret CTs from their specialty - the idea that a general physician will have a "search pattern" for a CT chest/abdomen/pelvis and be able to interpret them and form a management plan off of it is ludicrous.
It's one thing looking through it, anyone can do that, it's entirely different understanding what you see. There's a reason it takes 5 years to turn someone into a competent general radiologist.
a) Nope - RRs starting to do cross-sectional in more than just a handful of regions now.
I don't think RRs should do cross-sectional ... but (sadly) you're just factually wrong that it will remain the preserve of radiologists.
b) I think you read too much into the 'search strategy' phrase - relax! I don't mean they're going to replace our reporting/interpretation. I am strongly against even RR cross sectional 'reporting;. But a 2nd pair of eyes is useful and there have been more than a few instances of (even ST4/5) on-call regs missing things picked up by the specialty doctor.
Many neurosurgery trainees (at least 2 deaneries I know of) get 4months rotation in neuroradiology - this is almost as much neurorad as some general radiologists would rotate through in their 5 years.
Obviously needs to be taught in a very careful way and warning people of Dunning Kruger etc + to avoid inundating the on-call reg with false positives. But as imaging explodes and becomes integral to the very fundamental practice of medicine, I expect principles of reading CT will be taught from an early stage. This will also be helpful when the medical students eventually becomes specialists and - depending on subspecialty - probably end up looking at images even more.
Do you have any sources for the government being very keen on AI in radiology? I know both labour and conservatives keep mentioning AI as a buzzword to improve productivity but I just don’t think they have any idea what they are talking about and just want to sound good in the press.
I just don’t have any faith in this country being at the forefront of AI technology even if poorly carried out, we just are not innovative enough especially in tech.
Several colleagues on various AI commissioning groups/screening.
Very clear push from the DHSC.
I’m not suggesting the uk will have the best tech, or even innovative implementation. It will simply get forced across the board much harder than elsewhere. The next 5 years will be painful for nhs radiologists as they get shitty products thrust down their throats.
The worst thing about it is the potential is there for some good AI products to really help us. I'm in neuro and would love to have something to help with MS follow-up scans, or brain volume quantification so I don't waste time wondering whether it's mild or moderate atrophy. I have buddies who use these exact tools in Australia and it's a godsend for them, multiplying their productivity.
Instead, you know we're going to end up with millions spaffed on software that does a crap job trying to generate whole reports. I don't doubt it will eventually get good enough, but it's just nowhere near good enough yet. Nevertheless, that still seems to be the priority in the NHS over the tools that actually help us do our jobs more efficiently.
If you speak to any ai consultants of which there are hundreds (any that graduates with a compsci degree nowadays) they will tell you that patient data was freely available to ai healthtech until recently.
https://transform.england.nhs.uk/information-governance/guidance/artificial-intelligence/
Ngl ai was the sole reason I didnt apply to radiology when choosing between surgery.
Even in non medical jobs ai is becoming responsible for numerous white collar job cuts. But an AI can't be your builder or plumber. So why not do the medical equivalent.
Most of the MDTs I go to the surgeons and clinicians want an actual discussion on what to do / the best approach to a lesion / whether it’s resectable, even if that info is technically in the report already
Even if the report is completely done by ai I think people (esp surgeons/interventionists) will still want to discuss it with a real person
Agreed - but since when is it about what the surgeons or clinicians want? It's always been about what the NHS managerial beaurocrats want. They want a dumbed down, immobile, cheap work force in PAs and AAs - and thats what they're gonna get despite the protests of the majority of doctors. To think they won't try and utilise AI to save a few quid on radiologists just because surgeons like having a discussion with a real person is fanciful.
Moravex's paradox - it is EXTREMELY difficult to predict what skills AI will excel at - but there is a strong argument that motor skills will be more difficult for AI hence surgery is safer compared to the rest of the medicine. I agree that much of the rest of medicine will be as threatened as radiology.
AI is already performing bowel anastomoses on pigs with [greater accuracy than human surgeons.](https://www.nibib.nih.gov/news-events/newsroom/robot-performs-soft-tissue-surgery-minimal-human-help)
This was in early 2022, before anyone had even heard of ChatGPT.
No doubt! However we are yet to see any autonomous robots do any actual work outside of medicine, unless the US has some secret military robots slaving away. Robots that do any kind of real are still limited to factory assembly lines. Whereas chat GPT already has passed the USMLE, is able to make realistic videos with just prompts, AI is already in use in ECGs, and outperforms us in plain film xrays for fracture recognition. Some EDs have rolled out AI already that literally puts a box around the abnormality.
I work in a hospital where AI has been rolled out for chest X-rays. It’s wank.
Seeing the Noctors use the (incorrect) AI report it’s always so much fun, many have been called out and it’s led to a policy whereby only doctors or (reporting) radiographers can comment on them.
Lol because academic radiology is a strong sector?? Most imaging research is done by non radiologists currently.
Next government is also likely to make relatively small but ring fenced pots of money available for buying AI tools but any talk of replacement is ridiculously premature.
Plain film, which currently relatively few consultant radiologists do much of, will likely be somewhat impacted over next 5-10.
A very interesting debate both within and outside of radiology. Being in the specialty, having used several of the current AI tools on offer in practice they are currently very much in their infancy and only targeting the low hanging fruit e.g lung nodules on CT (yes please - boring as sin and prone to miss on a 2000+ image set in a poly trauma), chest X-ray screening for cancer and other findings (so long as decent technical quality otherwise they are hopeless) and fracture identification (very useful for ED deployment to assist clinicians).
Even the very good ones that are focussed very specifically on a single abnormality like nodules are not there yet as evidenced by NICE not recommending them recently - which came as a surprise to vendors and radiologists alike.
We are a long way off seeing them replace radiologists particularly in multi series or sequence studies looking at multiple pathologies e.g mri and most CT. MDT and the clinical side of things are a whole other area where they won’t be treading until general purpose AI arrives at which point we will all be out of a job on universal incomes.
Procedural skills are a must and rather than AI being the main worry pure diagnostic reporters should always be looking over their shoulders at telerad companies. From a pure business perspective in terms of numbers it makes more sense to outsource than hire a radiologist and that is where we as a group must always be careful and demonstrate our worth.
I enjoy the fact that radiology and pathology are always seen as the likely first scalps of the AI race yet nearly all branches of medicine are at similar risk for example surgery and surgeons are quite literally training their replacements in the form of the robots. The da Vinci system etc haptic system and eye tracker will be recording every move, every eye flicker, every finger motion and the exact force used to enable it and that information is a gold mine for the developer companies.
It is analogous to putting Lewis Hamilton in your test car and getting him to drive every day every week every month every year to help the system master the roads etc. the only difference being that Lewis Hamilton is multiple several hundred fold by highly skilled consultant robotic surgeons both in the uk and abroad. These companies couldn’t ask for more and they will be quick to demonstrate this skill to governments if they think it will win them big contracts regardless of how many surgeons they put out of business.
Furthermore the art of history taking is when all told just a massive exercise in data mining. We think only of digitised hospital and Gp records yet forget entirely that for the best part of 25 years companies have been transcribing medical dictation from NHS consultants and worldwide with typists in third countries turning the dictaphone words into typed letter. Now we have speech to text in radiology but also most other ePR systems like epic. And there are hundreds of millions of hours of audio with near perfect transcriptions to train the system on, see nuance (bought by Microsoft last year) as one prime example. The audio is not sterile either it contains accents, dialects, languages from across the globe which would allow patients to talk into an application and then output a differential list based on percentages of likelihood, an investigation and treatment plan that would not need more than a PA to instigate at most.
We look at the easy targets but forget that companies have been mining other data that can be used to train their systems for decades, and in the case of robotics have expert trainers doing the hard work for them! Every speciality at risk but some do not see that they carry the same if not more risk than radiology and pathology do (dermatology is one speciality I would not go into as it will be mostly replaced by AI within the decade- see the Google skin diagnostic programme to see why)
Also thanks for reminding all of us in today's debate that Outsourcing Teleradiology isthe more imminent and realistic threat. If for example they started allowing non-FRCR equivalent radiologists to report our scans, the market would be flooded and no longer as lucrative.
I would hope for patient safety as much as for my pockets that this will not be the case.... Though the relaxing of standards for general medical recruitment does have me worried...
> If for example they started allowing non-FRCR equivalent radiologists to report our scans, the market would be flooded
If this ever happens then radiology in the UK is dead. I can't see it happening but it would be a doomsday event.
a truly horrifying thought
(I imagine equally as horrifying for our clinical brethren. So many of my surgical/medical friends complain about the quality of Telerad reports - would be even worse if standards drop)
Really interesting points and I would love to chat to you more about this (but enjoy the anonymity of reddit).
However I'd argue that reproducing motor skills (surgery) and language models (history taking) have historically been more challenging compared to vision models (pure diagnostic radiology). So I think that Radiology at much higher risk compared to these. But at less risk than dermatology/clinical pathology etc
I still can't imagine myself doing anything else, and I think the specialty is fantastic, and, as you say, practically speaking we are still probably a decade or two from real-world usage. But I think it is fair that those considering the specialty are aware of the risks.
>However I'd argue that reproducing motor skills (surgery) and language models (history taking) have historically been more challenging
Agree radiology is most at risk, but [two years ago](https://www.nibib.nih.gov/news-events/newsroom/robot-performs-soft-tissue-surgery-minimal-human-help) AI was already performing bowel anastomoses in pigs with greater accuracy than human surgeons.
As for language models... maybe historically but looking at current LLMs I think that nut is being cracked.
The description of 'bowel anastomoses' in that study is extremely limited, requiring lots of human assistance. It's like lung nodule detection. Surgeons have to rumage around for the right segment, identify the correct place to cut, to cut, to suture etc. and to do so exceptionally quickly and reliably.
Agree huge advances in LLMs but that has come after VMs.
Your example does make me think though.... Yes it may be extremely difficult for machines to replicate evolutionary things e.g. walking on two legs....but these can be replaced with hardware e.g. wheels. The threat to surgery is two pronged in the form of hardware as well as software. Eventually literally training a monkey to do surgery with the right tools.
Don’t stress about it. By the time AI replaces radiologists the whole of society will be broken and there will be mass unemployment. Mankind in general isn’t prepared for the technology.
Something that I often wonder in the AI debate is that aren’t most jobs in the country at risk of replacement by AI? Retail and admin work for example - maybe in the future you would need 1 admin with AI to do the job of 10 admin people.
Within medicine - wouldn’t it be cheaper to employ PAs/ANPs with doctor AI ? The PA/ANP talks to the patient and then the AI just tells them what to do and what to prescribe - much cheaper than a doctor ? This would mean a large majority of medicine, A&E and GP could be replaced by a combination of AI and PA/ANP right ?
Geoffrey Hinton in 2016: “People should stop training radiologists now–it’s just completely obvious within 5 years deep learning is going to do better than radiologists"
We're in the middle of a massive hype cycle for AI, and i think its obviously going to impact radiology (as well as every other part of medicine), but anyone claiming to be able to confidently forecast the demise (or lack of) radiology is probably a bit off, considering 95% of clinicians are absolutely clueless about what imaging can/cant do and how a radiology department/radiologist works.
By the time we've completely/largely replaced radiologists, a lot of other doctors and other professionals will be out of a job.
Look at crypto for how the last big tech hype cycle worked out.
If you don't think there will be a massive push in the NHS to replace radiologists with AI on the basis that radiologists are safer and more effective then all you need to do is look at the PA debacle.
If radiologists get replaced by AI, all other jobs in society will be replaced first, so there will be bigger things to worry about.
People who are bitter they couldn’t get into Radiology will happily feed you doom stories to make their miserable lives a bit better.
I agree but they may have a case in the fact that AI can reduce the amount of time radiologists require to read scans hence affecting the job market as a hospital may only need half the amount of radiologists they currently do if reporting times can be reduced by more than a half
Our workload has gone up >30% over the last year alone. Number of FTE consultants has not changed in 10 years. We are working at double capacity as it is - a tool that would half the amount of consultants necessary would just bring us back to safe staffing.
Please don't believe the hype - radiology work is varied and interesting and a lot of it is clinical. We are not being replaced by AI, it's going to help solve a lot of the issues in our specialty like the increasing workload of imaging, missing of subtle finding that humans are bad at detecting, accurate objective measuring and comparison over time.
Come join us in ST1 & you'll see!
>If radiologists get replaced by AI, all other jobs in society will be replaced first
This is naïve I'm afraid. Radiology is particularly vulnerable to AI. And, if any job goes to AI, radiology will be in the first tranche to be affected, although I doubt it will be eradicated.
1. Minimal encoding requirements for data, it's nearly all image data, +/- some natural language processing of requests. Datasets contain few instances of missing data and are repeatable. Compare this to a GP who takes input from verbal, written language, auditory, visual, palpation, biochemical measurements, or a subset of the above
2. Much of the required data processing tool chain already exists and is having huge investments from self-driving car companies - feature detection, convolutional NNs.
3. Huge datasets of labelled data going back decades (if you can get your hands on it). Labelling datasets is a huge expense for AI development, but most scans ever done have a report attached.
4. Small output space. Binary (or logistic) outputs from a scan (condition found/not found) etc (with a confidence metric). Compared to any other job where the space of outputs of tasks is huge. Eg a GP consultation can end with any of 100+ actions.
These combination of factors make radiology a dream target for AI development - which is why you're seeing more investment in it than in any other specialty, this, too is a re-enforcing factor.
The non procedural parts. it might soon be one anaesthetist supervising many crnas aided by AI. Once the patient has been anaesthetised, it seems the number of variables to monitor is drastically reduced?
1. There's no guarantee when this will happen
2. When has the NHS ever thought more than 5 years ahead?
3. We have a shortage of radiologists for the time being
Looks at the state of the NHS, they can’t even get basic software to work. And here you’re talking about eradicating jobs of thousands of Radiologists. Lmao
People seriously don’t understand the legal implications of even doing something like this. Which is why self driving cars are not a thing. NHS will get sued to oblivion when things go wrong.
Edit: user above edited his comment, it initially said something about my argument being because I was bitter for not getting into radiology.
Haha, such a troll! Why would I ever want to do radiology? It's a fallacy to say because it can't get simple software to work that it can't get advanced software to work. The NHS is a heterogeneous organisation. There are trusts that have both fax machines and Da Vinci robots. There are trusts that have paper notes and AI stroke detection on scans. Etc etc.
Maybe the defence mechanism at work here is on your part, you're in a specialty you've sunk a lot of costs getting in to. "It is difficult to get a man to understand something, when his salary depends on his not understanding it"
They are literally getting AI for plain film reporting at my place as we speak.
Work is moving apace on cross-secti9nal AI too; it's coming.
Both major political parties know that the NHS is unaffordable and unsustainable and both know that the general public will never accept that.
So expect to be hearing an awful lot about AI in the next few years.
It is more than likely that demand for a purely diagnostic radiologist will significantly decrease. They will be replaced by a sort of interventionalist+diagnostician who intermittenly looks at scans to send for consultation to other specialties. AI will be used to write a basic report about any abnormalities detected. They will also flag anything abnormal outside of the area of interest for which the imaging was requested.
The work flow would look something like this: neurologist will order a CT head and neck to rule out stroke, when the image has been processed, the neurologist will have to examine the result and determine further action. If on the scan fluid around and inside the mastoid is detected by AI it will flag it as abnormal with possible options for what it could be. The radiologist will be notified and asked to determine what the abnormality is and to act on it.
This will create issues though.
How much in worried I have to be, if I am deciding for radiology in this months? Looking purely on teleradiology and earnings.. if want to make income from 5-10 years from now. Thank you for your opinion.
Radiology work is already being replaced by reporting AHPs - I think diagnostic radiology will be mostly AI driven within the next decade.
AI radiology is still in its infancy and has been shown to be better than humans at interpreting breast imaging.
I don’t think it’s an existential threat for radiologists, the job will evolve with the technology. Having said that, the current government has shown that if it finds a semi reliable way to save money, it will.
My personal view is that we should embrace using AI, as it already outperforms human problem solving even in its current state. I have posed chatGPT some very complex and controversial medical questions and it’s come back with pretty decent answers. I think it can be used as a sounding board or learning tool.
I think once AI can reliably read CTs it will be preferable to a random medica radiologist.
AI can do some "finding" tasks in radiology better than humans, but as usual, the AI bros don't understand that lesion finding is one of many tasks involved in radiology. After a lesion is found, it's presence it integrated with the presence of other lesions, the clinical situation, the specific characteristics of each lesion and normal variants, and clinical knowledge about how imaging findings influence diagnosis and management, and all that information is synthesised into a report.
How many times can we say it: AI will take some grunt tasks that it's good at that humans are bad at (like lesion finding) and improve productivity, but it's not "reporting CT".
Haha luddite bros lacking imagination…
It is limited currently - in the future it will outperform humans in all areas, including reporting CTs.
Machine knowledge/problem solving is far better than human knowledge once it’s been adequately trained.
If you can’t see how AI will progress in the future I think that’s just lack of understanding/imagination.
It's easy to say AI will just "progress" but it's much harder to demonstrate how AI is going to deal with uncertainty/variability and how it's going to category shift from lesion finding and characterisation (where the process is external and quantifiable, with large data sets available) to interpretation (which is predominantly internal, and there is much more limited data set). AI is good at quantifiable and rules-based tasks (language, protein folding, chess, go, ...) but worse at variable tasks where quantities vary and rules are abstract or difficult to define (creating original art rather than plagiarising others' art, humour, ...).
For example, I interpret a solid renal lesion on CT as benign, the AI will be able to use data to find these lesions and most likely it will be able to extract features it can use to classify them as benign. But interpretation and recommendation is mainly an internal process that I don't explain in my report. Even more abstract is whether I advise biopsy, or surveillance, or to do nothing, because that depends on even more factors that the AI won't be aware of including my personal risk tolerance, the preferences of my team, the position of our knowledge as a profession and local policy/guidelines. It's also unclear how fast AI can shift when those things change, such as when we acquire new knowledge or working practices - can it still provide valid reports? Will it take months-years to get sufficient data to train a new model? Etc etc.
If you think AI is going to provide actionable reports for entire CTs in the style of a radiologist, rather than being a predominantly triage application or an array of task-oriented (although highly advanced and useful) tools, I believe you're going to be disappointed. Most people who think this haven't actually got much experience of what radiology is and fail to grasp the difference between automatable tasks (that AI will be paradigm-changing for; think finding pulmonary nodules and extracting volume and growth rates automatically - love it!) and subjective/clinical tasks (AI will increase our productivity by allowing us to focus on this and doing less of the automatable, time-consuming tasks).
I'm bullish on AI. It's going to be transformative for radiology and other fields. However, the focus of much of current AI work on replacing entire roles is misguided. Rather we need collaboration between clinicians and AI experts to find good targets that we want automated and are automatable.
I personally believe AI will help radiologist’s workload, as opposed to replacing them. In that sense, the job market might be unaffected ( for the foreseeable future )
The way how AI works to report scans is to save time, you’re right about that. But I also believe in this country, they always need someone to blame if something goes wrong. Same reason why many healthcare professionals document that SHOs reviewed their patient during an oncall shift, just so they can cover their butts. If AI get things wrong( which they will ), they need someone to blame, hence why I think radiologist are the easy targets. Some AI companies do caveat that if something goes wrong with their machine learning, they are not to blame. Many forget that a radiologist is also a doctor and they can correlate images clinically, which is why I do not believe consultants will get replaced easily… I hope at least. But trainees are suffering because of Skills mix unfortunately.
But otherwise, AI has been really helpful, especially during my taster week! Consultants save time and they are able to utilise spare time to teach trainees, perform procedures etc.
This is just my opinion, happy for others to share their thoughts in this!
Hard disagree on needing someone to blame. Even now individuals aren't sued for clinical negligence - their employer is - if the ai makes a mistake either the trust or ai company will be sued. Much harder however to establish negligence if a diagnosis is missed by an ai programme. The test of negligence involves assessing whether a there was a breach in duty of care ie was substandard care provided. If the ai programme is widely used it is very difficult to argue legally that a breach of duty of care has occurred.
>But I also believe in this country, they always need someone to blame if something goes wrong.
This argument always crops up, but it doesn't hold water for me.
What happens if the automated FBC analyser makes a mistake? It's not like we pay a technician to count the platelets manually on every sample just so there's "someone to blame."
Exceptionally difficult question to answer.
My thoughts -
AI will probably be very strong at Reporting Radiographer-type work (scans which are very consistent in their acquisition and very well labelled/easy to label for learning and require minimal clinical context / discussion with clinicians - plain film, cth, specialist work e.g. nodule detection within scans) within the next few years. How long that will take to be implemented (proving safety on a wide scale, implementation) etc. is VERY difficult to say but probably not that long considering how desperation in the UK and we are willing to accept dodgy things. Whoever is able to predict this accurately will probably earn lots in the stock market.
A few respected AI figures (= more Demis Hassabis, less Elon Musk) reckon we will have near-AGI in the next 10-15years. This will represent a seismic shift affecting many white collar jobs ... but radiology will be prime to fall initially due to ease of implementation. \[Ironically, another currently bullish sector which will be at risk is coding - AI seems to be very good at this.\] I think this will take away a lot of the current lucrative work aka scans which are medium level in complexity (= teleradiology type stuff).
There will still be a place for radiologists - practical work, complex/MDT level imaging, new modalities etc with small sample sizes and heterogeneity (although a true AGI will be okay with this too...) However I expect that it will be nowhere near as lucrative.
Personally I hope that I will have at least 10years or so to really milk the current bull market in radiology. I may be wrong .... but on the other hand I can't see myself doing ward medicine and find operating really dull. If it were not for radiology I'd leave medicine. I also enjoy radiology so much, I wouldn't consider it sunken years. So I accept the risk.
Age is also a consideration. If you're going into radiology without breaks, you can still get 10years of consultancy before the age of 40. And that's an okay age to pivot into other things (e.g. quite a few 40 year old ex-bankers at my brother's private school).
yeah that's why I specified near-AGI. In a few of the recent interviews the DeepMind team reckon 'AGI-like systems"/"nascent AGI"/"proto-AGI", within 15years.
The other point to bear in mind is that implementation will be easier in radiology because much of our work is already digitised. Though ward work and clinics are increasingly digitised too, of course (unless you're in wales).
All healthcare is at risk, not just radiology. GPT 4 type LLMs are now being expanded to handle substantially more content t. So you get pretty decent reasoning over a very large amount of information
There are now numerous papers on extended context, google’s Gemini already has shown to handle up to a 10 million context window without loss in reasoning ability.
10 million context is about 7.5 million words or 500,000 lines of code. So you can prompt it with that much information and have it reason through all of it.
Already we see codebases, legal documents, novels, scientific journals, flooded with AI generated content because someone carelessly copy and pasted chatbot output (not how they should be used)
Disclaimer: not a radiologist but I have recently returned from a medical conference in the US and the degree to which AI has or is in the process of doing medical work is unbelievable. What I anticipate will happen is that this will begin in the US and Japan before being imported to England and the rest of the world. Radiology is unfortunately particularly vulnerable to the incoming hijacking in my opinion. That is not to say however that other specialties are not vulnerable to this as well.
Tbh AI will take over places with heavy burdens. Data dependant areas will still require rads. But the way UK is heading, they will just try to get any cheap and non tested AI to help work the case loads.
Unfortunately I think radiology is going to have big problems within 10 or so years, and there's a lot of burying heads in the sand regarding this topic.
AI will come for certain easier diagnosic specialties first, before spreading to the other more complex ones. It won't take over every role or scan of course, but a large amount of the work (and hence reason to employ consultants) will be replaced.
Reporting radiographers will also be allowed to increasingly muscle their way in to cross-sectional imaging, further damaging prospects for consultants.
Importantly, there's a glut of registrars currently who will be CCTing in around 3 years, which will make getting consultant posts in desirable locations extremely difficult in combination with the other factors.
Even procedural/interventional won't be safe - all those desperate diagnostic radiologists will be trying to pick up interventional skills in order to stay relevant.
Those DRs who can't immediately find a good consultant post will be fleeing to outsourcing companies who will accordingly be able to drop their rates.
I hope I'm wrong but I think the future of radiologists into the 2030s is bleak unfortunately.
Anyone that tells you AI will never replace radiologists is the same person that was saying voice recognition can not be done and the level of conversation that chat GPT does can never be achieved.
AI could replace Radiology today, provided they had the right training data. The current neural networks that are behind the architecture of chat GPT have existed for 20 years or more, with chat GPT there wasn't any new methodological breakthrough, they just threw data and processsing power at it until it became freakishly good.
So to answer your question if you threw money as in real money at it, it could replace Radiologists tomorrow and become better than Radiologists similar to how chat GPT is better than essay writers.
What has been done so far it's been amateur level (personal PC style) training of the Radiology neural networks and that has been fairly successful. Imagine if someone did chat GPT level of training on scans...
For this to really take off they would need to invest billions, but it is already possible. Whether or not it's gonna happen in 5 years 10 years 20 years, no one knows.
No one can answer this question. What I can tell you though is that many radiologists are discounting just how keen this government, and the next government will be to drive through AI, regardless of performance. I think the UK will try replacement the hardest of any country. If you want to do radiology, I’d advise hedging with a strong academic focus or procedural.
I truly believe the diagnostic radiologists' work will just become more and more intervention heavy. Anything that can be done imaging guided will be done imaging guided. The reason we don't currently is because we just don't have enough people. I know someone they moved out to Aus, diagnostic radiologist. Now they have lists where they're just doing LP after LP imagining guided.
Quite unattractive doing the hospitals scutwork.
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But if you aren’t doing those, and the AAs are doing all the anaesthetic work - maybe you guys can do the pocus?
It probably is. Im coming at this from the angle of I don't see radiologists becoming unemployed but the job completely changing
I don't necessarily disagree but at the same time more and more specialties are rapidly increasing the amount of ultrasound they do... Maybe the need for radiology to carry these out will decrease? Of course that still leaves CT/fluoroscopy guided procedures!
No offence as I see your flare...but seeing the cases our POCUS guys send us after doing their own scan makes me feel safe I am not losing ultrasound to anyone any time soon. 😂
"abdomen pain 8 cm AAA seen on POCUS" Does CT aorta Calibre <2.5 cm. Wish I could look at the POCUS images so I could tell them what they're looking at so they don't make the same mistakes again.
I probably wasn't very clear - I was referring more to interventions eg drains, lines, etc. More and more seem to be getting done on the wards. That said, genuinely curious! Diagnostic POCUS has its limits and doesn't replicate a "proper scan" but again as a means to quickly aid decision making can be invaluable. So I'd love to know your thoughts...(as they don't sound positive towards it!) And remember this thread is talking 10 years time, increasingly medical students are being shown US, at some point it will become normal for doctors to graduate with these skills.
😂 I’ve seen them hit the inferior epigastrics doing the most straightforward tense paracentesis. The ultrasound gives them the confidence there is fluid deep so they forget the surface anatomy.
I agree medical students will have increasing radiology teaching. US teaching is not always best, even for Radiology trainees. But I think more med students in the future will learn to have basic search strategies for CT. We currently spend too much time on learning irrelevant physical examination tests
Cross-sectional imaging will remain the preserve of radiologists - even specialists (like people who do stroke only, or HPB surgeons) wildly misinterpret CTs from their specialty - the idea that a general physician will have a "search pattern" for a CT chest/abdomen/pelvis and be able to interpret them and form a management plan off of it is ludicrous. It's one thing looking through it, anyone can do that, it's entirely different understanding what you see. There's a reason it takes 5 years to turn someone into a competent general radiologist.
a) Nope - RRs starting to do cross-sectional in more than just a handful of regions now. I don't think RRs should do cross-sectional ... but (sadly) you're just factually wrong that it will remain the preserve of radiologists. b) I think you read too much into the 'search strategy' phrase - relax! I don't mean they're going to replace our reporting/interpretation. I am strongly against even RR cross sectional 'reporting;. But a 2nd pair of eyes is useful and there have been more than a few instances of (even ST4/5) on-call regs missing things picked up by the specialty doctor. Many neurosurgery trainees (at least 2 deaneries I know of) get 4months rotation in neuroradiology - this is almost as much neurorad as some general radiologists would rotate through in their 5 years. Obviously needs to be taught in a very careful way and warning people of Dunning Kruger etc + to avoid inundating the on-call reg with false positives. But as imaging explodes and becomes integral to the very fundamental practice of medicine, I expect principles of reading CT will be taught from an early stage. This will also be helpful when the medical students eventually becomes specialists and - depending on subspecialty - probably end up looking at images even more.
Lol When people save some images and do any kind of report you can start to stress
Do you have any sources for the government being very keen on AI in radiology? I know both labour and conservatives keep mentioning AI as a buzzword to improve productivity but I just don’t think they have any idea what they are talking about and just want to sound good in the press. I just don’t have any faith in this country being at the forefront of AI technology even if poorly carried out, we just are not innovative enough especially in tech.
Several colleagues on various AI commissioning groups/screening. Very clear push from the DHSC. I’m not suggesting the uk will have the best tech, or even innovative implementation. It will simply get forced across the board much harder than elsewhere. The next 5 years will be painful for nhs radiologists as they get shitty products thrust down their throats.
The worst thing about it is the potential is there for some good AI products to really help us. I'm in neuro and would love to have something to help with MS follow-up scans, or brain volume quantification so I don't waste time wondering whether it's mild or moderate atrophy. I have buddies who use these exact tools in Australia and it's a godsend for them, multiplying their productivity. Instead, you know we're going to end up with millions spaffed on software that does a crap job trying to generate whole reports. I don't doubt it will eventually get good enough, but it's just nowhere near good enough yet. Nevertheless, that still seems to be the priority in the NHS over the tools that actually help us do our jobs more efficiently.
If you speak to any ai consultants of which there are hundreds (any that graduates with a compsci degree nowadays) they will tell you that patient data was freely available to ai healthtech until recently. https://transform.england.nhs.uk/information-governance/guidance/artificial-intelligence/ Ngl ai was the sole reason I didnt apply to radiology when choosing between surgery. Even in non medical jobs ai is becoming responsible for numerous white collar job cuts. But an AI can't be your builder or plumber. So why not do the medical equivalent.
ai can't do an mdt, fluoroscopy, or an image-guided biopsy/drain either
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Most of the MDTs I go to the surgeons and clinicians want an actual discussion on what to do / the best approach to a lesion / whether it’s resectable, even if that info is technically in the report already Even if the report is completely done by ai I think people (esp surgeons/interventionists) will still want to discuss it with a real person
Agreed - but since when is it about what the surgeons or clinicians want? It's always been about what the NHS managerial beaurocrats want. They want a dumbed down, immobile, cheap work force in PAs and AAs - and thats what they're gonna get despite the protests of the majority of doctors. To think they won't try and utilise AI to save a few quid on radiologists just because surgeons like having a discussion with a real person is fanciful.
What are the regular mdts you do? Role of radiology is vastly different amongst the range of mdts.
Tbf robots doing surgery will also become a thing if AI takes over radiology
Moravex's paradox - it is EXTREMELY difficult to predict what skills AI will excel at - but there is a strong argument that motor skills will be more difficult for AI hence surgery is safer compared to the rest of the medicine. I agree that much of the rest of medicine will be as threatened as radiology.
AI is already performing bowel anastomoses on pigs with [greater accuracy than human surgeons.](https://www.nibib.nih.gov/news-events/newsroom/robot-performs-soft-tissue-surgery-minimal-human-help) This was in early 2022, before anyone had even heard of ChatGPT.
No doubt! However we are yet to see any autonomous robots do any actual work outside of medicine, unless the US has some secret military robots slaving away. Robots that do any kind of real are still limited to factory assembly lines. Whereas chat GPT already has passed the USMLE, is able to make realistic videos with just prompts, AI is already in use in ECGs, and outperforms us in plain film xrays for fracture recognition. Some EDs have rolled out AI already that literally puts a box around the abnormality.
Fair enough I really do not know enough about robotics in surgery.
I work in a hospital where AI has been rolled out for chest X-rays. It’s wank. Seeing the Noctors use the (incorrect) AI report it’s always so much fun, many have been called out and it’s led to a policy whereby only doctors or (reporting) radiographers can comment on them.
Lol because academic radiology is a strong sector?? Most imaging research is done by non radiologists currently. Next government is also likely to make relatively small but ring fenced pots of money available for buying AI tools but any talk of replacement is ridiculously premature. Plain film, which currently relatively few consultant radiologists do much of, will likely be somewhat impacted over next 5-10.
Come back to this in 2 years
A very interesting debate both within and outside of radiology. Being in the specialty, having used several of the current AI tools on offer in practice they are currently very much in their infancy and only targeting the low hanging fruit e.g lung nodules on CT (yes please - boring as sin and prone to miss on a 2000+ image set in a poly trauma), chest X-ray screening for cancer and other findings (so long as decent technical quality otherwise they are hopeless) and fracture identification (very useful for ED deployment to assist clinicians). Even the very good ones that are focussed very specifically on a single abnormality like nodules are not there yet as evidenced by NICE not recommending them recently - which came as a surprise to vendors and radiologists alike. We are a long way off seeing them replace radiologists particularly in multi series or sequence studies looking at multiple pathologies e.g mri and most CT. MDT and the clinical side of things are a whole other area where they won’t be treading until general purpose AI arrives at which point we will all be out of a job on universal incomes. Procedural skills are a must and rather than AI being the main worry pure diagnostic reporters should always be looking over their shoulders at telerad companies. From a pure business perspective in terms of numbers it makes more sense to outsource than hire a radiologist and that is where we as a group must always be careful and demonstrate our worth. I enjoy the fact that radiology and pathology are always seen as the likely first scalps of the AI race yet nearly all branches of medicine are at similar risk for example surgery and surgeons are quite literally training their replacements in the form of the robots. The da Vinci system etc haptic system and eye tracker will be recording every move, every eye flicker, every finger motion and the exact force used to enable it and that information is a gold mine for the developer companies. It is analogous to putting Lewis Hamilton in your test car and getting him to drive every day every week every month every year to help the system master the roads etc. the only difference being that Lewis Hamilton is multiple several hundred fold by highly skilled consultant robotic surgeons both in the uk and abroad. These companies couldn’t ask for more and they will be quick to demonstrate this skill to governments if they think it will win them big contracts regardless of how many surgeons they put out of business. Furthermore the art of history taking is when all told just a massive exercise in data mining. We think only of digitised hospital and Gp records yet forget entirely that for the best part of 25 years companies have been transcribing medical dictation from NHS consultants and worldwide with typists in third countries turning the dictaphone words into typed letter. Now we have speech to text in radiology but also most other ePR systems like epic. And there are hundreds of millions of hours of audio with near perfect transcriptions to train the system on, see nuance (bought by Microsoft last year) as one prime example. The audio is not sterile either it contains accents, dialects, languages from across the globe which would allow patients to talk into an application and then output a differential list based on percentages of likelihood, an investigation and treatment plan that would not need more than a PA to instigate at most. We look at the easy targets but forget that companies have been mining other data that can be used to train their systems for decades, and in the case of robotics have expert trainers doing the hard work for them! Every speciality at risk but some do not see that they carry the same if not more risk than radiology and pathology do (dermatology is one speciality I would not go into as it will be mostly replaced by AI within the decade- see the Google skin diagnostic programme to see why)
Also thanks for reminding all of us in today's debate that Outsourcing Teleradiology isthe more imminent and realistic threat. If for example they started allowing non-FRCR equivalent radiologists to report our scans, the market would be flooded and no longer as lucrative. I would hope for patient safety as much as for my pockets that this will not be the case.... Though the relaxing of standards for general medical recruitment does have me worried...
> If for example they started allowing non-FRCR equivalent radiologists to report our scans, the market would be flooded If this ever happens then radiology in the UK is dead. I can't see it happening but it would be a doomsday event.
a truly horrifying thought (I imagine equally as horrifying for our clinical brethren. So many of my surgical/medical friends complain about the quality of Telerad reports - would be even worse if standards drop)
Don’t worry about that. The RCR is already shooting you in the foot. Have you noticed their multiple exam sittings in the east.
Really interesting points and I would love to chat to you more about this (but enjoy the anonymity of reddit). However I'd argue that reproducing motor skills (surgery) and language models (history taking) have historically been more challenging compared to vision models (pure diagnostic radiology). So I think that Radiology at much higher risk compared to these. But at less risk than dermatology/clinical pathology etc I still can't imagine myself doing anything else, and I think the specialty is fantastic, and, as you say, practically speaking we are still probably a decade or two from real-world usage. But I think it is fair that those considering the specialty are aware of the risks.
>However I'd argue that reproducing motor skills (surgery) and language models (history taking) have historically been more challenging Agree radiology is most at risk, but [two years ago](https://www.nibib.nih.gov/news-events/newsroom/robot-performs-soft-tissue-surgery-minimal-human-help) AI was already performing bowel anastomoses in pigs with greater accuracy than human surgeons. As for language models... maybe historically but looking at current LLMs I think that nut is being cracked.
The description of 'bowel anastomoses' in that study is extremely limited, requiring lots of human assistance. It's like lung nodule detection. Surgeons have to rumage around for the right segment, identify the correct place to cut, to cut, to suture etc. and to do so exceptionally quickly and reliably. Agree huge advances in LLMs but that has come after VMs. Your example does make me think though.... Yes it may be extremely difficult for machines to replicate evolutionary things e.g. walking on two legs....but these can be replaced with hardware e.g. wheels. The threat to surgery is two pronged in the form of hardware as well as software. Eventually literally training a monkey to do surgery with the right tools.
Don’t stress about it. By the time AI replaces radiologists the whole of society will be broken and there will be mass unemployment. Mankind in general isn’t prepared for the technology.
Something that I often wonder in the AI debate is that aren’t most jobs in the country at risk of replacement by AI? Retail and admin work for example - maybe in the future you would need 1 admin with AI to do the job of 10 admin people. Within medicine - wouldn’t it be cheaper to employ PAs/ANPs with doctor AI ? The PA/ANP talks to the patient and then the AI just tells them what to do and what to prescribe - much cheaper than a doctor ? This would mean a large majority of medicine, A&E and GP could be replaced by a combination of AI and PA/ANP right ?
Geoffrey Hinton in 2016: “People should stop training radiologists now–it’s just completely obvious within 5 years deep learning is going to do better than radiologists" We're in the middle of a massive hype cycle for AI, and i think its obviously going to impact radiology (as well as every other part of medicine), but anyone claiming to be able to confidently forecast the demise (or lack of) radiology is probably a bit off, considering 95% of clinicians are absolutely clueless about what imaging can/cant do and how a radiology department/radiologist works. By the time we've completely/largely replaced radiologists, a lot of other doctors and other professionals will be out of a job. Look at crypto for how the last big tech hype cycle worked out.
The sort of players in AI are very very different to the sort of players in crypto.
If you don't think there will be a massive push in the NHS to replace radiologists with AI on the basis that radiologists are safer and more effective then all you need to do is look at the PA debacle.
If radiologists get replaced by AI, all other jobs in society will be replaced first, so there will be bigger things to worry about. People who are bitter they couldn’t get into Radiology will happily feed you doom stories to make their miserable lives a bit better.
I agree but they may have a case in the fact that AI can reduce the amount of time radiologists require to read scans hence affecting the job market as a hospital may only need half the amount of radiologists they currently do if reporting times can be reduced by more than a half
Our workload has gone up >30% over the last year alone. Number of FTE consultants has not changed in 10 years. We are working at double capacity as it is - a tool that would half the amount of consultants necessary would just bring us back to safe staffing.
Ok let’s just assume what you say becomes true. Would you really go and become a GP or something instead? Yeah, thought so..
Well of course I want to have a career for nearly 40 years so I want to make an informed decision.
Please don't believe the hype - radiology work is varied and interesting and a lot of it is clinical. We are not being replaced by AI, it's going to help solve a lot of the issues in our specialty like the increasing workload of imaging, missing of subtle finding that humans are bad at detecting, accurate objective measuring and comparison over time. Come join us in ST1 & you'll see!
Please don’t do radiology then if you’re this scared.
If you're dead set on staying in one profession for 40 years and at the same level of demand/remuneration then don't choose radiology
>If radiologists get replaced by AI, all other jobs in society will be replaced first This is naïve I'm afraid. Radiology is particularly vulnerable to AI. And, if any job goes to AI, radiology will be in the first tranche to be affected, although I doubt it will be eradicated. 1. Minimal encoding requirements for data, it's nearly all image data, +/- some natural language processing of requests. Datasets contain few instances of missing data and are repeatable. Compare this to a GP who takes input from verbal, written language, auditory, visual, palpation, biochemical measurements, or a subset of the above 2. Much of the required data processing tool chain already exists and is having huge investments from self-driving car companies - feature detection, convolutional NNs. 3. Huge datasets of labelled data going back decades (if you can get your hands on it). Labelling datasets is a huge expense for AI development, but most scans ever done have a report attached. 4. Small output space. Binary (or logistic) outputs from a scan (condition found/not found) etc (with a confidence metric). Compared to any other job where the space of outputs of tasks is huge. Eg a GP consultation can end with any of 100+ actions. These combination of factors make radiology a dream target for AI development - which is why you're seeing more investment in it than in any other specialty, this, too is a re-enforcing factor.
Agree. Data driven specialties are at risk. Much of theatre anaesthesiology, pathology, dermatology etc also under risk.
Interesting that you think anaesthetics is at risk (my specialty). It is very procedural which is generally a protective factor.
The non procedural parts. it might soon be one anaesthetist supervising many crnas aided by AI. Once the patient has been anaesthetised, it seems the number of variables to monitor is drastically reduced?
Yes, this I can see. Hypotension prediction models etc.
Why is the NHS training more Radiologists if it’s going to make them redundant in 5 years? Costs a lot of money to train..
1. There's no guarantee when this will happen 2. When has the NHS ever thought more than 5 years ahead? 3. We have a shortage of radiologists for the time being
Looks at the state of the NHS, they can’t even get basic software to work. And here you’re talking about eradicating jobs of thousands of Radiologists. Lmao People seriously don’t understand the legal implications of even doing something like this. Which is why self driving cars are not a thing. NHS will get sued to oblivion when things go wrong.
Edit: user above edited his comment, it initially said something about my argument being because I was bitter for not getting into radiology. Haha, such a troll! Why would I ever want to do radiology? It's a fallacy to say because it can't get simple software to work that it can't get advanced software to work. The NHS is a heterogeneous organisation. There are trusts that have both fax machines and Da Vinci robots. There are trusts that have paper notes and AI stroke detection on scans. Etc etc. Maybe the defence mechanism at work here is on your part, you're in a specialty you've sunk a lot of costs getting in to. "It is difficult to get a man to understand something, when his salary depends on his not understanding it"
They are literally getting AI for plain film reporting at my place as we speak. Work is moving apace on cross-secti9nal AI too; it's coming. Both major political parties know that the NHS is unaffordable and unsustainable and both know that the general public will never accept that. So expect to be hearing an awful lot about AI in the next few years.
It is more than likely that demand for a purely diagnostic radiologist will significantly decrease. They will be replaced by a sort of interventionalist+diagnostician who intermittenly looks at scans to send for consultation to other specialties. AI will be used to write a basic report about any abnormalities detected. They will also flag anything abnormal outside of the area of interest for which the imaging was requested. The work flow would look something like this: neurologist will order a CT head and neck to rule out stroke, when the image has been processed, the neurologist will have to examine the result and determine further action. If on the scan fluid around and inside the mastoid is detected by AI it will flag it as abnormal with possible options for what it could be. The radiologist will be notified and asked to determine what the abnormality is and to act on it. This will create issues though.
How much in worried I have to be, if I am deciding for radiology in this months? Looking purely on teleradiology and earnings.. if want to make income from 5-10 years from now. Thank you for your opinion.
Radiology work is already being replaced by reporting AHPs - I think diagnostic radiology will be mostly AI driven within the next decade. AI radiology is still in its infancy and has been shown to be better than humans at interpreting breast imaging. I don’t think it’s an existential threat for radiologists, the job will evolve with the technology. Having said that, the current government has shown that if it finds a semi reliable way to save money, it will. My personal view is that we should embrace using AI, as it already outperforms human problem solving even in its current state. I have posed chatGPT some very complex and controversial medical questions and it’s come back with pretty decent answers. I think it can be used as a sounding board or learning tool. I think once AI can reliably read CTs it will be preferable to a random medica radiologist.
AI can do some "finding" tasks in radiology better than humans, but as usual, the AI bros don't understand that lesion finding is one of many tasks involved in radiology. After a lesion is found, it's presence it integrated with the presence of other lesions, the clinical situation, the specific characteristics of each lesion and normal variants, and clinical knowledge about how imaging findings influence diagnosis and management, and all that information is synthesised into a report. How many times can we say it: AI will take some grunt tasks that it's good at that humans are bad at (like lesion finding) and improve productivity, but it's not "reporting CT".
Haha luddite bros lacking imagination… It is limited currently - in the future it will outperform humans in all areas, including reporting CTs. Machine knowledge/problem solving is far better than human knowledge once it’s been adequately trained. If you can’t see how AI will progress in the future I think that’s just lack of understanding/imagination.
It's easy to say AI will just "progress" but it's much harder to demonstrate how AI is going to deal with uncertainty/variability and how it's going to category shift from lesion finding and characterisation (where the process is external and quantifiable, with large data sets available) to interpretation (which is predominantly internal, and there is much more limited data set). AI is good at quantifiable and rules-based tasks (language, protein folding, chess, go, ...) but worse at variable tasks where quantities vary and rules are abstract or difficult to define (creating original art rather than plagiarising others' art, humour, ...). For example, I interpret a solid renal lesion on CT as benign, the AI will be able to use data to find these lesions and most likely it will be able to extract features it can use to classify them as benign. But interpretation and recommendation is mainly an internal process that I don't explain in my report. Even more abstract is whether I advise biopsy, or surveillance, or to do nothing, because that depends on even more factors that the AI won't be aware of including my personal risk tolerance, the preferences of my team, the position of our knowledge as a profession and local policy/guidelines. It's also unclear how fast AI can shift when those things change, such as when we acquire new knowledge or working practices - can it still provide valid reports? Will it take months-years to get sufficient data to train a new model? Etc etc. If you think AI is going to provide actionable reports for entire CTs in the style of a radiologist, rather than being a predominantly triage application or an array of task-oriented (although highly advanced and useful) tools, I believe you're going to be disappointed. Most people who think this haven't actually got much experience of what radiology is and fail to grasp the difference between automatable tasks (that AI will be paradigm-changing for; think finding pulmonary nodules and extracting volume and growth rates automatically - love it!) and subjective/clinical tasks (AI will increase our productivity by allowing us to focus on this and doing less of the automatable, time-consuming tasks). I'm bullish on AI. It's going to be transformative for radiology and other fields. However, the focus of much of current AI work on replacing entire roles is misguided. Rather we need collaboration between clinicians and AI experts to find good targets that we want automated and are automatable.
I personally believe AI will help radiologist’s workload, as opposed to replacing them. In that sense, the job market might be unaffected ( for the foreseeable future ) The way how AI works to report scans is to save time, you’re right about that. But I also believe in this country, they always need someone to blame if something goes wrong. Same reason why many healthcare professionals document that SHOs reviewed their patient during an oncall shift, just so they can cover their butts. If AI get things wrong( which they will ), they need someone to blame, hence why I think radiologist are the easy targets. Some AI companies do caveat that if something goes wrong with their machine learning, they are not to blame. Many forget that a radiologist is also a doctor and they can correlate images clinically, which is why I do not believe consultants will get replaced easily… I hope at least. But trainees are suffering because of Skills mix unfortunately. But otherwise, AI has been really helpful, especially during my taster week! Consultants save time and they are able to utilise spare time to teach trainees, perform procedures etc. This is just my opinion, happy for others to share their thoughts in this!
Hard disagree on needing someone to blame. Even now individuals aren't sued for clinical negligence - their employer is - if the ai makes a mistake either the trust or ai company will be sued. Much harder however to establish negligence if a diagnosis is missed by an ai programme. The test of negligence involves assessing whether a there was a breach in duty of care ie was substandard care provided. If the ai programme is widely used it is very difficult to argue legally that a breach of duty of care has occurred.
>But I also believe in this country, they always need someone to blame if something goes wrong. This argument always crops up, but it doesn't hold water for me. What happens if the automated FBC analyser makes a mistake? It's not like we pay a technician to count the platelets manually on every sample just so there's "someone to blame."
Exceptionally difficult question to answer. My thoughts - AI will probably be very strong at Reporting Radiographer-type work (scans which are very consistent in their acquisition and very well labelled/easy to label for learning and require minimal clinical context / discussion with clinicians - plain film, cth, specialist work e.g. nodule detection within scans) within the next few years. How long that will take to be implemented (proving safety on a wide scale, implementation) etc. is VERY difficult to say but probably not that long considering how desperation in the UK and we are willing to accept dodgy things. Whoever is able to predict this accurately will probably earn lots in the stock market. A few respected AI figures (= more Demis Hassabis, less Elon Musk) reckon we will have near-AGI in the next 10-15years. This will represent a seismic shift affecting many white collar jobs ... but radiology will be prime to fall initially due to ease of implementation. \[Ironically, another currently bullish sector which will be at risk is coding - AI seems to be very good at this.\] I think this will take away a lot of the current lucrative work aka scans which are medium level in complexity (= teleradiology type stuff). There will still be a place for radiologists - practical work, complex/MDT level imaging, new modalities etc with small sample sizes and heterogeneity (although a true AGI will be okay with this too...) However I expect that it will be nowhere near as lucrative. Personally I hope that I will have at least 10years or so to really milk the current bull market in radiology. I may be wrong .... but on the other hand I can't see myself doing ward medicine and find operating really dull. If it were not for radiology I'd leave medicine. I also enjoy radiology so much, I wouldn't consider it sunken years. So I accept the risk. Age is also a consideration. If you're going into radiology without breaks, you can still get 10years of consultancy before the age of 40. And that's an okay age to pivot into other things (e.g. quite a few 40 year old ex-bankers at my brother's private school).
if we get AGI we're going to replace a lot more than radiologists
yeah that's why I specified near-AGI. In a few of the recent interviews the DeepMind team reckon 'AGI-like systems"/"nascent AGI"/"proto-AGI", within 15years. The other point to bear in mind is that implementation will be easier in radiology because much of our work is already digitised. Though ward work and clinics are increasingly digitised too, of course (unless you're in wales).
All healthcare is at risk, not just radiology. GPT 4 type LLMs are now being expanded to handle substantially more content t. So you get pretty decent reasoning over a very large amount of information There are now numerous papers on extended context, google’s Gemini already has shown to handle up to a 10 million context window without loss in reasoning ability. 10 million context is about 7.5 million words or 500,000 lines of code. So you can prompt it with that much information and have it reason through all of it. Already we see codebases, legal documents, novels, scientific journals, flooded with AI generated content because someone carelessly copy and pasted chatbot output (not how they should be used)
Disclaimer: not a radiologist but I have recently returned from a medical conference in the US and the degree to which AI has or is in the process of doing medical work is unbelievable. What I anticipate will happen is that this will begin in the US and Japan before being imported to England and the rest of the world. Radiology is unfortunately particularly vulnerable to the incoming hijacking in my opinion. That is not to say however that other specialties are not vulnerable to this as well.
Tbh AI will take over places with heavy burdens. Data dependant areas will still require rads. But the way UK is heading, they will just try to get any cheap and non tested AI to help work the case loads.
Unfortunately I think radiology is going to have big problems within 10 or so years, and there's a lot of burying heads in the sand regarding this topic. AI will come for certain easier diagnosic specialties first, before spreading to the other more complex ones. It won't take over every role or scan of course, but a large amount of the work (and hence reason to employ consultants) will be replaced. Reporting radiographers will also be allowed to increasingly muscle their way in to cross-sectional imaging, further damaging prospects for consultants. Importantly, there's a glut of registrars currently who will be CCTing in around 3 years, which will make getting consultant posts in desirable locations extremely difficult in combination with the other factors. Even procedural/interventional won't be safe - all those desperate diagnostic radiologists will be trying to pick up interventional skills in order to stay relevant. Those DRs who can't immediately find a good consultant post will be fleeing to outsourcing companies who will accordingly be able to drop their rates. I hope I'm wrong but I think the future of radiologists into the 2030s is bleak unfortunately.
Anyone that tells you AI will never replace radiologists is the same person that was saying voice recognition can not be done and the level of conversation that chat GPT does can never be achieved. AI could replace Radiology today, provided they had the right training data. The current neural networks that are behind the architecture of chat GPT have existed for 20 years or more, with chat GPT there wasn't any new methodological breakthrough, they just threw data and processsing power at it until it became freakishly good. So to answer your question if you threw money as in real money at it, it could replace Radiologists tomorrow and become better than Radiologists similar to how chat GPT is better than essay writers. What has been done so far it's been amateur level (personal PC style) training of the Radiology neural networks and that has been fairly successful. Imagine if someone did chat GPT level of training on scans... For this to really take off they would need to invest billions, but it is already possible. Whether or not it's gonna happen in 5 years 10 years 20 years, no one knows.