ECVDI Interview - Petra Agthe (August 2023)

ECVDI Interview - Petra Agthe (August 2023)

Tell us a bit about your path to becoming a radiologist.

For me, radiology has been a bit of an afterthought. All I ever wanted to do is to work in clinical practice. However, I soon realized that my imaging skills were lacking…significantly! And as many fellow vets, I perceived this as a very personal ‘not being good enough’ issue. So, I decided to do something about it and embarked on self-study. This was in the late 90’s and early 00’s when veterinary diagnostic imaging was largely about radiology and a bit of ultrasound. Resources were relatively limited and free online teaching materials and quizzes were only just becoming available, but I simply got hooked. I have always been a visual learner and discovering the logic and science behind imaging techniques and image interpretation was an absolute (and literal) eye opener. And I loved the notion of visual non-invasive ‘detective work’ to advance the diagnostic workup of a patient. I learnt lots, but in my mind, I did still not know enough. So, I enrolled in the UK RCVS diagnostic imaging certificate, naively thinking that becoming a certificate holder would enable me to reach a satisfactory level of confidence and competence. Of course, it didn’t! And therefore, I went on to complete a residency in diagnostic imaging at the University of Cambridge, thinking that as a diplomate I would reach a satisfactory level of confidence and competence…you can probably guess where that is leading! Luckily, I eventually figured out that competence as experienced by ourselves can be very different to competence as experienced by others, and that confidence is somewhat overrated. In fact, some of the best radiologists I have come across in my life were very happy to express doubt. The reason why I am sharing this is because I have found that many other people go through similar experiences, and we can end up putting tremendous pressures on ourselves in this way. While the ‘not being good enough’ issue can be part of the reason why we go into specialization, we don’t need to stick to this narrative. In fact, we will actually enjoy our jobs a lot more, and even become better at them, when we can free ourselves from it!   

What is your practice and work day like?

No two days are the same! Working in a large multidisciplinary small animal referral centre is not only often very fast paced but also very varied. Most working days contain several components of the following: interpretation of imaging studies (our modalities include radiography, ultrasound, MRI, CT and fluoroscopy) +/- imaging guided sampling, supervision of our resident, dealing with external advice cases, together with the radiographer and tech team, dealing with any technical/equipment as well as radiation and MR safety issues, rounds and case discussions within the team and with team members of other disciplines, as well as a variety of management and leadership tasks (the working on the rota is particular fun!). The only constant is that I now have a ½ day a week that is largely reserved for administrative tasks, which has been hugely helpful.

Your favourite imaging modality?

This is a really good question, and the answer has changed over the years! It started with radiography, changed to ultrasound until reaching CT, which I currently enjoy most!

How do you think veterinary radiology will change in 10 years time?

Another really good question. Artificial Intelligence is clearly going to have an impact, although it is perhaps difficult to fully predict the degree to it will change our work within this time period. However, in my opinion we don’t need to worry too much: if we use AI and the greater accessibility of knowledge to our advantage, we can spend more time focusing on aspects of our work that cannot be replaced by algorithms. The longer I have been in the profession, the more I have started to realise that there is so much more to providing a good imaging service than simply generating an accurate report – as good as it may be. In fact, I believe that we have a bit of a way to catch up regarding our understanding of and training in human factors, a field where our anaesthesia and ECC colleagues are currently further ahead. Imaging is a team sport with communication at its core, and my hope is that we can all collectively become better at this – whether this is in clinics or integrating teleradiology services as seamlessly as possible. I also hope that with time, we will be able to reverse the current trend and find more radiologists on the clinical shop floor, in order to provide best patient care and train more residents. 

What advice would you go back in time and give yourself when you were a resident?

Quite a few things, really, including: 

1. Communication and teamwork is everything: The way how we pass on information to others (or not) and how we work together with them is the central key to best patient outcome. So, learning the rules of good communication and teamwork is a priority.
2. Less is more: We often know so much more than we think that we do. The real secret and art lie in combining the knowledge that we have and applying it flexibly and creatively. For this, we need to make sure that we plan in enough recovery time to recharge our brains.
3. Confidence is over-rated: While people may subjectively prefer a confident radiologist, we don’t need to be confident to be good at our job. In fact, there is some evidence to suggest that confidence can be counterproductive in some situations. 
4. Making honest mistakes is truly human. It is not only ok but also brings you into good company. So treat yourself with some kindness, learn from the event as much as you can and move on.

What do you like to do for fun?

Seeing friends

What have you always wanted to do but never done?

A long-distance trail

Favourite quote or words to live by?

Ooooh, there are so many I like so this is really difficult to answer!!! One of my most recent favourite ones is 

‘An achievement is not one day in the future, it is the sum of all these moments where you have lived, and loved, and nourished our passion.’ by Christian Louboutin

Please complete the following sentences…

I usually start my day with…a coffee

The time of my residency was…..a privilege and fascinating opportunity of growth

If I had more time…I would still not have enough of it to do all the things I have on my wishlist

Sometimes I ask myself…how I got here!

I solve problems…in many different ways: sometimes rationally, sometimes intuitively and sometimes by just simply accepting that there is a problem which cannot be solved.

Teaching is…as essential as learning- we should do both more often every day!

My favourite radiograph: 

The choice was really difficult. In the end, I decided for this radiograph of an intrathoracic lipoma as a reminder that even though CT is now widely available and often used as a primary imaging modality for the examination of the thorax, radiographs can still provide us with so much information which may be sufficient for the diagnosis in some cases.