How to Get Into Clinical Radiology ST4

Published December 27, 2025 | Updated December 27, 2025

MedCourse Blog

By MedCourse

Useful, relevant, and interesting content for UK Junior Doctors.


About the Author

Dr. Muhammad Khan, ST4 Clinical Radiology Trainee & RadCast Co-Founder, North West School of Radiology

Clinical Radiology Registrar who consumes an unhealthy amount of coffee, spends excessive time in dimly lit rooms, and quotes far too many radiology stereotypes. Also, Co-Founder of RadCas, where we support legends applying for radiology with their applications and try to increase awareness of the specialty through our podcasts – https://www.radcast.co.uk/

Courses & Conferences

Honestly, the best thing to do is align the courses and conferences to the portfolio requirements. You will see there are generic things across all the domains. That includes showing commitment by attending a radiology-specific course, which could be as simple as a radiology crash course on the need-to-know radiology for medical students/foundation training. Make sure to also attend at least one radiology-focused conference, ideally present at them, with the big four being the RCR, BSIR, SRT, and UKIO annual conferences. Finally, find a 2-day teaching course that helps you develop your skills as an educator and also helps you with those pesky teaching points.

Search Education
All Course Events
On-Demand Events
Question Banks Icon

How to Maximise Your Portfolio

Apply the golden rule: follow the damn portfolio guidance!

Like genuinely, it’s there to help you focus your time and energy. Just go through it systematically and prioritise the domains you’re either weakest in or know it will take the longest to get the achievement, e.g., publications.

In terms of breaking it down:

  • Commitment to Specialty: easy, peasy, lemon squeezy. First things first, two taster weeks of a minimum duration (3 days as of writing this). Great opportunity to build networks that will help with the other domains. Go onto a radiology-specific course/conference and crucially, align all your projects into radiology (after all, this is a job advert for radiology, so it makes sense).
  • Leadership/Management: must be a minimum of 6 months, so get on this asap. Best is national, but points for local/regional. Speak to your Foundation School and nearest medical school to see what opportunities there are, e.g., supporting the postgraduate teaching, rota coordinators, and radiology societies
  • Teaching and training: speak to your department about what radiology-specific teaching you can offer to the medical students and/or other healthcare professionals. Get in touch with us since we run an international radiology-focused teaching programme.
  • Formal Teaching Qualifications: top marks for a degree, but marks up for grabs by attending a teaching course. Make sure to book in early as these go rapidly.
  • Audit and Quality Improvement: You should all be audit/QIP connoisseurs since you gotta do it for portfolios already. Speak to the radiology regs/consultants and see if you can help out with any existing project. Remember, you don’t need to reinvent the wheel. Provided it is radiology-specific and a full cycle, you’re good to go. Aim for a minimum of 2 audits/QIPs.
  • Academic Achievements: one of the notoriously hardest domains to get any marks in. Be strategic, submit your audits/QIPs/research to conferences that publish the abstracts in their journals. You can then add these to this domain. But you have to start early to nab marks in this domain. Remember, peer-reviewers may reject your research, so always ask yourself, “could I use my time elsewhere,” i.e,. on other portfolio domains and/or enjoying life
  • Prizes and Awards: Who doesn’t love a juicy prize, right? Top marks for a radiology-specific prize at a national/international level. You can also get top marks if you achieve a distinction/honour in your medical degree, e.g., MBChB (Hons). That doesn’t mean a distinction/honours on INDIVIDUAL components but your OVERALL degree. Now for prizes, look at what the radiology conferences offer, e.g., RCR elective prize/SRT conference prizes/BSIR essay prize. We also offer prizes as part of our RadCast Roentgen radiology anatomy competition, so make sure to check that out too.

Making the Most of Your Day Job

Spoilers ahead (you’ve been warned).

You remember that scene in The Sixth Sense where Bruce Willis asks the kid how often he sees dead people, and the kid replies with “all the time”. Well, that’s kinda like radiology. Weird analogy, I know, but stick with me. You see, no patient nowadays goes without a scan. From headaches to heartache, everybody gets a scan. That means that regardless of what rotation you’re on, you can bet your bottom dollar that there’s an imaging (radiology) based project you can do. Working as an Ortho “bro”? Do an audit assessing adherence to Ottawa ankle/knee rules. Writing musical notes over lung fields as a respiratory doctor? See if CTPAs are being requested appropriately for identifying PE.

Also, remember to go say hi to your friendly neighbourhood radiologist. The best opportunity is to either go straight to the radiology department or just introduce yourself to us during the MDT. Honestly, we’re a nice bunch and we love to support the future generation of radiologists. Plus, great way to organise a taster week and get stuck in with what other projects are going on.

Making the Most of Clinical Radiology ST4 Placements

If you’ve managed to secure a radiology rotation, then please, can you tell me what the lottery numbers will be, too? Genuinely, they are rare as hen’s teeth. But if you are one of the lucky handful, this is a golden opportunity to smash your portfolio since you’ll be supernumerary at best. Work with the registrars/consultants and systematically go through your portfolio and use your time in the department to make it all radiology-focused. Plus, whilst you’re there, start tuning your “mind’s eye” about what a normal image looks like. Start with plain films since you’ll be most familiar/comfortable with them.  Whatever you do, don’t just watch the radiologist’s report. It’s as boring as watching paint dry. The real fun starts when you give it a go yourself.

What About Non-Clinical Radiology ST4 Placements?

Get a calendar and mark down the days till you never have to do a TTO again!

Jokes aside, make sure to align your projects strategically with radiology. As I mentioned earlier, this isn’t difficult since imaging is such a core component of patient treatment. However, it can be difficult at first to say no to your seniors. Rather than blankly saying yes or no, suggest ideas that align with their specialty and your own desire for radiology. Whether that be in terms of audit ideas, teaching topics, or potential publication projects, you can work “synergistically” with your supervisor and kill two birds with one stone.

Top 3 Tips for Getting Into Clinical Radiology ST4

  • Start early.
  • Radiology is getting hella competitive, and as they say, the early bird catches the worm.
  • Say hi to your friendly neighbourhood radiologist.
  • We don’t bite, I promise! Make introductions, start the taster weeks, and get stuck in with existing radiology projects with the registrars/consultants. Feel free to reach out to us at RadCast if you want any support.
  • Smash the MSRA.
  • Do not neglect this exam; it will come to bite you in the butt. It’s presently used for shortlisting and contributes to your final rank.


Share Your Wisdom

  • £50-100 per blog post!
  • Portfolio Certificate
  • Bragging Rights

Latest Posts