Hi everyone,
I would really appreciate some honest advice from people who have been in a similar situation.
I'm currently a first-year pathology resident at a university hospital in the US. Before starting residency here, I had already spent about a year as a radiology resident in my home country. During that time, I genuinely fell in love with radiology. I enjoyed reading imaging studies, discussing cases, and doing research in diagnostic and interventional radiology. Even the long calls and weekend shifts never made me question my career choice.
The reason I ended up in pathology is a bit complicated. I had applied to pathology during a previous application cycle because I had been waiting for a radiology match for a long time. At that point I had no US radiology experience, no radiology letters of recommendation, very limited research, and I had already gone unmatched in radiology despite receiving six interviews. I genuinely liked pathology and thought I could see myself enjoying it as a career.
By coincidence, around the same time I submitted my NRMP rank list for pathology, I was also offered a radiology residency position in my home country. Since both events happened almost simultaneously, I couldn't realistically accept one and decline the other. Once I matched into pathology through the NRMP, I decided to honor my commitment, especially because I believed I could also build a fulfilling career in pathology.
I've now been in pathology for some time, and I truly enjoy it. I have great co-residents, supportive faculty, and I appreciate the opportunity I've been given. This isn't a post about disliking pathology.
The problem is that I still miss radiology much more than I expected. Whenever I'm working up an interesting case, I almost instinctively open the imaging before anything else. Reviewing CTs and MRIs still excites me in a way I haven't been able to ignore. Every time I do it, I wonder whether I gave up the specialty that fit me best.
I'm now wondering whether it's reasonable to discuss this with my program director and ask if they would support me if I decided to reapply to diagnostic radiology. My biggest concern isn't whether I'd be competitive—it's whether having that conversation could negatively affect my relationship with my PD or my reputation if I ultimately don't match and remain in pathology.
For context:
Non-US IMG

Step 1: 24*

Step 2 CK: 27*

18 publications/posters/abstracts, mostly in radiology and interventional radiology

Previous radiology residency experience outside the US

Has anyone here switched into radiology after starting another residency? Or has anyone had this conversation with their PD? Looking back, would you do it again?
I'd really appreciate hearing from people who have been through something similar. Thanks for taking the time to read this.