Breast Imaging Fellowship - future job market, compensation and demand?

[CreedBobody]

I'm at the end of my first year of radiology residency and am thinking about breast fellowship. Are breast imagers commanding higher salaries compared to other subspecialties now and in the future? I understand breast is in high demand now, but will these trends continue in the future? Any thoughts on AI or getting replaced by mid-levels?

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[odyssey2]

Second this, and also want to know about lifestyle/working hours compared to other radiology subspecialties

 

[Cognovi]

The medicolegal environment is not amenable to midlevels in mammography in the US currently. In the UK there are many radiographers reading mammography, with demonstrated equivalent performance with radiologists (Radiology Podcasts | RSNA - Performance of Radiologists and Radiographers in Double Reading Mammograms), but they have a two-reader paradigm that is not applicable to the US, a biennial screening schedule that is less labor intensive than the annual scheme in the US, and also strict training/ongoing volume requirements that are beyond what the US requires via MQSA. I think the strength of historical inertia related to the screening paradigm in the US and the lobbying power of relevant groups (breast cancer patient advocates, ACR) will serve to protect the turf and volume of breast radiologists for the foreseeable future.

Radiologists are already using CAD routinely and it's shown to be less efficient to have to review the results. That's why they could get payers to pay extra for using CAD, which is just amazing... Improved CAD via AI/DL will improve accuracy but will only significantly reduce radiologist work if it can take out studies altogether, which requires the vendor to take on the risk of false negatives (which there will be... due to the inherent limitations of the modality). Whether anyone is willing to take on that risk is unknown.

It may be instructive to see how automated Pap smear screening has impacted the cytopathologists and cytotechnologists.

 

[Aurum]

While I cannot speak for the effect of mid levels and AI on future prospects for mammo trained rads, the job market for breast imagers is great at the moment. It seems like every group needs breast trained radiologists, and if you are willing to do any degree of general work you can write your own ticket.

If you join a traditional private practice partner position, you should be making the same as your partners regardless of specialty. Most employed gigs will pay their breast imagers equivalently, with the caveat that some of the 100% breast positions may pay a little less due to the lack of evening or weekend call.

 

[CreedBobody]

Any thoughts on law suit rates in breast imaging? Are people who do breast fellowships less likely to be sued than other fellowship trained folks reading breast?

Thanks for everyone's input so far

 

[guytakingboards]

Second this, and also want to know about lifestyle/working hours compared to other radiology subspecialties

This is entirely group/job dependent.

If you want lifestyle, there's plenty of mammo-only gig's with no evening/weekend call. Flip side it's usually employee tract, not partner tract, and you get paid less.

If you want the full PP experience, you can find a job where you take just as much evening/weekend call as anyone else.

Some mammo gigs are NOT busy. My current job the mammo rads average 60 RVU per day, which is a joke. In my old gig the mammo rads averaged 115rvu per day.

 

[vm26]

I'm at the end of my first year of radiology residency and am thinking about breast fellowship. Are breast imagers commanding higher salaries compared to other subspecialties now and in the future? I understand breast is in high demand now, but will these trends continue in the future? Any thoughts on AI or getting replaced by mid-levels?

As a partner in PP you would be paid the same and expected to participate in the general call pool...Certainly high demands for breast imagers these days. However in general there is high demand for IR, and any radiologist these days...By the time you graduate, who knows. If there's an AI+ mid-level solution to cover high RVU ($) tomo-screeners, the market for breast imagers changes drastically. With all this said, deciding on fellowship at the end of your 1st year is akin to a med student deciding upon their specialty after 6 months of med school. I would keep an open mind, as you are early in the game. Your feelings about the field and what suits you will likely change a bit with time/exposure.

 

[Cognovi]

At the end of my first year of radiology residency, I had zero time working in breast radiology!