Is the competitiveness of Diagnostic Radiology picking up again?

[XxSynapsexX]

I have been reading SDN and asking questions about matching into Radiology. The general answer I get about match chances is " A passing Step score and a pulse" are all that is needed to match Radiology. Yet the Step 1 average is 240. On Charting outcomes I also see that a score greater than 220 has a 98% match.

HOWEVER, I have also been reading posts about the job market picking up again, how last years match there were surprisingly more applicants, less people getting their preferred match and being " a shoe in" for radiology even with scores around the 230s.

So will Radiology be competitive again in the next 5 years, next 10 years? How about in the 2019 which is when I would have my match day lol. Any information would be appreciated!

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[qxrt]

Getting into just any radiology residency is not difficult. Getting into a radiology residency that will give you good training is more difficult. There are unfortunately many low quality residencies out there that primarily use residents to take call and dictate cases and skew the Step 1 average down to only 240. Top programs have always had Step 1 averages in the 250s-260s, regardless of the overall competitiveness of the field. It is these low-tier sweatshop residencies that primarily went unmatched during radiology competitiveness' downturn.

IR/DR integrated residency has also served a role in attracting applicants who otherwise would have been on the fence about radiology and not have applied. Medical students currently have the perception of IR as an awesome high-tech field that gets much of the glory of saving the day without the associated terrible lifestyle of surgery residency. DR residencies now have to distinguish these applicants from the general DR applicant pool, since their ranking patterns will not be the same as that of a standard DR residency applicant. If the residencies are not careful, and they rank too many people who are only interested in DR for IR, they run the risk of dropping far down their list or even going unmatched.

 

[msk2016]

Getting into just any radiology residency is not difficult. Getting into a radiology residency that will give you good training is more difficult. There are unfortunately many low quality residencies out there that primarily use residents to take call and dictate cases and skew the Step 1 average down to only 240. Top programs have always had Step 1 averages in the 250s-260s, regardless of the overall competitiveness of the field. It is these low-tier sweatshop residencies that primarily went unmatched during radiology competitiveness' downturn.

IR/DR integrated residency has also served a role in attracting applicants who otherwise would have been on the fence about radiology and not have applied. Medical students currently have the perception of IR as an awesome high-tech field that gets much of the glory of saving the day without the associated terrible lifestyle of surgery residency. DR residencies now have to distinguish these applicants from the general DR applicant pool, since their ranking patterns will not be the same as that of a standard DR residency applicant. If the residencies are not careful, and they rank too many people who are only interested in DR for IR, they run the risk of dropping far down their list or even going unmatched.

As someone who recently joined a mid size practice in the southeast, the radiology job market is healthy. We recently interviewed a current fellow who had several job offers already. I think residency spots will continue to grow more competitive.

 

[Rads4lyfe]

I have been reading SDN and asking questions about matching into Radiology. The general answer I get about match chances is " A passing Step score and a pulse" are all that is needed to match Radiology. Yet the Step 1 average is 240. On Charting outcomes I also see that a score greater than 220 has a 98% match.

HOWEVER, I have also been reading posts about the job market picking up again, how last years match there were surprisingly more applicants, less people getting their preferred match and being " a shoe in" for radiology even with scores around the 230s.

So will Radiology be competitive again in the next 5 years, next 10 years? How about in the 2019 which is when I would have my match day lol. Any information would be appreciated!

According to RadiologyPD in his thread, applications are up about 25% this year. It seems like it definitely has picked up in competitiveness in the last few years and will continue that way.

Again, matching into any program isn't that difficult. Matching into a top program even in the nadir still required 250-260s with research with most of them having AOA.

 

[Naijaba]

I'm wondering about the motivation of currently radiology applicants. Maybe others can share their stories, but here are a few anecdotal ones from my med school:

1. Myself: Engineering background, interested in computer science / machine learning applied to medicine. Enjoy procedures. Applied IR/DR, matched DR at UW; I may pursue neuro-IR or IR, or something else!
2. Classmate #1: Engineering background, very smart. Matched UCSF. Enjoys tinkering / building things on the side. Interested in research.
3. Classmate #2: Incredibly good at anatomy, memorized Netter's. Matched UCSF. Not sure why he went into rads, but presumably because he's great at anatomy.
4. Classmate #3: Very well-rounded, excellent with patient care, chose radiology over emergency med to have more time with her kid(s). Matched UNC.
5. Classmate #4: Engineering background, very smart. Interested in device development. Matched OHSU (Dotter Institute) IR/DR.
6. Classmate #6: Not sure of her background, had a mentor in neuro-IR. Matched New York Presbyterian (Cornell campus).

My conclusion is that radiology attracts a large number of engineering-minded individuals. I'm hugely biased, but I think more and more computer-science majors are attending med school and looking for reasonable outlets for their dual skill sets. Radiology has been highly receptive to such individuals.

Edit: I've also observed that highly-qualified IR applicants, who would've matched at "better" DR places, matched at lower IR places. I don't know if they ranked IR places higher, or if the programs ranked them lower for DR.

 

[recycledpaper]

Makes sense. Radiology is one of the few specialties built almost entirely around technology.

 

[qxrt]

The IR fellowship I matched at, one of my interviews pretty much entirely consisted of my interviewer gushing about my engineering background and telling me about all the engineering opportunities at their institution. They really like former engineers.

 

[Lnsean]

I'm wondering about the motivation of currently radiology applicants. Maybe others can share their stories, but here are a few anecdotal ones from my med school:

1. Myself: Engineering background, interested in computer science / machine learning applied to medicine. Enjoy procedures. Applied IR/DR, matched DR at UW; I may pursue neuro-IR or IR, or something else!
2. Classmate #1: Engineering background, very smart. Matched UCSF. Enjoys tinkering / building things on the side. Interested in research.
3. Classmate #2: Incredibly good at anatomy, memorized Netter's. Matched UCSF. Not sure why he went into rads, but presumably because he's great at anatomy.
4. Classmate #3: Very well-rounded, excellent with patient care, chose radiology over emergency med to have more time with her kid(s). Matched UNC.
5. Classmate #4: Engineering background, very smart. Interested in device development. Matched OHSU (Dotter Institute) IR/DR.
6. Classmate #6: Not sure of her background, had a mentor in neuro-IR. Matched New York Presbyterian (Cornell campus).

My conclusion is that radiology attracts a large number of engineering-minded individuals. I'm hugely biased, but I think more and more computer-science majors are attending med school and looking for reasonable outlets for their dual skill sets. Radiology has been highly receptive to such individuals.

Edit: I've also observed that highly-qualified IR applicants, who would've matched at "better" DR places, matched at lower IR places. I don't know if they ranked IR places higher, or if the programs ranked them lower for DR.

I think this is a very plausible reason. We have alot of incoming med students that have gap years and/or are career changers or not initially studying bio/premed in undergrad. Schools have really started to look and select for more diverse applicants with varying backgrounds than just premed or bio. Also, IR i think has this kool feel to it that attracts alot of computer/tech savy people.

 

[tartrate]

Getting into just any radiology residency is not difficult. Getting into a radiology residency that will give you good training is more difficult. There are unfortunately many low quality residencies out there that primarily use residents to take call and dictate cases and skew the Step 1 average down to only 240. Top programs have always had Step 1 averages in the 250s-260s, regardless of the overall competitiveness of the field.

I would agree. Most other specialties you can get into big name programs in nice locations with a reasonable application. Much harder for radiology even with scores at the far right end of the bell curve, where the applicants are indistinguishable from applicants going into derm or competitive surgical subspecialties.

 

[Andrige]

I think it's more competitive this year. Just went to a community program in a smallish city. Even there, they had 850 applications and an average step score for interviewees around 240.

 

[CharlieBillings]

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[applesnoranges]

I think it's more competitive this year. Just went to a community program in a smallish city. Even there, they had 850 applications and an average step score for interviewees around 240.

Do you mind giving more details about this program? Just curious

 

[cyberchicken001]

What would be the negatives of going to a low tier residency besides the awful residency life?

I've heard that rads fellowships aren't that competitive, but could you possibly not get a fellowship due to a low tier residency? Or would it make it much harder to get a fellowship?

Would a low tier residency have any influence on your eventual job placement outside of location?

I know there was a pretty lengthy thread about this a few months back but it kind of got dominated by 2 or 3 people with very strong opinions arguing, and I'm also interested in hearing other residents/attendings thoughts on this.

 

[Rads4lyfe]

What would be the negatives of going to a low tier residency besides the awful residency life?

I've heard that rads fellowships aren't that competitive, but could you possibly not get a fellowship due to a low tier residency? Or would it make it much harder to get a fellowship?

Would a low tier residency have any influence on your eventual job placement outside of location?

Fellowships in general are not that competitive and there are people from low tier residencies in brand name places for stuff like body fellowships, etc. It can be tricky landing a more competitive fellowship at a very desireable location coming from a low tier program though.

I'm still a resident, but what I've gathered is that going to a top residency will open up more doors for better jobs, ESPECIALLY in the location of the residency.

For instance, NYU vs lower tier program in NY, the NYU resident will have the edge if staying in NY and if leaving NY.

It gets more tricky comparing NYU vs community program in cali if wanting to work in cali. I've heard that(for example) NYU resident can do a fellowship at UCSF and be pretty set for jobs in nor cali and likely would beat out the person at the community cali program.

 

[cyberchicken001]

Fellowships in general are not that competitive and there are people from low tier residencies in brand name places for stuff like body fellowships, etc. It can be tricky landing a more competitive fellowship at a very desireable location coming from a low tier program though.

I'm still a resident, but what I've gathered is that going to a top residency will open up more doors for better jobs, ESPECIALLY in the location of the residency.

For instance, NYU vs lower tier program in NY, the NYU resident will have the edge if staying in NY and if leaving NY.

It gets more tricky comparing NYU vs community program in cali if wanting to work in cali. I've heard that(for example) NYU resident can do a fellowship at UCSF and be pretty set for jobs in nor cali and likely would beat out the person at the community cali program.

Thanks for this reply. Just wondering, why is body less competitive?

 

[DrfluffyMD]

So the most competitive radiology fellowship is MORE competitive than the radiology residency match.

Case in point: IR this year. There are folks with grant funding who couldn’t match their top 8 programs. we are talking places like UNC, etc, not bad program but not exactly MCVI too, that bypassed them, persumably due to the fact that they went to a smaller program.

Caliber of one’s residency program is the biggest determinant of where they go for fellowship and subsequently, jobs. Anyone can get a body fellow at Stanford because there are like more body fellowship spots there than residency. Meanwhile, between UCSF and Stanford there are probably only 4-5 open IR fellowship spots last year (excluding internal filling), so anyone not in a top program was pretty much shut out.

 

[Gadofosveset]

Thanks for this reply. Just wondering, why is body less competitive?

Body fellowship training is sometimes perceived as not offering anything new to the group, since everyone supposedly is equally good at reading body imaging, although subspecialist body imaging (e.g. prostate MR) is left to the dedicated body rad. There's a perception that one has learned everything that can be learned in body imaging by the end of residency. This is a pervasive but false belief. The body-fellowship-trained rad is much better at body imaging than a comparable nonbody-trained rads (duh), but whether this translates to a practical advantage in the workplace is really what's up for debate. It's certainly better for patients and referring docs. Does this advantage get you a better contract from your group?

It is true that, in general, most residents get more exposure to body imaging than, say, higher end neuro or MSK. So it is popular to go into Neuro or MSK fellowships to be able to offer that expertise to a group. These subspecialities tend to be more MRI heavy as well -- especially neuro -- which theoretically would mean they are more valuable RVU-wise, but in practice, this doesn't end up making as big a difference as one might think.

 

[Tiger100]

Body fellowship training is sometimes perceived as not offering anything new to the group, since everyone supposedly is equally good at reading body imaging, although subspecialist body imaging (e.g. prostate MR) is left to the dedicated body rad. There's a perception that one has learned everything that can be learned in body imaging by the end of residency. This is a pervasive but false belief. The body-fellowship-trained rad is much better at body imaging than a comparable nonbody-trained rads (duh), but whether this translates to a practical advantage in the workplace is really what's up for debate. It's certainly better for patients and referring docs. Does this advantage get you a better contract from your group?

It is true that, in general, most residents get more exposure to body imaging than, say, higher end neuro or MSK. So it is popular to go into Neuro or MSK fellowships to be able to offer that expertise to a group. These subspecialities tend to be more MRI heavy as well -- especially neuro -- which theoretically would mean they are more valuable RVU-wise, but in practice, this doesn't end up making as big a difference as one might think.

Agree with above with some caveats.

Practice makes you better and better over time. No matter how big or small your group is, most radiologists participate in call, even in subspecialized groups.
Most of what you read on call is chest and body CT, CT head non-con, general ultrasound, brain MRI and some spine MRI. I have been in practice for almost 15 years and I've read many more CT abdomen and pelvis than any body fellow. But you can not say the same for many other modalities.

As a result, most radiologists in practice feel comfortable reading body or chest imaging compared to let's say high end MSK, high end Neuro or mammo or prostate MRI. When it comes to hiring a new person, a lot of groups hire someone that (right or wrong) covers the modalities that they can't or don't want (esp in case of mammo) to do. If the body imager goes on vacation it is easier to fill his gap compared to mammographer or MSK radiologist.

If you do an MSK fellowship and you are offered an MSK job, always ask them how much MSK you will do in the future (if that's important to you). It is not uncommon to hire an MSK radiologist to do minimal MSK work, but be the back up person for the older radiologist who does the bulk of MSK imaging. My 2 cents.

 

[Radology]

Body is less competitive more because of supply and demand. The best MSK fellowships have 3-4 spots, and most fill internally. Body fellowships often have 10 spots, so there’s are plenty to around.

Body has actually been one of the more marketable fellowships in terms of job availability the past couple years.