Radiology Residency Competitiveness

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.
Why the decrease in radiology interest? Job market?

The realization that it's not the easy $$$ it was way back when.
Market has changed--slashed reimbursements, more graduates, alternate pathway, older RADS staying in the market.
Contraction of imaging demand relative to imagers in the market.
Widespread use of PACS and gov't catching on that efficiency has increased and as such reimbursements should go down (see: Cataract advancement back in the 80s/90s)

Members don't see this ad.
 
The republican party will never nominate him... They like the crazies--Rick Santorum, Marco Rubio, Mike Huckabee...
I would take a Chris Christie or a Mitt Romney as well.
 
Members don't see this ad :)
Mitt Romney would be a tough sell... he is not going to sell reducing the deficit by cutting top earners tax to 20% like he proposed in the last election.
Honestly. I don't think we can cut taxes any further NOT without huge decreases in spending. I respect Ben Stein on this issue. You can only do a few things - (cut or raise) taxes or (cut or raise) spending. The GOP are fools in that they cut taxes (whatever that's fine) but they either keep spending the same or raise it. There's a reason income inequality has INCREASED in this country where people in the middle class or lower feel the deck is stacked against them. In that respect I liked the Clintons bc they had one of the best and fairest economies for good reason - Clinton raised taxes initially in 1992 and spending cuts and welfare reform was instituted at the same time. I'll take the Clinton years over the incompetent buffoon who was elected into office now.
 
Honestly. I don't think we can cut taxes any further NOT without huge decreases in spending. I respect Ben Stein on this issue. You can only do a few things - (cut or raise) taxes or (cut or raise) spending. The GOP are fools in that they cut taxes (whatever that's fine) but they either keep spending the same or raise it. There's a reason income inequality has INCREASED in this country where people in the middle class or lower feel the deck is stacked against them. In that respect I liked the Clintons bc they had one of the best and fairest economies for good reason - Clinton raised taxes initially in 1992 and spending cuts and welfare reform was instituted at the same time. I'll take the Clinton years over the incompetent buffoon who was elected into office now.
You are right about that... It seems like cutting taxes has become a religion for the GOP... This is the main reason that I am so skeptical of them... They just spend like the democrats while they also want to cut taxes..
 
some rad fellows at my school end up having to do a 2nd fellowship since they cant find jobs
 
The realization that it's not the easy $$$ it was way back when.
Market has changed--slashed reimbursements, more graduates, alternate pathway, older RADS staying in the market.
Contraction of imaging demand relative to imagers in the market.
Widespread use of PACS and gov't catching on that efficiency has increased and as such reimbursements should go down (see: Cataract advancement back in the 80s/90s)
no good deed shall go unpunished
 
some rad fellows at my school end up having to do a 2nd fellowship since they cant find jobs

Yeah but where are they wanting to get a job? Mid sized city in the Midwest? San Francisco? New York?
 
I like radiology because of the technology and the fact we play an important role in diagnosing patients. Nothing feels better than picking up a crucial fracture or SAH and letting the ED/primary team know, potentially saving a pt's life. All of the interesting pathology funnels through radiology since weird stuff usually merits imaging studies.

Just keep in mind though, the learning curve is STEEP, especially as an R1. The amount of reading is incredible. During intern year I read exactly 0 pages. The amount of information, , pathology and associated findings in each modality (not to mention having to know the physics of each modality) is potentially overwhelming. Neuro in particular is in its own league. This is why rads is 4 years + fellowship. I still enjoy it and cannot see myself anywhere else. As for the job market, I would worry about that later.

As far as the lack of patient contact part, I am satisfied with the amount of pt contact in rads. In flouro, MSK/neuro procedures, Peds, Mammo and especially IR, there is plenty of patient contact if that floats your boat.

Don't take your radiology rotation too seriously. It is like watching someone play video games. Of course watching someone do stuff is going to be boring!
 
  • Like
Reactions: 3 users
Don't take your radiology rotation too seriously. It is like watching someone play video games. Of course watching someone do stuff is going to be boring!
That's a great analogy
 
I don't understand why people in SDN keep saying radiology is competitive when match rat is 99% for US seniors... It is not even that bad for independent applicants. Is it because of the job market?
 
Members don't see this ad :)
I don't understand why people in SDN keep saying radiology is competitive when match rat is 99% for US seniors... It is not even that bad for independent applicants. Is it because of the job market?

Yes. Also bc of the long residency and decrease pay.
 
I don't understand why people in SDN keep saying radiology is competitive when match rat is 99% for US seniors... It is not even that bad for independent applicants. Is it because of the job market?
Radiology as a whole is still quite competitive at top programs. At a community, no-name program probably not. It's also become less competitive bc of a tightening attending job market and the de facto need to do a fellowship.
 
Radiology as a whole is still quite competitive at top programs. At a community, no-name program probably not. It's also become less competitive bc of a tightening attending job market and the de facto need to do a fellowship.
I am sure people can say that for FM/psych as well. It seems like you have to be a bad US applicant to not match into rad when 181-210 step1 has a almost 90% match rate...
 
I am sure people can say that for FM/psych as well. It seems like you have to be a bad US applicant to not match into rad when 181-210 step1 has a almost 90% match rate...

Except you have to be able to get a fellowship after you do residency. I also think TeleRads has destroyed a lot of Rads as well.
 
Except you have to be able to get a fellowship after you do residency. I also think TeleRads has destroyed a lot of Rads as well.
I get what you are saying... What I am trying to convey here is that people should stop saying radiology is competitive when the # of spot = the number of applicants... I am watching the job market closely since I am very interested in rad, but I am not willing to do a fellowship since I am a non trad student. If the job market does not change by the time I am applying for residency, I will proceed with plan B.
 
I get what you are saying... What I am trying to convey here is that people should stop saying radiology is competitive when the # of spot = the number of applicants... I am watching the job market closely since I am very interested in rad, but I am not willing to do a fellowship since I am a non trad student. If the job market does not change by the time I am applying for residency, I will proceed with plan B.
Not willing to do a 1 year fellowship? Sounds like rads isn't for you.
 
  • Like
Reactions: 3 users
Literally reads like a Foxnews.com editorial

Watevs, im used to this after being in medical school for a while

You are?

I haven't met a single physician in my school who hasn't been a vocal Democrat. (This in contrast with the docs I've seen in private practice, who have almost always had a certain distaste for the Democratic Party.

Not that I'm particularly attached to either.
 
Radiology as a whole is still quite competitive at top programs. At a community, no-name program probably not. It's also become less competitive bc of a tightening attending job market and the de facto need to do a fellowship.

Any thoughts on how the new IR residency might affect the overall outlook for rads or IR specifically?
 
I get what you are saying... What I am trying to convey here is that people should stop saying radiology is competitive when the # of spot = the number of applicants... I am watching the job market closely since I am very interested in rad, but I am not willing to do a fellowship since I am a non trad student. If the job market does not change by the time I am applying for residency, I will proceed with plan B.
Uh, then Rads is definitely not for you.
 
I get what you are saying... What I am trying to convey here is that people should stop saying radiology is competitive when the # of spot = the number of applicants... I am watching the job market closely since I am very interested in rad, but I am not willing to do a fellowship since I am a non trad student. If the job market does not change by the time I am applying for residency, I will proceed with plan B.

You HAVE to do a fellowship because you won't be able to take your boards until 1 year after you finish your last year of residency. This was recently implemented to get more people to do fellowships. You should thank the leadership of the ABR for this.

Personally, I think rads is the next path unless they decrease the number of residency spots.
 
Last edited:
  • Like
Reactions: 1 user
You HAVE to do a fellowship because you won't be able to take your boards until 1 year after you finish your last year of residency. This was recently implemented to get more people to do fellowships. You should thank the leadership of the ABR for this.

Personally, I think rads is the next path unless they decrease the number of residency spots.
Wow, I can't believe the ABR would purposefully would do that to their own diplomates. They're the only specialty that does this I believe.
 
Wow, I can't believe the ABR would purposefully would do that to their own diplomates. They're the only specialty that does this I believe.

They are also the only one to let foreigners bypass residencies and go straight into fellowships.
 
They are also the only one to let foreigners bypass residencies and go straight into fellowships.
Not the only one. Just the easiest one.

Ortho has a similar one called the "Distinguished Scholar Pathway" that lets you do your 5 years of training in the US through fellowships. The only caveat is it requires you to work in academia 5 years after you finish your fellowships or you won't get the board certificate.

IM has one but it requires 8+ years as an academic faculty member before you could even be proposed for it.
 
Last edited:
Wow, I can't believe the ABR would purposefully would do that to their own diplomates. They're the only specialty that does this I believe.
Wrong. Rads and Path were one of the only few who let their graduates be board certified prior to finishing residency.

The move now is more in line with other specialties for better or worse.
 
Wrong. Rads and Path were one of the only few who let their graduates be board certified prior to finishing residency.

The move now is more in line with other specialties for better or worse.
No other specialty makes you take your initial board certification exam nearly a year later from the time you finish your residency June 30th. You take your certification boards w/in the month or 2 after your residency is over.
 
No. No other specialty makes you take your initial board certification exam nearly a year later from the time you finish your residency June 30th. You take your certification boards w/in the month or 2 after your residency is over.
It's more like the surgical fields now.
 
You HAVE to do a fellowship because you won't be able to take your boards until 1 year after you finish your last year of residency. This was recently implemented to get more people to do fellowships. You should thank the leadership of the ABR for this.

Personally, I think rads is the next path unless they decrease the number of residency spots.

so what kind of fellowships are available after diag-rad residency? And do fellowships increase your job opportunities? As a third year looking into possible Rad i'm also somewhat concerned about the possibility of job market. I've looked online and it doesn't look too bad if you're willing to be flexible about where you work.
 
It's more like the surgical fields now.
Except until you take your boards you are "board-eligible". In Radiology, bc the certification exam is nearly one year later, you can't really apply for jobs bc of the tight job market where there will be someone else who has already taken his certification boards and he gets the job. So you're essentially forced into a fellowship to wait it out and take your boards. In surgery that isn't a problem as there are more than enough jobs available.
 
so what kind of fellowships are available after diag-rad residency? And do fellowships increase your job opportunities? As a third year looking into possible Rad i'm also somewhat concerned about the possibility of job market. I've looked online and it doesn't look too bad if you're willing to be flexible about where you work.
http://www.abms.org/member-boards/specialty-subspecialty-certificates/
American Board of Radiology
Diagnostic Radiology*
Interventional Radiology and Diagnostic Radiology*
Radiation Oncology*
Medical Physics*Hospice and Palliative Medicine
Neuroradiology
Nuclear Radiology
Pediatric Radiology
Vascular and Interventional Radiology
 
Except until you take your boards you are "board-eligible". In Radiology, bc the certification exam is nearly one year later, you can't really apply for jobs bc of the tight job market where there will be someone else who has already taken his certification boards and he gets the job. So you're essentially forced into a fellowship to wait it out and take your boards. In surgery that isn't a problem as there are more than enough jobs available.
Considering this is the first crop of board eligible graduates just hitting the market, it's too soon to really make any real analysis. Soon the BE will be the norm and not a big deal.
 
Considering this is the first crop of board eligible graduates just hitting the market, it's too soon to really make any real analysis. Soon the BE will be the norm and not a big deal.
Tell that to Saurabh Jha.
 
http://www.abms.org/member-boards/specialty-subspecialty-certificates/
American Board of Radiology
Diagnostic Radiology*
Interventional Radiology and Diagnostic Radiology*
Radiation Oncology*
Medical Physics*Hospice and Palliative Medicine
Neuroradiology
Nuclear Radiology
Pediatric Radiology
Vascular and Interventional Radiology

Yeah, I have no idea why they all aren't listed. Maybe they all don't have a certification exam (just the ABMS ones):
http://radiology.duke.edu/education/fellowships/

To clarify, not all of those are fellowships. You'll notice that's a list of both specialties and subspecialties, as the ABR grants certificates for multiple fields. IR, neuro, nucs, peds, and (apparently) palliative are the fellowships. I'll add that the next fellowship-trained palliative radiologist I meet will be the first one. Lots of people do body (GI/GU), cardiothoracic, breast/women's imaging, MRI, or MSK, none of which have a certifying exam. In fact, the overwhelming majority of the fellowship programs for these non-certifying subspecialties aren't ACGME accredited. That's not a knock on their quality; it's just that they don't bother (and don't have to).
 
No other specialty makes you take your initial board certification exam nearly a year later from the time you finish your residency June 30th. You take your certification boards w/in the month or 2 after your residency is over.

This is straight up wrong. Here's a list of specialties with their respective time between end of residency and final certification.

  • Ophthalmology: 24 mo
  • Urology, Orthopedic Surgery: 20 mo
  • Neurosurgery: 18 mo
  • Plastic Surgery: 16 mo
  • Radiology, PMNR: 15 mo
  • Ob/Gyn: 12 mo
  • Pathology: ~10.5 mo
  • Radiation Oncology: 10 mo
  • ENT, Anesthesiology: 9 mo
  • Emergency Medicine: 8 mo
  • Family Practice, General Surgery: 4 mo
  • Pediatrics, Psychiatry, Nuclear Medicine: 3 mo
  • Neurology: 2 mo
  • Internal Medicine: 1 mo
  • Dermatology: < 1 mo

Some of those numbers look a little off to me, but the idea that certification comes immediately after finishing residency is way off.
 
Considering this is the first crop of board eligible graduates just hitting the market, it's too soon to really make any real analysis. Soon the BE will be the norm and not a big deal.

I agree. Many specialties are accustomed to hiring BE physicians, usually with a contractual requirement to become BC. The idea that radiology is off on its own with this concept is a fallacy. Personally, I think the oral boards worked, so taking a page from the if-it's-not-broke-don't-fix-it playbook, I would have preferred them to leave it alone.

The major problem is that the transition period is coming at the same time as a poor job market. Practices, who are unaccustomed to hiring BE docs, will be allowed to adjust their hiring practices even more slowly because there will be quite a few BC radiologists with a couple of years of experience looking to change jobs. I also think the timing of 15 months is strange and inconvenient. Assuming a 1-year fellowship, it creates this dead period of 3 months. That's too long to go without paycheck, but it's not long enough to both get used to a new job AND study.

Eventually, everything will work itself out once practices adjust. But I don't envy the people finishing residency right now.
 
This is straight up wrong. Here's a list of specialties with their respective time between end of residency and final certification.

  • Ophthalmology: 24 mo
  • Urology, Orthopedic Surgery: 20 mo
  • Neurosurgery: 18 mo
  • Plastic Surgery: 16 mo
  • Radiology, PMNR: 15 mo
  • Ob/Gyn: 12 mo
  • Pathology: ~10.5 mo
  • Radiation Oncology: 10 mo
  • ENT, Anesthesiology: 9 mo
  • Emergency Medicine: 8 mo
  • Family Practice, General Surgery: 4 mo
  • Pediatrics, Psychiatry, Nuclear Medicine: 3 mo
  • Neurology: 2 mo
  • Internal Medicine: 1 mo
  • Dermatology: < 1 mo

Some of those numbers look a little off to me, but the idea that certification comes immediately after finishing residency is way off.
I was using IM and Derm as examples, but I was saying less than 12 months.
 
No other specialty makes you take your initial board certification exam nearly a year later from the time you finish your residency June 30th. You take your certification boards w/in the month or 2 after your residency is over.

I was using IM and Derm as examples, but I was saying less than 12 months.

??
 
EDIT: got tricked into necro'ing :(
 
Top