The State of the Radiology Job Market

When Muntasir Hoque, MD, decided several years ago on radiology as a profession, the job market was excellent.

“There were numerous job openings for recent graduates and fellows, and relative compensation was excellent as well,” Hoque said. He is now completing his second fellowship, this one in cardiothoracic imaging and intervention at the University of Southern California in Los Angeles.

The market has since turned, forcing many fellows like Hoque to sub-specialize beyond what they might have done in a loose market, as well as consider compromises on compensation, hours and even geography.

For Hoque, there are added constraints. His wife, Kristina Hoque, MD, also is a radiologist and in her third year of residency. The couple has three young children and wants to stay together in Los Angeles, one of the nation’s most competitive locations.

“My whole family’s here,” Kristina Hoque explained. “I think in the back of our minds we know we’re both good radiologists and will find our place somewhere.”[[{"type":"media","view_mode":"media_crop","fid":"27363","attributes":{"alt":"","class":"media-image media-image-right","id":"media_crop_3286178958641","media_crop_h":"0","media_crop_image_style":"-1","media_crop_instance":"2646","media_crop_rotate":"0","media_crop_scale_h":"0","media_crop_scale_w":"0","media_crop_w":"0","media_crop_x":"0","media_crop_y":"0","style":"height: 300px; width: 200px; border-width: 0px; border-style: solid; margin: 1px; float: right;","title":" ","typeof":"foaf:Image"}}]]

Crunching the Numbers
If the numbers from the American College of Radiology are correct, Hoque could be among a pool of 1,100 fellows competing for approximately 1,115 open positions in 2014. Adding to the competition is those radiologists already in practice who are looking to change positions.

“There’s a job for everyone but not necessarily where you want to be,” said the ARC’s Edward I. Bluth, MD, head of the college’s Human Resources Commission.

Bluth’s numbers come largely from a survey sent to 1,900 or so radiology group leaders and department chairmen around the country. He calculated a 22 percent response rate representing 35 percent of practicing radiologists.

“Several of the [available] jobs are in areas where they don’t have family or hadn’t thought about living,” Bluth said, citing more openings in the southern and Midwestern regions. Hours worked are also emerging as a factor, with more and more radiology departments seeking radiologists willing to handle nights.

Other market constraints include mergers. There are approximately 1,900 radiology groups today, down from approximately 2,100 just three years ago, he said. Coupled with the decrease in practices, fewer people are retiring, Bluth said. He identified approximately 8,700 radiologists older than 56 who “conceivably could retire,” but for various reasons are remaining in the workforce.

“It’s an international phenomenon,” Bluth said. “People are healthier, and there’s an element of people hit by the economic downturn who have to support their families, relatives and children.”

And then there are those who prefer to work. “They’re living longer and want a more active lifestyle,” he said.

Today’s Employer Market
Also crunching the numbers, physician recruiter Craig Fowler said there were 5,009 residents in diagnostic radiology competing for 5,000 advertised positions in 2012.

Adding to that applicant pool, approximately 1,900 of the 27,500 or so diagnostic radiologists already in practice sought to change jobs that year, said Fowler, vice president of Pinnacle Health Group in Atlanta. While the 2014 figures are not yet available, Fowler said he does not have any indication much has changed in the past two years.

“Seven to 10 years ago, the demand for radiology was extremely high,” he said. “There were more jobs than there were radiologists.”

In today’s employer market, job seekers may have to compromise.  “In radiology, vacation is a big deal,” Fowler said. Radiologists may have to lower their expectations and accept salaries below the national average in the more desirable areas.

The Importance of Connections
While it’s difficult to predict who may be the most attractive candidate, Roger S. Eng, MD, president of Golden Gate Radiology Medical Group in San Francisco, said sub-specializing can make a candidate stand out, especially if he or she is capable and willing to perform a range of radiology imaging.

Connections also help - and the combination of sub-specializing and networking could make the difference for the Hoques, who are looking to remain where they have studied, worked and networked.

Traditionally, Eng said, most fellows have been successful at finding positions within an hour of where they trained. Other options are those companies such as NightHawk Radiology Inc., which may not suit everyone, but are hiring.

Southeast Regional Director Richard Steinman, MD, said a distinct advantage is that NightHawk employees can live wherever they want.

“If you want to live in Colorado, but you’re trained to practice medicine in Maryland, you can do that,” he said.

Seeking Fulfillment
Technology, Eng pointed out, is yet another factor leading to today’s oversupply.

“There was the large technological change from when I got out of training [in 1997] to the 2000s,” he said. “Studies have shown a benefit of the transition [from film to digital] was in our productivity; we were increasingly productive. When each radiologist is more productive, you need fewer.”

Even with the population aging and a growing need for imaging, he said, the increased productivity is greater than the need.

Eng said anecdotally he believes the tight market may be dissuading some medical students from pursuing radiology. While he can understand a graduate’s desire to pay off a student loan debt that could top $200,000, in the end he advises medical students to choose professional fulfillment over economics.

“The job market will go back and forth, and usually balances out,” said Eng, who runs a small, fully staffed practice. “Those I’ve seen who are most professionally satisfied are those who love what they do.”

Hiring
Among radiology departments hiring is the University of Tennessee Medical Center in Knoxville.  Radiology Associate Professor and Chair Laura K. Findeiss, MD, said she has received “an incredible number of applications” for each of three open positions. All candidates are highly qualified, she said. 

While candidates from the medical center’s residency program may have a slight competitive advantage, Findeiss described qualities she seeks in a hire. These include having subspecialty expertise, but also a willingness to be flexible and behave as a generalist, she said. 

Findeiss said she also seeks candidates who are personable. “I’m very interested in the consultative interaction, talking to the patient, talking to the referring physician and putting the imaging in the context of the patient’s overall care,” she said. 

The Ending of Uncertainty
Findeiss described two competing forces in radiology: teleradiology companies such as NightHawk providing off-site reading and her model of radiologists becoming an integral part of the patient care team. “It will be interesting to see what wins out here,” she said.

Should consultation emerge as the future for radiology, the shift may increase the demand for radiologists, she said.

The ACR’s Bluth also sees the potential for a more open job market as more people without health insurance become insured.

Bluth said he also believes many radiology groups are being conservative about their hiring practices because of the uncertainty of the Affordable Care Act and how it will impact the economics of radiology.

“Uncertainty causes people to pause and see how things shake out,” he said.  “Once people know the rules and what the reality will be, they will be able to accept the changes and make accommodations.”