Radiology On The Increase

Three years ago, if you asked radiology residency directors if they felt optimistic about the specialty’s future, you were likely met with a grimace. That year, 64 diagnostic radiology residency programs failed to fill all their positions.

There’s been much justifiable hand-wringing about waning interest among medical students in a field largely known for being the “doctor’s doctor.”

But, fast-forward to 2018. Radiology now looks far different. Like the industry’s job market, its residency programs have entered a boon year. According to the 2018 Match, run by the National Resident Matching Program, radiology residency programs for first- and second-year students filled to capacity.

It’s clear, industry experts say, that student interest in the profession is rising. And, there are several factors driving their professional selection.

“We’ve still struggled with exposing medical students to the field,” says Carol Geer, MD, associate professor and diagnostic radiology residency program director at Wake Forest School of Medicine. “But, we have done many things in the last couple of years to try to improve exposure so students have enough time to decide if radiology could be a good career fit.”

Increasing exposure isn’t the only factor responsible for stronger diagnostic radiology matches, but giving medical students a radiology introduction sooner can’t be discounted, Geer says. In a growing number of medical schools, radiology professors are now an integral part of first- and second-year anatomy courses. This interaction is critical, she says, to dispel the myth that radiologists never leave the reading room.

“If you don’t see the specialty, you don’t consider the specialty,” she says. “In these classes, students meet the radiologist and ask questions about what he or she does.”

Enter the interventional radiology residency

Perhaps the biggest push behind the recent interest increase is the advent of the interventional radiology (IR) residency. Until now, IR has been a subset within the overall diagnostic radiology program with students spending one year of a five-year residency focused on an IR fellowship.

Students opting for this specialty path now spend the last two years focused on IR, and they’ll take separate board exams. Upon graduation, they’ll be certified in both diagnostic radiology and IR.

“Now that we have two increasingly distinct pathways with diagnostic radiology and IR, some people view that as a schism,” says Alex Grieco, MD, assistant professor and advisory to the Ohio State University College of Medicine diagnostic radiology interest group. “But, I don’t view it as a divisive thing. It’s optimizing options for our invariably well-qualified students.”

The interest among students in noninvasive procedures has caused IR to skyrocket in popularity almost overnight, Geer says. As of yet, not enough time has passed to determine if more students will select careers in IR, decreasing the number of diagnostic radiologists overall. She anticipates seeing the full impact within a few years.

Job market rebound

The robust job market has also helped reignite medical student interest in radiology, says Charlotte Taylor, MD, a third-year radiology resident at the University of Mississippi School of Medicine (UMSM). She is lead author on a study published in the October Journal of the American College of Radiology issue focused on generating medical student interest.

When the economy declined several years ago, fewer radiologists retired, and some even returned to work. The shrinking job market made the specialty less attractive. As the economy improved, though, she says, and more radiology jobs have become available, more medical students are taking an active interest.

“We have enough residents to fill the jobs that are out there,” she says. “The job market is certainly opening back up.”

In addition, radiology-always technology-based-is expanding its use of artificial intelligence (AI). This generation has a lifelong familiarity with technology and is ready to actively embrace it at a professional level.

“They’re aware that radiology isn’t going to be replaced by a new app from the Apple Store,” Grieco says. “And, they want to know and want to be shown how they can use AI to improve their own practice.”

What are medical schools doing?

Having radiology professors teach anatomy lectures isn’t enough, though. Many medical schools are giving students more opportunities to experience the specialty through radiology interest groups.

Recently, Taylor says, UMSM launched its radiology interest group with four scheduled meetings throughout the academic year with each session introducing different radiology facets. The residency director led a session; a body radiologist gave an interactive ultrasound demonstration; students had an interactive ultrasound session using gelatin molds, straws, and balloons to simulate the body; and fourth-year students who chose radiology returned to talk with third-year students.

After only one year, the numbers selecting radiology soared, she says.

“Our medical school classes range from around 140 to 150. In some years, there’s been one person selecting radiology,” she says. “After only one full year of the interest group, we had 14 students apply-that’s roughly 10 percent of their entire class.”

Groups leaders play to students’ intrigue with AI at Ohio State, Grieco says, with a presentation by the department’s chair of informatics on how the specialty uses this technology now and what might be on the horizon.

“AI is a go-to tool that everyone wonders about,” he says. “So, we make sure students can connect and interface with the one person at the school who is the driving force for our efforts in AI.”

Students also have the option to participate in a simulation symposium where they test their skills and try out many areas of radiology, ranging from ultrasound to interventional procedures.

Growing interest among women

Despite overall growing interest among medical students, radiology still lags behind as a favored specialty among women. And, simply increasing a female student’s exposure to it early in medical school isn’t enough to push her to select the career, says Carolynn DeBenedectis, MD, associate professor and radiology residency program director for University of Massachusetts Medical School (UMass).

“We have a great radiology interest group at UMass. A radiologist is co-director of our anatomy course, and our residents teach medical students how to read CT scans,” she says. “Our students get exposed early, but our female students still haven’t been choosing radiology.”

It turns out, women need more than exposure to radiology to make it attractive. Female students need to see the profession as female-friendly and compatible with the lives they want to lead. In essence, DeBenedectis says, younger women in medical school need to see women radiologists at work.

To bring women into the forefront, DeBenedectis launched an initiative to integrate female providers into more aspects of medical education. Today, female faculty mentor the fourth-year capstone projects, and at least one female faculty member attends every medical school event. Additionally, women instructors invite female students over for dinner, letting them see a work-life balance is possible.

She also steers female students to radiology areas that offer the most patient contact, she says, because these students often have a stronger desire to see how they’re helping others.
To date, UMass has seen an uptick in interest in the specialty among female students. Of the seven most recent residency applicants, five were female.

Whatever the school or reason, Taylor says, the message to radiology is clear. Radiology is on medical students’ radar, and they’re choosing it as a career option more often. Continuing these tactics throughout medical school could help solidify that growing strength.

“Interest in radiology has gone up exponentially,” she says. “We’ve gone from being less competitive in the last few years to being more competitive. Right now, we don’t know if things will swing back the other way, but radiology, as a whole, has become more desirable.”