by Harvey L. Neiman Health Policy Institute

Credit: Unsplash/CC0 Public Domain

A new study from the Harvey L. Neiman Health Policy Institute found that attrition (i.e., exit) from the radiology workforce increased for all subspecialties, but with varying magnitude. The study,published in theAmerican Journal of Roentgenology, was based on all Medicare radiologists who submitted claims between 2014 and 2022 and covered 159,490 radiologist-year observations for 29,770 radiologists practicing as subspecialists.

The researchers found that the unadjusted attrition rate over the study period (2014–2022) averaged 2.2% across all subspecialist radiologists but varied over fourfold from a low of 1.0% for vascular/interventional radiologists (IR) to a high of 4.3% for cardiothoracic imaging. After adjusting for differences in radiologist characteristics and practice setting (i.e., years of practice, gender, and academic status), odds of attrition were highest for cardiothoracic imaging and breast imaging and lowest for vascular/IR.

Previous work from the Neiman Institute found subspecialist radiologists more likely to leave the workforce than generalists whose attrition rate was 1.6%, compared to the 2.2% rate for subspecialists or 37% higher odds for subspecialists. "Given the attrition difference between generalists and subspecialists, we wanted to understand if there were also attrition differences among subspecialists. Our subspecialist-focused study identified substantial differences that have implications for workforce sustainability and access to specialized radiologic care," said Elizabeth Rula, Executive Director of the Neiman Institute.

"Our previous studies have shown years of practice—seniority—to be the most important driver of attrition. We found that seniority varied widely among the subspecialties and was highest for cardiothoracic imaging and lowest for vascular/IR," said Eric Christensen, Ph.D., Research Director at the Neiman Institute and lead author of the study. "Hence, some of the unadjusted attrition differences (ranging from 1.0% to 4.3%) are due to differences in seniority among the subspecialties."

Over time (2014 to 2022), the researchers found that the unadjusted attrition rate increased for all subspecialties with musculoskeletal imaging having the smallest increase (0.4 percentage points) and cardiothoracic imaging having the largest increase (2.1 percentage points).

"Our study provides an important foundation for needed efforts to understand why attrition rates differ among the subspecialties. The persistent radiology workforce shortage is a potential driver worth exploring, as the associated workload burden may be disproportionate across subspecialties," said Jay Parikh, MD, professor, Division of Diagnostic Imaging at the University of Texas MD Anderson Cancer Center and study co-author.

The study found that the projected career length was 1.1 years longer for male than female academic subspecialists compared with 1.5 years longer for non-academic subspecialists. But, when examined for each subspecialty, career lengths were more similar between sexes and with career lengths ranging between 0.2 and 0.6 years longer for males than females.

"Our previous study found a larger gender difference in career length for subspecialists collectively—about 3.5 years," said Dr. Parikh. "The findings of this study show that much of the previous estimated gender difference can be explained by differences in subspecialty chosen by gender. For example, we found 63.7% of breast radiologists are women compared with 9.5% for vascular/IR."

Publication details Eric W. Christensen et al, Increasing—Yet Varying—Radiologist Workforce Attrition Across Subspecialties, American Journal of Roentgenology (2026). DOI: 10.2214/ajr.26.34579 Journal information: American Journal of Roentgenology