If more radiology residents are going to go into pediatric radiology practice, recruiters need to emphasize the availability of job opportunities, diverse practice settings and well-compensated private practice positions in that subspecialty, according to an article in the September issue of the Journal of the American College of Radiology.

Ryan W. Arnold, MD, from the radiology department at Aultman Hospital in Canton, Ohio, said that pediatric radiology is a field that has suffered a chronic workforce shortage—that hasn’t abated. The authors pointed to a recent update on the radiology employment market that reported that pediatric radiology was considered to be the third most difficult subspecialty in which to fill vacancies in academic centers.

The seriousness of the situation is demonstrated by the fact that only about 57 pediatric radiology fellows have been trained annually over the last ten years. 

“With roughly 100 positions currently being advertised in the field,” the authors wrote, “and with many unadvertised openings available, the pediatric radiology shortage may continue for several years to come.”

For purposes of the study, Arnold and his colleagues sent a survey to 1,000 radiology trainees (randomly selected from the American College of Radiology’s resident and fellow database). The survey contained 24 questions focusing on fellowship and career plans, factors that might affect participant’s choices of a fellowship, personal perceptions that might impact fellowship and career choices, and—if a respondent indicated they weren't interested in pediatric radiology as a career—the circumstances that might lead a trainee to reconsider a career or fellowship choice.

The authors received 337 responses. Of those respondents, 81 percent indicated they “definitely” planned to pursue fellowships after residency.

The four most popular subspecialties were body imaging (16 percent), neuroradiology (15 percent), interventional radiology (14 percent) and musculoskeletal imaging (13 percent). Only seven percent of the respondents selected pediatric radiology as their first choice. Factors leading to fellowship choices included—in descending order of importance:

1. Area of strong personal interest;

1. Advanced imaging modalities/multimodality imaging;

1. Intellectually challenging;

1. Area of strong personal knowledge;

1. Marketability of the subspecialty; and

1. Enjoyable resident rotations.

Financial compensation ranked 13^th (out of 20) as a determining factor in fellowship choice.

For those respondents who indicated pediatric radiology was their first fellowship choice, several factors ranked “significantly higher” than for other respondents in making their subspecialty choice, including:

• The degree of patient contact;
• The degree of personal interaction with other doctors;
• The health and physical status of patients encountered in the subspecialty; and
• Making the biggest impact in the lives of patients.

“Inflexible career opportunities” was the strongest factor keeping residents from choosing pediatric radiology as a subspecialty. The authors also noted that because residents choose their fellowships between their second and third years of residency, it underscores the importance of exposing residents to pediatric radiology early in a fellowship.

As far as the appeal of pediatric radiology to trainees, the authors found that “pediatric radiologists enjoy several unique advantages compared with other subspecialists,” such as exposure to a wide variety of advanced imaging modalities, and the possibility the radiologist will find the increased interaction with patients, parents, and clinicians rewarding.

The authors concluded that the effective recruitment of residents to pediatric radiology involves giving residents early exposure to the subspecialty (with its wide use of advanced imaging modalities), and emphasizing the number of job opportunities, diverse practice settings and well-compensated private practice positions available to pediatric radiology graduates.

“If these recruiting strategies are successful,” the authors suggested, “pediatric radiologists will be able to continue offering their unique contributions in the care of humankind's most important resource: our children.”