DOI:10.2214/AJR.06.0344
AJR 2006; 187:W249-W254
© American Roentgen Ray Society
Update on the Diagnostic Radiology Employment Market: Findings Through 2005
Adam Licurse1,
Daniel D. Saket2,
Jonathan H. Sunshine1,3,
C. Douglas Maynard4 and
Howard P. Forman1,5,6,7
1 Department of Diagnostic Radiology, Yale University School of Medicine, 333
Cedar St., TE-2, New Haven, CT 06510.
2 Department of Radiology, Hospital of the University of Pennsylvania,
Philadelphia, PA.
3 Research Department, The American College of Radiology, Reston, VA.
4 Department of Radiology, Wake Forest University School of Medicine,
Winston-Salem, NC.
5 Yale School of Management, Yale University, New Haven, CT.
6 Economics Department, Yale University, New Haven, CT.
7 Yale School of Public Health, Yale University, New Haven, CT.
Received March 7, 2006;
accepted after revision March 30, 2006.
Address correspondence to A. Licurse
(adam.licurse{at}yale.edu).
WEB
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Abstract
OBJECTIVE. The purpose of this study is to analyze and summarize the
latest data describing the diagnostic radiologist employment market.
MATERIALS AND METHODS. Three sources of data—vacancies in
academic radiology departments as of July 1, 2005; the ratio of job listings
to job seekers at a major placement service; and the number of positions
advertised in the American Journal of Roentgenology and
Radiology—are presented and compared with previous data.
RESULTS. Vacancies in academic departments averaged 4.5 in 2005, an
increase of 16% from 2004 but a decrease of 16% from the 2001 peak. Vacancies
increased from 2004 in all specialties except nuclear medicine and
"other," and vacancies decreased from 2001 in all specialties
except pediatric radiology and purely research positions. Job listings per job
seeker increased 8% from 2004 but remain far below peak levels. The total
number of positions advertised decreased by 6% from 2004, reaching the lowest
level since 1998. In 2005, 42% of the total advertised jobs were academic, as
compared with 45% in 2004. Proportional decreases were seen between 2004 and
2005 in total advertisements per region except the Northwest and California.
The largest proportional increases in subspecialties occurred in general
radiology, abdominal imaging, and "other."
CONCLUSION. Data from the American College of Radiology Professional
Bureau and a survey of academic radiology departments show an increased demand
for diagnostic radiologists in 2005, whereas data from the help wanted index
show a decrease. In addition, the regional distribution of advertisements and
the proportion of advertisements for certain specialties have shown some
shifting in 2005. We believe the job market remains strong, with regional and
specialty shifting.
Keywords: radiology assistant • radiologist employment • radiology practice • teleradiology
Introduction
Anecdotal evidence suggests that a radiologist shortage exists. Observers
of this apparent trend have raised concerns that a prolonged radiologist
shortage could detract from the specialty's ability to provide optimal patient
care in an era when medical imaging demand has risen rapidly
[1,
2]. Members of our group (all
the authors of this article except Dr. Licurse) have shown that in the past 7
years, except for the peak that occurred around 2002, the radiology employment
market has been in a downtrend, perhaps stabilizing by 2004
[3-6].
In this update, we present the most recent findings regarding the status of
the radiologist job market, using three information sources: our 14-year help
wanted index of job advertisements
[3-6],
an annual survey of vacancies in academic radiology departments, and an
analysis of the American College of Radiology's (ACR) Professional Bureau
records. All are compared with previously published data.
Materials and Methods
Survey of Vacancies in Academic Radiology Departments
Since 2001, one of our investigators has conducted annual surveys of the
vacancies in academic radiology departments
[7]. Departments were contacted
each summer and asked to report their numbers of vacancies for each specialty
as of July 1 of that year. Each department was contacted by telephone and,
since 2003, also by e-mail to follow up. In 2005, 106 of the 116 departments
surveyed responded. The departments surveyed were those whose heads are
members of the Society of Chairmen of Academic Radiology Departments. The data
summary and breakdown by subspecialty are presented for 2005 and compared with
those of recent years in Table
1.
ACR Professional Bureau Data
Since 1990, the ACR has been tracking the ratio of diagnostic job listings
to job seekers at its placement service, the ACR Professional Bureau. The data
are collected during the annual meeting of the Radiological Society of North
America (RSNA), at which the Professional Bureau has an on-site presence.
These data have been previously published and validated as a useful relative
measure of the radiology employment market
[8]. The methods have been
described in greater detail in previous articles
[8]. It has been found that
this ratio tends to magnify true market changes by a factor of 2 to 3. In this
article, the ratio for the year 2005 is reported and compared with those of
previous years. Note that there are no data from 2001 because the Professional
Bureau did not operate on site at the RSNA meeting that year.
Help Wanted Index for Job Advertisements
The methodology used to create the help wanted index was identical to that
used in previous articles
[3-6].
During the 12-month period from January 2005 to December 2005, every
advertisement from the classified sections of the American Journal of
Roentgenology (AJR) and Radiology was reviewed and coded. Each
advertisement was divided into the number of unique positions being offered,
with each of these positions described using a code that represented the
following characteristics: type of practice, geographic region, and
subspecialty. The subspecialty category included the code "other,"
which represented purely administrative positions. Also of note, chest
radiology included cardiovascular imaging positions, a distinction made for
the first time in the 2005 index. The map used for coding geographic regions
is shown in Figure 1. The
difference between this study and our previous studies
[3-6]
is that a new individual conducted the primary coding. In the current study,
data obtained from 2005 are compared directly to those from 2004. Data from
1991 to 2003 are presented in graphs (Figs.
2,
3, and
4) that show long-term
trends.
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Fig. 3 —Graph showing actual number of advertisements (bars) per
month in American Journal of Roentgenology and Radiology
from January 1991 through December 2005, with 12-month rolling average
(blue line). Note downtrend in rolling average from February 2002 to
December 2005.
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Fig. 4 —Bar graph showing both overall number of advertisements per
year (red bars) in American Journal of Roentgenology and
Radiology, and number of advertisements sorted by private practice
(yellow bars) and academic practice (green bars).
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Results
Survey of Vacancies in Academic Radiology Departments
The academic radiology survey has achieved a response rate of greater than
85% in all 5 years it has been conducted
(Table 1). The survey data
indicate that the average number of vacancies per academic program decreased
from 5.38 in 2001 to 3.91 in 2003, remained stable at 3.89 in 2004, and rose
markedly to 4.51 in 2005 (Fig.
5). All specialties reported increased vacancies from 2004 to 2005
except for nuclear radiology and positions denoted as "other,"
although all specialties reported fewer vacancies compared with 2001 except
for pediatric radiology and research positions. The most significant increases
in vacancies between 2004 and 2005 were seen in research (120%), general
radiology (36%), and chest radiology (35%), whereas the "other"
category decreased most over the same period (-56%). The academic department
reporting the greatest number of vacancies in 2005 was mammography, with
66.
ACR Professional Bureau Data
The ACR Professional Bureau data indicate that a 3-year stabilization of
the ratio of job vacancies to job seekers, at approximately 1.1 since 2002,
ended in 2005, with an increase in this ratio of 8% (from 1.1 to 1.19).
Although still far below the ratio's peak in 2000 (at 3.8), it remains higher
than it was from 1991 to 1997, during which time it dropped as low as 0.22 in
1994 (Fig. 6).
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Fig. 6 —Line graph showing number of job listings per job seeker at
American College of Radiology Professional Bureau's placement service during
week of annual meeting of Radiological Society of North America, 1990-2005.
Gap in line indicates no data for 2001.
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Help Wanted Index for Job Advertisements
Totals—A total of 3,454 advertisements for radiologist
positions were run in AJR and Radiology during 2005,
compared with 3,668 total advertisements in 2004 (a 6% decrease). October had
the most advertisements of any month during 2005, and March had the fewest
(Fig. 3). The 12-month rolling
average, calculated to minimize seasonal variation of advertisements per
month, dropped steadily from January to December in 2005, beginning at 303.9
and ending at 287.4, the lowest level since September 1999. The only months in
which an increase of the rolling average occurred were August and October
(0.5% and 0.2%, respectively) (Fig.
2).
Type of practice—Advertisements for academic positions
dropped from 1,660 in 2004 to 1,455 in 2005 (45% and 42% of the total
advertisements per year, respectively)
(Fig. 4). This drop represented
a 12% proportional change in the academic positions advertised against the
backdrop of decreased total advertisements (which was, again, 6%). Notable
changes were also seen in regional proportions of academic to total
advertisements (Fig. 7). The
percentage of academic to total advertisements in the Northeast increased from
47% to 61% between 2003-2004 (2 years of data) and 2005, along with a decrease
of 9% in total advertisements in the Northeast. The same ratio of academic to
total advertisements decreased from 32% to 15% in the Northwest between
2003-2004 and 2005, along with an increase of total advertisements by 82%.
Regional—Advertisements in the Northwest increased
significantly, from 102 (2.8% of the total) in 2004 to 186 (5.4%) in 2005
(Fig. 8). The Northeast was the
region with the most total advertisements, at 31.3% during 2005, compared with
32.3% for 2004. The Midwest region had 26.3% of total advertisements during
2005, compared with 26.9% during 2004. The Southwest decreased from 297 (8.1%)
in 2004 to 270 (7.8%) in 2005. California increased from 175 (4.8%) in 2004 to
207 (6.0%) in 2005 (Table
2).
Specialties—General radiology positions represented the
greatest proportion of total positions in 2005 (29.5%), well above the 23.3%
seen in 2004 when it was almost the most advertised field
(Fig. 9). The next largest
advertised specialty in 2005 was abdominal imaging (14.8%), whereas in 2004
the second largest specialty was mammography (14.4% in 2004 and 12.1% in
2005). The greatest proportional change between 2004 and 2005 was seen in
sonography positions (-47.6%), followed by those positions coded as
"other" (45.9%) (Table
3).
Discussion
Our previous investigations have shown that the demand for diagnostic
radiologists has declined significantly since a peak near the beginning of the
decade
[3-6].
In our last article [6], data
from each of the three sources used for analysis reflected a congruent
downtrend in demand: fewer jobs per job seeker, fewer advertisements, and
fewer vacancies per program from 2002 to 2004. In 2005, for the first time
since we began studying the employment market, the three sources of data show
divergent trends. The survey of academic radiology departments shows that the
average number of vacancies in these departments, after stabilizing from 2003
to 2004, increased in 2005, suggesting an increase in demand and an increased
shortage of radiologists. The ACR Professional Bureau shows a similar trend:
the number of job listings per job seeker, after being stable at approximately
1.1 for 3 years, rose to 1.19 in 2005. The third data source, the help wanted
index, shows a different trend. The number of total advertisements decreased
by 6% from 2004 to 2005, including a 12% proportional decrease in the number
of academic positions advertised.
The divergence among data sources could be caused by a number of factors.
Concerns have recently been raised regarding the validity of help wanted
indexes in describing employment market trends in absolute terms
[9]. Internet employment search
sites have become increasingly popular, offering employers a cheaper way to
reach job seekers. Our 2005 data seem to indicate that the help wanted index,
for the first time since it was begun, might not accurately reflect the
employment market. If Internet employment sites (or other electronic media,
head-hunting agencies, etc.) are the reason for our divergent data, it is no
surprise that the Society of Chairmen of Academic Radiology Departments and
ACR data are still congruent because each directly reflects demand for
radiologists without relying on print advertising.
What these two sources of data do confirm is a tightening of the diagnostic
radiology employment market. A shortage of radiologists presents various
problems, including losing turf to other specialties
[10]. Solutions to a radiology
shortage include using teleradiology services and radiology assistants.
According to an ACR survey conducted in 1999, teleradiology services were in
place for an average of 56% of all diagnostic radiology practices. However,
these services were used relatively sparingly: 5% of studies were interpreted
using teleradiology in multiradiogist practices, and 14% of studies were
interpreted using teleradiology in solo practices
[11]. Other more recent
evidence has shown that this utilization is higher in emergency departments
[12]. It seems that
teleradiology is an important tool to address increasing demands on radiology
practices.
Radiology assistants are another possible answer, providing radiology
services with further clinical support and increasing their ability to provide
patient care [13]. Little
direct evidence on their effect, however, is available because the profession
has just begun to develop. Further data are needed to assess the market's move
in 2005, data that may have to rely less on our help wanted index and more on
the academic department survey and Professional Bureau data.
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Abstract
Introduction
