SPECIAL EDITION
Cover Story

By C.P. Kaiser

Yes, radiology is booming, but for how long? No one knows and no one trusts the forecasts. All anyone knows is that residency recruits today are the cream of the crop.

Though no single factor may be the one attracting medical schools' best and brightest into radiology, the smart money is on the money. Published literature shows that choice of specialty is associated with the job market and current economic forces within that specialty, said Dr. Jannette Collins, who recently stepped down as the radiology residency program director at the University of Wisconsin Hospital and Clinics.

"Right now, there's a high demand for radiologists, which drives their income up," she said. "Medical students, especially with high debt, learn there are a lot of jobs that pay well."

Radiologists' salaries reportedly jumped from an average of $225,000 in 2000 to $271,000 in 2001. Compare this with entry-level salaries for family physicians, which advanced from $135,000 in 2000 to $136,000 in 2002.

Others say radiology is hot for more cerebral reasons: It's intellectually stimulating. It is one of the last general practice areas that affords access to all diseases and all fields. Its scope has expanded to include patient contact and treatment. And it affords the choice of an academic or private practice job.

"I hope it's the exciting technology that's attracting them," said Dr. C. Douglas Maynard, acting dean at Wake Forest Medical School. "I have a hard time believing someone would pick it on the basis of economics six years down the road."

Many institutions reported receiving twice as many applications as in past years. Consequently, they interviewed only honor students. Four of the six residents in the 2003 class at Thomas Jefferson University in Philadelphia were members of the Alpha Omega Alpha academic honor society. Their average score on Part 1 of the National Board of Medical Examiners test was more than one standard deviation above the mean, according to Dr. Levon N. Nazarian, chair of Thomas Jefferson's radiology residency selection committee.

But high grades aren't everything. One applicant scored the highest mark Nazarian had ever seen, but the interview made it clear he would not work out, Nazarian said.

Since nothing guarantees that residents will pursue academic careers, institutions consider keeping residents a real challenge. The triple-threat paradigm-the academician who excels in clinical care, research, and teaching-has shifted. Academic centers are therefore beginning to identify resident candidates who will excel in clinical patient care and teaching, and those good at research. By fostering both types, academic departments ensure their own survival.