Strategies to Mitigate Radiology Workforce Shortage

Radiology in the United States faces a widening workforce gap (about 1,500 fewer radiologists than needed, potentially 3,100 soon) driven by surging imaging demand, more complex studies and attrition from burnout and early retirement. Effects include backlogs and temporary centre closures. Responses span AI-supported interpretations, more training positions and immigration pathways, team-based models, improved IT infrastructure, appropriate use criteria and leadership initiatives such as RETAIN.

Key Points

• Imaging demand outpaces radiologist supply, widening U.S. shortages.
• Backlogs and delays worsen patient care and shut centres temporarily.
• AI supports triage, reporting and workflow to lift productivity.
• Team-based models extend roles for radiologist assistants.
• Training expansion, immigration and retention programmes grow the pipeline.

The Issue

The United States faces a significant shortage of radiologists. Estimates suggest there are about 1,500 fewer radiologists than required, with roughly 37,500 currently practising nationwide. The exact number who have transitioned to part-time work remains unknown, but this shift is believed to worsen the workforce shortage. Without effective strategies, the deficit could rise to 3,100 in the near future (Christensen et al. 2025).

Causes of the Shortage

The root cause of the radiologist shortage is a classic supply-and-demand imbalance.

Increasing Demand for Radiologic Imaging

There is an increasing demand for radiologic imaging studies due to several factors:

• An ageing population. An estimated 20% of the U.S. population will be on Medicare (U.S. federal insurance for people aged 65+ and certain others) in 2023, up from 14% in 2013.
• A younger population presenting with increased health complexities, such as higher rates of cancer detection in younger patients. (Piersol 2025)
• Busy clinicians ordering more tests.

From 2002 to 2016, ultrasound, CT and MRI each saw annual growth of around 1–5%. Interpretation has also become more complex due to the rising number of images per study. Approximately 100 million CT examinations are performed annually through hospital emergency departments (EDs) across the country. In general, prior authorisation (a U.S. private insurance utilisation-management requirement) is not required for imaging ordered in the ED. The number of CT scans has been increasing by eleven million studies each year over the past decade. Recent data indicate that while ED visits rose by about 30% over recent decades, emergency CT requests surged by up to 330%, increasing radiologists’ workloads and contributing to burnout (Murphy 2025).

Insufficient Supply of Radiologists

While demand grows, supply has tightened amid the “Great Resignation”. Earlier retirements and a shift to part-time work are both cited as drivers. Moral distress and burnout are major contributors, with an estimated 51–54% of radiologists reporting burnout (McKenna 2024). A considerable number are seeking new roles, with 11–39% expressing interest in changing jobs (Dibble et al. 2025; Berg 2025).

More radiologists are working as independent “1099” contractors (a U.S. self-employed tax designation) and shifting to remote work following the COVID pandemic (Fornell 2025). Others are moving into industry and executive positions, including senior clinicians leaving high-level clinical posts, such as Chairs of Radiology, for roles outside radiology, for example, Deans of medical schools. High turnover is disruptive and costly: replacing a radiologist can cost an organisation about $2.8 million (€2.43 million), including roughly $250,000 (€217,000) in recruiting costs and considerable lost revenue over months or years.

There are also too few funded radiology residency positions. Currently, about 1,400 funded first-year radiology positions exist, including those authorised through the Centers for Medicare & Medicaid Services (CMS), the Veterans Affairs Administration and privately funded hospitals. Across all training levels, there are approximately 5,400 radiologists in training, encompassing both Diagnostic and Interventional Radiology.

Consequences

The shortage is affecting patient care. Some hospital systems are temporarily closing outpatient imaging centres so radiologists can address backlogs (Stempniak 2025d). Overwhelming workloads with fewer radiologists have led to reports of near-fatal exhaustion and contemplation of suicide related to moral distress (Stempniak 2025a; Stempniak 2025c).

Solutions

A range of approaches is being advanced to mitigate the workforce gap:

• Leveraging artificial intelligence. Countries such as the UK and South Korea are developing AI algorithms to independently read chest radiographs.
• Expanding training capacity. In the U.S., the Consolidated Appropriations Acts of 2021 and 2023 authorised 1,200 new Medicare-supported graduate medical education (GME) positions over six years. However, of the first 200 newly approved posts, only six went to diagnostic radiology and three to interventional radiology. The Resident Physician Shortage Reduction Act (a U.S. congressional bill) is under discussion and could add 2,000 funded GME positions annually from federal fiscal years 2025 to 2031.
• International recruitment. There is new bipartisan support in the U.S. to reintroduce the Healthcare Workforce Resilience Act (a U.S. federal immigration measure focused on healthcare staffing), which would help recruit foreign-born physicians into radiology and other specialities (Stempniak 2025b).
• Team-based models. Extending the roles of non-physician practitioners, such as Physician Assistants, Nurse Practitioners and Registered Radiologist Assistants, can support radiologists’ workflows.
• Appropriate use criteria. Renewed bipartisan support is sought in the U.S. Congress for appropriate use criteria to decrease unnecessary imaging (ACR 2025).
• Information technology. Better IT can streamline operations and reduce friction points in reporting and communication.
• Leadership and culture. Servant leadership and workplace improvements, such as peer learning rather than peer review, are emphasised to improve the workplace environment (McKee 2025).
• Lastly, innovative strategies like the RETAIN initiative, developed by Dr. Weissman, provides a modern approach to sharing evidence-based leadership and organisational tactics. This strategy is designed to improve workplace culture through concise 60-second videos that can be easily viewed on a smartphone or computer.

Since the radiology community needs to work together collaboratively to effect positive change, the RETAIN strategy brings all these issues to the forefront, allowing them to be easily shared and discussed (Weissman 2025).

Conflict of interest

None