At ECR 2026, the session on whether the shortage of radiologists is myth or reality approached the question from several angles: European workforce data, the U.S. policy and training landscape, international variation in training across Asia and the Middle East, and the expectations of younger radiologists entering practice. Across the presentations, the message was not that one simple number can settle the debate, but that workforce pressure is real, unevenly distributed and closely tied to training capacity, working conditions and future models of practice.
Mapping the Workforce Gap in Europe
Adrian Brady (Cork, Ireland) opened with the EU-REST project, which set out to define workforce availability across Europe in professions linked to medical ionising radiation, assess education and training, and produce recommendations for the future. He explained that the project involved not only radiologists but also radiographers, nuclear medicine physicians, radiation oncologists, radiation therapists and medical physicists. “Essentially what they wanted us to do was to define the status of workforce availability across Europe,” he said, adding that the work then had to “produce recommendations and guidelines for the future.”
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The scale of the data collection was considerable. After a pre-survey to identify the right sources, the consortium sent a main survey with nearly 500 questions and received 186 responses from all 27 EU member states. Brady said the resulting report showed an average of 127 radiologists per million inhabitants across the EU27, with 16 countries below that average. He highlighted not only the current shortage but also the age profile behind it. On average, 19% of radiologists were projected to retire within five years from 2022, while in seven countries more than half of practising radiologists were over 51. “There’s a cliff edge,” he warned, arguing that many countries face worsening shortages on top of existing insufficiency.
Because no accepted international guideline existed to define how many radiologists should be available, Brady said the group had to create a new approach. Existing methods based on crude study numbers, daily modality targets or RVUs were judged inadequate because they failed to reflect complexity and ignored non-reporting work. “Non countable work should be taken account of,” he argued, referring to multidisciplinary team meetings, education, research and patient communication. The resulting model linked workforce needs to machine or system activity by modality, while also building in an allowance for these tasks. Brady said the key outcome was that “the European Commission has now accepted these guidelines” and published them as a Commission document, giving radiologists in each country a basis to press for more training posts.
The U.S. Debate: Shortage, Distribution and Acceptable Solutions
Geraldine B. McGinty (New York, United States) presented what she described as “some insights” into the U.S. situation, stressing early on that the question of whether the country has enough radiologists is “a complicated one.” She noted that around 30% of imaging in the United States is estimated to be low or no value, raising the possibility that some of the problem lies in overuse rather than only in workforce numbers. At the same time, she pointed to clear geographical imbalance: well-resourced areas can recruit more easily, while poorer urban areas and rural regions have far more difficulty finding subspecialty or even general radiologists. “There’s certainly a perception among our workforce that volumes have increased and become untenable,” she said.
McGinty showed that radiology remains a popular and competitive specialty. Training places attract strong demand, but supply is shaped by a funding structure that is largely government-based and not especially flexible. Medicare, Medicaid, the Veterans Affairs system and other government-linked mechanisms fund most training positions, which means decisions on expansion can be slow and politically complicated. “It is the government which decides how many training slots,” she said, but also noted that “change can be very difficult” in a centralised system. Radiologists, she added, are not seeking scarcity as leverage. Instead, organisations such as the American College of Radiology are lobbying hard for more training capacity because of population ageing and rising imaging demand.
She also addressed the possible responses to workforce strain, including private-sector training expansion, greater use of advanced practice providers and AI. None, she suggested, is straightforward. Private equity-backed hospitals may have the means to create new training programmes, but their incentives are financial. The idea of non-radiologist providers taking on some tasks remains “extremely contentious” in the United States. AI adds another layer of uncertainty: early modelling suggests it could reduce radiologists’ working hours substantially, but workforce planning cannot rest on projections alone. McGinty concluded that the workforce does not appear to be keeping up with demand, but also made clear that distribution, regulation and the value of imaging all need to be part of the conversation.
Training Diversity, International Standards and What Young Radiologists Want
Laura Oleaga Zufiria (Barcelona, Spain) then widened the discussion to Asia and the Middle East through the lens of the European Diploma in Radiology (EDiR). She showed that radiology training differs markedly across countries in duration, structure, certification and access to subspecialty fellowships. In Asia, training ranged from three years plus optional additional training to five-year competency-based programmes, while in the Middle East most programmes lasted four to five years, though national requirements varied. “There is a huge variation in the training programs in Asia,” she said. At the same time, she argued that “international communication and collaboration in radiology education are increasing” and that the EDiR is helping to support benchmarking, harmonisation and mobility beyond Europe.
Merel Huisman (Nijmegen, Netherlands) closed the session by focusing on the future radiologist and the expectations of younger generations. She framed the current moment as a “double crisis” of workforce shortage and rising disease burden, but said the profession also needs to understand wider social change. Flexibility, hybrid work, sustainable schedules and a sense of purpose now matter deeply to younger radiologists. “Flexibility really is the key word,” she said. She also argued that unpaid hours, administrative overload and repeated interruptions are major drivers of exhaustion and burnout. On quality and speed, her point was direct: “faster is not better if the report is wrong.” AI, in her view, is generally seen by younger radiologists as an opportunity rather than a threat, especially for drafting, triage and quantification, but she stopped short of suggesting immediate transformation.
The session did not produce a simple answer to whether the shortage of radiologists is myth or reality. It showed that workforce pressure is real, but uneven across countries and systems. Europe now has a Commission-backed framework for planning needs, the United States is grappling with capacity and distribution, and training pathways across Asia and the Middle East remain highly variable. Future workforce strength will depend not only on training numbers, but also on whether radiology can offer working conditions that younger doctors are willing to sustain.
Source & Image Credit: ECR 2026
