HealthManagement, Volume 13 - Issue 1, 2013

How many new radiologists graduate each year in the UK?
The Royal College of Radiologists (RCR) will recommend around 190 clinical radiologists per annum for their Certificate of Completion of Training (CCT), although there are natural fluctuations in this figure. The numbers of clinical radiologists receiving their CCT is rarely the same year on year. This is due to factors such as trainees taking extra time to pursue additional study, undertake a research project or taking maternity leave.
How many radiologists are working in the UK?
The RCR’s 2011 annual census showed that there are 2,964 whole time equivalent (WTE) consultant clinical radiologist posts in the United Kingdom. In addition there are 1,207 Specialist Registrars; these are radiologists who have not yet reached consultant level.
Which is stronger in your country: public or private radiology? Are radiologists interested in a career in the public sector?
The National Health Service (NHS), which is the government funded health service provided across the UK, is the main employer of medical professionals in England so the vast majority of clinical radiologists work for the public sector for a large proportion of their time.
In terms of supply and demand, are there sufficient numbers of graduates and experienced radiologists in your country to fill the available posts? Does this fluctuate, and if so, has it been affected by any cuts in healthcare spending or availability of workers?
The RCR has long been concerned about the relative shortage of radiologists in the UK when compared with figures available from other nations. In recent years there has been a sustained rise in demand for imaging within the NHS, and the need for additional radiologists has intensified despite huge efficiency gains through new technology such as the introduction of picture archiving and communication systems (PACS).

The 2011 RCR census shows that there are 210 WTE consultant clinical radiologist posts currently unfilled in the UK although this number has gone down from 235 in 2010. This equates to around eight percent of radiologist posts unfilled.

The figure of 2,964 WTE consultant clinical radiologists works out as around 47 WTE consultant clinical radiologists per million population, which is an increase of 3 per million population from 2010. Although this increase is welcome it still places the UK well below the average number of radiologists for population compared with Europe, and does not cover the reported increase in workload being experienced by radiology departments. Feedback from the workforce shows a significant increase in the number of examinations conducted over recent years, with MRI and CT increasing by over a third since 2008 and interventional radiology activity also increasing by almost a third.

In addition, the frequency of multidisciplinary team (MDT) meetings between 2008 and 2011 shows a rise of nearly two-thirds, and their average length has almost doubled. These meetings are an essential part of the radiology workload and ensure that imaging is at the heart of diagnosis and treatment, but the additional work must be accounted for.
Is the resource to fill the demand likely to come from more trainees or recruiting from overseas? What does the College see as a sustainable solution to meeting demand?
The RCR has recently been informed that an extra 30 training places per annum for clinical radiology will be made available
over the next three years. Although there has been approval in principle and the capacity is there in existing schemes, the funding still has to be found at regional level. Whilst this is not the full 60 places per annum recommended by the College it is a very encouraging start. However, the College will continue to work on increasing the number of training places to ensure that there are enough trained clinical radiologists to manage the workload.

Currently, radiology is not one of the professions on the government shortage occupation list, and there is no nationally organised scheme to recruit from overseas. In practice, jobs will be advertised in the BMJ, for example, which has an international readership. Some hospital Trusts have proactively set up links abroad, usually using local contacts.

Ideally there should be a balance between UK trained radiologists going to work overseas and overseas trained radiologists
coming to the UK, as we do not want to be a net exporter of radiologists. In addition, employers have to be careful not to upset the balance in other countries by recruiting radiologists from those countries that already have a shortage.

Has the government made any cuts that directly affect the medical imaging workforce, in the face of the financial crisis? For example cutting the number of posts in the public sector or hiring more external contractors?
Until recently redundancies were very rare in the NHS. However the College is aware of radiologists leaving or retiring and the posts not being filled. The figure for unfilled radiology posts is an underestimate of the true position as some hospitals would have been agreeing new consultant radiology posts, but the climate is not right now, partly due to the financial crisis, and partly due to the lack of applicants for the existing posts. The change in health service pensions combined with the increased workload is causing radiologists to consider retirement at a younger age than previously.

What is your strategy to attract and retain the best radiologists?
Recruitment and selection into clinical radiology training posts in England, Scotland and Wales is carried out through a nationally coordinated process, which is governed by the Department of Health and run on behalf of the College by the London Deanery. As radiologists are at the heart of diagnostics and treatment, recruitment and selection to these positions is competitive. Applicants must meet a set of essential criteria to be eligible to apply for Specialty and Academic training, and undergo a rigorous application and interview process to ensure that we attract high quality candidates for the training programme.

Do sufficient numbers of radiologists enter a career in academic radiology in your country?
The RCR believes there are insufficient numbers of academic radiologists. Our Clinical Radiology Academic Committee is
working to increase the number of research-active radiologists and the quality of imaging research in the UK. The committee explores and develops methods for the RCR to encourage and foster research in clinical radiology by actively supporting trainees and consultant radiologists commencing research or developing their research interests as well as running joint Fellowship schemes with organisations such as the Medical Research Council and Cancer Research UK.

Further Reading
Centre for Workforce Intelligence (2012).
Securing the future workforce supply: clinical radiology stocktake. London: Centre for Workforce Intelligence.
Royal College of Radiologists (2012).
Investing in the clinical radiology workforce – the quality and efficiency case. London: Royal College of Radiologists

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