Radiology residency costs rising, posing a potential barrier to entering profession
Radiology residency costs are rising, posing a potential barrier to entering the profession, according to new research published Monday in JACR.
The COVID-19 pandemic provided a brief respite from some of these escalating costs with virtual interviews and program “preference signaling” helping limit money allocated toward travel. However, resident spending has started to inch upward since 2020, Ricardo Reyes, MS, with Harvard Medical School, and co-authors note.
Average total residency costs decreased 62% from pre-pandemic (2019-2020) to during the public health crisis (2021-2022) for diagnostic radiology, from $6,024 down to $2,288. Same for interventional rads, falling 58%—from $8,462 to $3,546. However, post-pandemic (2023-2025) costs have bounced back upward, rising about 65% for diagnostic residents (up to $3,783) and nearly 50% for those in interventional radiology (up to $5,309).
The largest post-pandemic contributors to total costs, the study found, were application fees in diagnostic radiology (57%) and away rotations or second-look visits in IR (49%).
“These findings suggest that despite cost-mitigating policies, applicant behaviors and in-person opportunities may offset financial benefits,” Reyes and co-authors concluded. “Radiology residency programs and advisors should consider these increasing financial barriers with ongoing efforts to maximize matching outcomes,” they added.
The retrospective study utilized information from Dallas-based UT Southwestern Medical Center’s Texas STAR (Seeking Transparency in Application to Residency) database. Researchers included all allopathic and osteopathic senior applicants, for a total count of 1,645 diagnostic and 339 interventional radiology applicants. Reyes and colleagues believe this is one of the first such studies to assess trends in radiology residency applications relating to the pandemic.
Overall, post-pandemic costs were about 37% lower for both DR and IR applicants when compared to before the public health crisis. The authors noted that the large volume of applications sent out by individuals may be one factor that’s driving the upswing in costs. Program “signaling”—where applicants indicate interest in a limited number of residency programs—was meant to help improve match outcomes. It would accomplish this by encouraging individuals to apply to less broadly, reducing the financial burden.
“However, the ERAS [Electronic Residency Application Service] database shows radiology applicants submitted a higher number of applications in the post-pandemic years,” the authors noted. “In the Texas STAR database, we also observed an increase in the number of applications submitted by DR applicants after the pandemic.”
Reyes and colleagues also noted that DR and IR applicants from the West had the highest financial burden post-pandemic. That’s likely because the region trains fewer radiology residents than the Northeast and South, leading to higher logistical costs. They urged residency programs to examine these increasing costs when considering whether to use away-rotations to assess applicants or second-look visits following interviews.
“Residency advisors are also encouraged to discuss the breakdown cost…to help applicants plan funding, since the recent introduction of program signaling may result in changes in interview yield,” they added. “Future studies could examine how costs may vary for applicants across different levels of competitiveness in radiology and evaluate the impact of the new AAMC fee assistance program on ERAS.”
Read more, including potential study limitations, in the Journal of the American College of Radiology.
Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic.