The most recent radiology match, announced earlier this year, was the most competitive for the specialty since 2001, researchers estimated on Tuesday.

The “crude match rate” for U.S. MD seniors in 2023 was roughly 81.1%. This was calculated by taking the number of matches into any radiology program and dividing it by applicants to advanced diagnostic radiology programs, experts wrote in Radiology [1].

Researchers believe this was the lowest crude match rate since 2001, which was 73.3%. Stated differently, more than 1 in 6 graduating U.S. MD students applying for radiology did not match into such a position in 2023. The specialty was not alone, as across all applicant types, the crude match rate was 67.2%, the lowest tally since 2004.

“This long-term analysis of the U.S. radiology residency match offers insight into the dynamism of this specialty,” Francis Deng, MD, and Linda Moy, MD, with the departments of radiology at Johns Hopkins and New York University, respectively, wrote Sept. 12. “Students should and do consider what it fundamentally means to be a radiologist as the driving force for their specialty choice. Additional factors modulate interest in radiology, however, and will continue to evolve, shaped by economic forces, broader trends in healthcare, technological innovations, and societal values.”

Deng and Moy noted that the availability of residency slots offered in U.S. radiology programs has grown steadily over the past 30 years. A total of 1,356 positions were available via the National Resident Matching Program in 2023 across various nuclear medicine, diagnostic and interventional radiology programs. That represents a roughly 65% increase in positions compared to the 1991 match, the authors estimated.

Meanwhile, interest in imaging also has appeared to grow among aspiring doctors, though not at the same steady rate. A total of 1,175 U.S. MD seniors graduating from American allopathic schools applied to advanced positions in diagnostic radiology this year. The number climbs to 2,014 when including doctor of osteopathic medicine medical students and past U.S. and international medical school graduates. Compared to 1991, the applicant numbers represent a 52% increase for U.S. MD seniors and 82% for total applicants, “both all-time highs,” Deng and Moy noted.

The two offered varying reasons for these trends. “Much of the absolute growth” in imaging stemmed from broader trends in U.S. healthcare. For instance, between 1991 to 2023, residency positions offered in the match surged by 104%, from 17,555 to 35,753. And as the number of positions grew, so too has the pool of applicants, climbing 42% for U.S. MD seniors (13,934 to 19,748) and 133% for all applicants (18,450 to 42,952).

Interest in radiology has “fluctuated widely” over the years, including a steep decline in the 1990s and sustained high interest in the 2000s. Demand appears strong in recent years, as students look to radiology when considering factors such as a “controllable lifestyle,” with predictable and flexible work hours allowing for a better work-life balance, the authors noted. In 2023, 5.9% of U.S. MD seniors applied in diagnostic radiology, which was the highest level since 2010.

“Ongoing understanding of these trends can better help educators and leaders in the field strategize to attract and retain the brightest minds in medicine,” Deng and Moy concluded. “At the moment, the future is gleaming with promise.”

Read much more in the flagship journal of the Radiological Society of North America at the link below.