Experts recently shared six takeaways from the latest American College of Radiology/Radiology Business Management Association Workforce Survey, covering topics including practice ownership, part-time physician duties and diversity gains.

The survey was conducted in fall of 2021, receiving more than 1,700 responses from individuals in the two associations’ member databases. Respondents included more than 400 decision-makers, nearly 1,000 “rank and file” radiologists and 300-plus retired ACR members, altogether representing 376 practices.

Members of the specialty believe the results, published in JACR [1], reveal promising gains in diversity and inclusion, along with other areas for potential improvement.

“This study demonstrates changes in the landscape of the radiology workforce, with increasing women and members of [underrepresented] racial and ethnic groups in the younger cohort and changing preferences for practice ownership, preferred work environments, and differences in subspecialties within radiology,” lead author Dr. Sherry S. Wang, an abdominal radiologist with the Mayo Clinic, and co-authors wrote Aug. 3. “Results suggest opportunities and future directions for improving diversity, equity and inclusion.”

The authors offered six takeaways from the survey:

1) Small gains in female representation: Since 2019, there has been a slight increase in female representation among the specialty (rising from 23% to 28%). Still, 60% of radiologists are white and 72% are men between the age of 40 and 65.

Female radiologists remain underrepresented in every organizational type, particularly private practice. They represent less than 30% of radiologists in practice, which is lower than the estimated averages for licensed physicians across the U.S. However, young female rads are more numerous than those of retirement age, the authors reported.  

“These findings demonstrate that there is still room in the house of radiology to further increase diversity of gender, race and ethnicity,” the authors wrote.

2)  Upward trends in diversity among younger rads: The survey found a growing proportion of female physicians, minorities underrepresented in medicine, and Asian physicians in radiology, particularly among those under age 46. With the exception of Black radiologists, who are 57% female, all other ethnic and racial groups are predominantly male.

“Given that the bulk of [underrepresented in medicine racial and ethnic groups] and women radiologists occupy a younger cohort, if this trend continues, this group will become the predominant group within radiology at some point in the future,” Wang et al. wrote. “This is an opportunity for the ACR and radiology societies to increase membership engagement with the early career radiologist and provide opportunities for growth, as this would be a vital link to radiology’s future.”

Nonbinary, transgender and other gender types are rare in the specialty, working most frequently in academic (1%) and teleradiology (5%) settings.

3) Younger women prefer academia: Female radiologists in the early stage of their career prefer to work in academic centers, the survey found.

“The gravitation of early career female radiologists towards academic settings may be related to greater flexibility available at these practice types as they may be larger, better resourced in terms of staffing, in more metropolitan locations, and therefore able to potentially better support work-life integration,” the authors noted. “The most likely practice setting to allow for telework during the day are academic practices, which may be an additional reason why female radiologists gravitate towards academic practices.”

4) Women dominate two subspecialties: Breast imaging and pediatric radiology are disproportionately practiced by female members of the specialty. The latter most frequently occurred in larger practices, which generally allow remote reading.

“Breast imaging has opportunities for less call than other subspecialties and now offers more telework opportunities,” the authors noted. “It has previously been found that specialties with a higher proportion of female physicians also had higher odds of women planning for a career in that field. Thus, the findings in pediatric and breast imaging are cases in point of diversity begetting diversity.”

5) Ownership concentrated among men: Women radiologists are “significantly” less likely than their male colleagues to own their practice, the study found. They also were more likely to consider such ownership “extremely” or “very” unimportant when compared to men. However, the authors speculated that this result “may be confounded by cause versus effect.”

“Women who enter the workforce who also plan to raise a family may believe that lack of practice ownership is a foregone conclusion,” the authors wrote. “This may be an area of further research and investigation to understand and identify underlying sentiments and differences in aspirations which contribute to these findings.”

6) Most radiologists work full time: The majority of those surveyed said they work a full schedule, though some still seek part-time work. About 87% of radiologists said they are employed in a full-time capacity, higher than the 83% figure for all U.S. professions. Among those who work reduced hours, 41% are female, with the highest rate of such work seen in academic practices. Academia employs more than twice as many part-time radiologists on average compared to private practice, the survey found.

“While myriad factors contribute to a physician’s desire and need to work part-time, there are structural inequities that limit opportunities for full-time employment for women including lack of parental leave policies, salary inequities, and unequal domestic burden,” the authors wrote. “To attract and retain women radiologists and provide equitable compensation, contract transparency is imperative. Part-time contracts, including equitable salary adjustments and call responsibility, should be standard, fair and clear.”