There is “scant” interest in the imaging community for the term “multispecialty radiologist,” according to a report published Thursday in JACR.

The American College of Radiology established a new task force following its 2020 annual meeting, charging experts with exploring the use of this new nomenclature. Members met eight times over the course of several months—reviewing survey data, poring over the literature, and collecting anecdotal reports. Those involved also considered similar terms such as multimodality or multisystem radiologist, used to describe a physician who spends more than 50% of their time working outside their subspecialty.

“After discussing this definition at length, the [task force] rejected the terminology for a number of reasons,” Jeffrey Robinson, MD, MBA, an emergency radiologist and associate professor with the University of Washington, Seattle, and co-authors wrote Jan. 27. “For example, how would it distinguish a radiologist with no fellowship training from a radiologist with multiple fellowships? TF members argued whether such a term was necessary or desirable given the durability and history of the term ‘general radiologist,’ which is commonly used to describe a radiologist who reads more than one type of modality or is expert in multiple body systems.”

ACR’s Commission on General, Small, Emergency and Rural Practice launched the effort in response to ongoing evolution in the profession. Many early career radiologists have opted to pursue hyper-specialized careers. However, in smaller community-based settings, radiologists must routinely provider care in areas outside of their expertise. Robinson et al. noted a “growing disconnect” between practice requirements and graduate expectations, making hiring and onboarding “increasingly difficult” in nonacademic settings.

Small and rural practices are seeking to land “hybrid” radiologists, holding subspecialization but also able to perform general work. But formal descriptions of these roles are lacking, the report authors noted. To clear confusion, they proposed definitions for three roles in diagnostic imaging:

• Single subspecialty radiology: A radiologist who performs more than 80% of their work in a single subspecialty.
• Multispecialty radiology: Rads who perform more than 70%-80% of their work in 2-3 subspecialty areas of diagnostic radiology.
• General radiology: Those whose work includes multiple subspecialty areas of diagnostic radiology without meeting either of the previous two definitions.

“Each of these roles could be performed by diagnostic radiologists or fellowship-trained diagnostic radiologists, and a single person could move among these roles throughout their career, potentially within the same group or institution,” Robinson and co-authors wrote. “If widely adopted, these terms could be used to classify jobs for employers and applicants resulting in better fit for new practicing radiologists,” they added later.

To help move this conversation forward, the task force issued four recommendations. Those included the ACR and other stakeholders working together to ensure educational programs meet market demands. Training programs should also adopt tracking systems to define thresholds needed to ensure trainees have completed sufficient procedures to practice in general radiology. Robinson et al. also urged the ACR Career Center to collect data from job postings and offer employers a standardized means to solicit candidates with a broader range of skills. And on the flipside, the authors urged practices to use the three definitions to specify what they want from candidates.

Read more from the task force’s report in the Journal of the American College of Radiology here.