Radiology

What are some important statistics around the specialty? 

Key Stats – Diagnostic and Interventional Radiology (2024 data):

• DR filled 99.7% of positions; IR filled 100% (NRMP 2024).
• IR is among the top 3 most competitive specialties.
• Step 2 CK averages: DR ~250, IR ~255+
• DR salary: ~$483,000; IR salary: ~$572,000
• Radiology has a strong job outlook with projected shortages.

Diagnostic and Interventional Radiology: Key Statistics and Trends

Workforce and Demographics

Number of Physicians: The diagnostic radiology workforce alone comprises roughly 34,000 radiologists (pmc.ncbi.nlm.nih.gov) Interventional radiologists (IR) represent a smaller subset – about 8–12% of radiologists. This translates to roughly 3,000–4,000 interventional radiologists practicing in the U.S.(radiologybusiness.com)(auntminnie.com). (One 2021 tally counted 4,011 IR physicians nationwide(radiologybusiness.com), whereas a 2023 analysis of board-certified IRs found 2,989 IRs in practice(auntminnie.com) – the difference reflecting varying definitions of who is counted as “IR.”) For comparison, the remainder (≈25–30k) are diagnostic radiologists who focus on imaging interpretation.

Demographics (Age & Gender): Radiology has a seasoned workforce – about 60% of radiologists are between 35 and 55 years old(pmc.ncbi.nlm.nih.gov). Only around 10% are under 35, while ~25% are nearing traditional retirement age (56+ years)(pmc.ncbi.nlm.nih.gov). A significant share of radiologists are nearing retirement, which is contributing to workforce concerns (in 2017, 25% of practices had a radiologist retire that year)(pmc.ncbi.nlm.nih.gov). Gender diversity remains a challenge: women remain underrepresented in both diagnostic and interventional radiology. Less than 27% of active diagnostic radiologists are female, and in interventional radiology the proportion is only ~10% female(rsna.org). In fact, among 48 major specialties, diagnostic radiology ranks near the bottom (41st) and IR almost last (47th) in female representation of trainees(rsna.org). This gap persists despite nearly 50% of current radiology residents being women (as of 2022)(rsna.org), indicating that the gender balance in the workforce may slowly improve as new cohorts enter practice.

Geographic Distribution: Radiologists (especially IRs) tend to cluster in urban and academic centers, leaving some areas underserved. Nearly one-third (31%) of the U.S. population has no local interventional radiologist available(auntminnie.com). A recent study showed IRs practice in only 15.5% of U.S. counties (487 out of ~3,100 counties)(auntminnie.com). Over 140 counties had just a single IR physician(auntminnie.com). Counties with IR services tend to have higher incomes and education levels on average(auntminnie.com). Diagnostic radiologists are more widely distributed than IRs, but there is still a well-documented urban-rural disparity in radiologist density(auntminnie.com). This maldistribution is an ongoing health policy issue as rural areas struggle to recruit radiologists.

What general advice do you have for someone choosing this specialty?

• Shadow both DR and IR early.
• Align strengths (analysis for DR, hands-on for IR).
• Take Step 2 CK seriously.
• Seek mentorship and research.
• Use DR as a backup if targeting IR.

Becoming either type of radiologist requires dedicated postgraduate training:

• Diagnostic Radiology Training: After medical school, a doctor pursuing DR completes 1 year of internship (preliminary medicine or surgery year) followed by a 4-year Diagnostic Radiology residency(medschoolinsiders.com). Residency provides broad training in all imaging modalities and basic procedures. Many DRs then do a 1-year fellowship in a subspecialty of their choice (e.g. neuroradiology, body imaging, musculoskeletal, pediatric, breast, etc.)(medschoolinsiders.com), though fellowship is optional for private practice general radiology. In total, DR involves ~5 years of post-graduate training (or 6 with fellowship). Competitiveness: Diagnostic radiology residency is moderately competitive. In recent residency matches, DR filled >99% of positions(radiologybusiness.com). U.S. MD seniors have around an 80–85% match rate into DR, reflecting more applicants than spots(radiologybusiness.com)(radiologybusiness.com). A strong application (good USMLE scores, some research, etc.) is usually needed, but there are a healthy number of DR positions (~1,186 offered in 2024)(radiologybusiness.com) which somewhat eases competition.
• Interventional Radiology Training: There are three pathways to IR, all of which build on diagnostic radiology training(medschoolinsiders.com)(medschoolinsiders.com):
  1. Integrated IR/DR Residency (6 years total): This is a categorical program combining DR and IR training. It consists of the 1-year internship, plus 5 years of radiology with dedicated IR training in the final 2 years (total 6 years including internship)(medschoolinsiders.com). The integrated pathway gives dual board certification in IR and DR. These programs are relatively new (first IR/DR integrated residencies began around 2016) and are quite competitive in the Match – nearly all positions fill, and a high proportion of applicants need top credentials. For example, IR integrated had a ~98% fill rate in 2024(radiologybusiness.com), and historically U.S. senior match rates for IR have hovered around ~80-85%, similar to DR (indicating significant competition).
  2. Independent IR Residency: This pathway is essentially a fellowship. One completes a DR residency first, then does a 2-year IR fellowship/residency(medschoolinsiders.com). This route (1+4+2 years) is often taken by residents who decide later in DR residency to specialize in IR. It also grants IR/DR certification but takes longer (total ~7 years post-MD).
  3. Early Specialization in IR (ESIR): A hybrid option where a DR resident completes extra IR training during the 4-year DR residency, then only 1 additional year of IR fellowship(medschoolinsiders.com). This requires committing to IR early (during DR residency) and meeting certain procedural case numbers. Total ~6 years (1 intern + 4 DR with ESIR + 1 IR).

Competitiveness for IR: The integrated IR residency is considered highly competitive – fewer positions are available (e.g. 187 IR spots in 2024)(radiologybusiness.com) and top candidates across the country vie for them. Matching IR often requires outstanding board scores, research, and clerkship performance (on par with competitive surgical subspecialties). In 2024, IR integrated had >91% of positions filled by U.S. MDs(radiologybusiness.com), indicating programs prefer domestic grads with strong applications. The independent IR fellowship is pursued after securing a DR residency, so its competitiveness depends on performance during residency (and is an avenue if one doesn’t match integrated IR from med school).

Takeaway: Both pathways require at least 5-6 years of training after med school. DR residency has more positions and thus slightly better odds in the Match, whereas IR integrated programs are fewer and more selective. If you are certain about IR, be prepared for a longer training haul and a tougher match process (though the reward is dual certification). If you prefer to keep training shorter or want flexibility, DR + optional fellowship is a more straightforward path. Notably, all IRs are trained in diagnostic radiology first – so you’ll become a radiologist either way, with IR adding extra procedural specialization.

Conclusion and Practical Takeaways

Choosing between Diagnostic and Interventional Radiology comes down to your interests, preferred work style, and long-term goals. Both are rewarding, high-tech fields pivotal to modern healthcare. Here are some practical questions and takeaways to guide your decision:

• Do you want to be the one performing procedures? If you love working with your hands, aren’t afraid of needles or blood, and get a thrill from fixing a problem in real-time, IR might be your calling. You’ll be a clinician-proceduralist, akin to a surgeon. If you prefer to focus on analysis and interpretation rather than doing procedures, and you’re satisfied being the expert consultant in the background, DR is a great fit.
• How much patient contact do you want? For a role with significant patient interaction – talking to patients, doing rounds, clinic visits – choose IR, where you’ll develop bedside manner and longitudinal patient relationships(glmi.com). If you’re comfortable with limited direct patient contact and find satisfaction in aiding patients indirectly through diagnoses, DR provides that behind-the-scenes impact.
• Consider your tolerance for urgent call and variable schedule: DR generally offers a more controlled lifestyle with fewer emergency disruptions. IR involves being on call for emergencies (which can be stressful but also highly gratifying when you save a life at 3am). If you prioritize predictability and sleep, lean DR. If you can handle (or enjoy) the adrenaline of being called in to stop a bleeding artery at night, IR could be for you.
• Length of training and competitiveness: Are you prepared to commit to 6-7 years of training including an IR fellowship and to compete for a relatively scarce IR residency spot? If yes, and you’re passionate about IR, go for it. If not, there’s nothing wrong with sticking to DR’s 5 years (and perhaps a shorter fellowship) and getting into practice sooner. Remember, there are pathways to add IR later (via fellowship) if you change your mind during DR residency.
• What aspects of radiology do you enjoy during rotations? Think about your experiences so far. Did you find yourself more intrigued by the imaging findings and diagnosing the case (pointing at the screen), or were you more excited when you saw a biopsy or cath procedure being done? Your genuine interests should guide you. Some students are drawn to radiology for the imaging itself – they might be happier in DR. Others are drawn by the procedures they saw in IR suites – they’d likely be happier in IR.
• Career flexibility vs. focus: If you want to maintain breadth – reading all kinds of scans on all body parts – DR allows that generalist career (or a mix of modalities). If you prefer to develop a narrower but deeper expertise (e.g. becoming the expert in PAD interventions or oncologic liver therapies), IR encourages that kind of specialization. Keep in mind IRs still do imaging, but their identity is often in a specific domain of procedures.
• Consider mentorship and gut feeling: Talk to radiologists and IRs in the field. If possible, spend elective time in both a diagnostic reading room and the IR suite. Often, students have a “gut feeling” about where they fit in. Pay attention to which environment’s physicians you identify with more. Can you see yourself as the person behind the monitors all day, or as the person scrubbed at the table? Sometimes imagining your future day-to-day happiness can provide clarity.

Finally, remember that your decision isn’t irrevocable. Radiology as a whole is one big family. Some people do a DR residency and later pursue an IR fellowship; some start in IR and end up doing more diagnostic work over time. You will obtain a strong foundation in diagnostic imaging no matter what, and you can shape your career as it progresses. Both diagnostic and interventional radiologists ultimately play complementary roles in patient care – one providing answers, the other providing treatments. Many radiology groups function as a team with DR and IR working hand-in-hand (often IR relies on their DR colleagues for interpreting studies, and DRs rely on IRs to provide minimally invasive treatment options).

In summary: choose Diagnostic Radiology if you love imaging and analysis, value a flexible lifestyle, and want a shorter training with numerous subspecialty avenues. Choose Interventional Radiology if you crave procedural work, don’t mind a more demanding training and schedule, and want to be on the front lines of treating patients in a minimally invasive way. Both are among the most exciting fields in medicine today, with outstanding prospects. Whichever path you choose, you’ll be entering the innovative world of radiology – diagnosing and/or curing disease with cutting-edge technology – and that’s a decision you’re unlikely to regret, given the high satisfaction reported in both careers(radiologybusiness.com). Good luck with your exploration, and know that whether DR or IR, you’ll be integral to patient care and likely find the career deeply rewarding.

What are the top three areas that students can focus on to help prepare themselves for a successful residency application and a successful transition to residency? (i.e. grades/academics, professionalism, any of the categories listed above, etc.)?

• Academic excellence (Step 2 CK, clerkship honors)
  • Radiology-specific research and involvement.
  • Professionalism, communication, and wellness habits

In summary, medical students targeting diagnostic or interventional radiology should focus on: (1) excelling academically and developing a strong clinical knowledge base, (2) engaging with radiology through research, leadership, and mentorship, and (3) refining their professionalism, communication, and wellness habits. These areas reinforce each other – for example, research involvement can deepen your knowledge, and strong communication skills will help you network with mentors. Residency program directors today are looking for the “complete package” – clinical excellence, commitment to radiology, and the personal qualities of a great colleague【39†L1154-L1162-L1160】. By starting early in both pre-clinical and clinical years to build these competencies, you will craft a compelling application and enter radiology residency well-prepared to learn and succeed. Radiology is an “amazing, dynamic specialty”(radpartners.com) – with the right preparation, you can confidently navigate the match process and thrive as a new radiology resident, ready to absorb all the knowledge and contribute to the team from day one.

What resources would you share with a student who is just starting to research their interest in this specialty and/or wants to learn more specifics of this specialty (anything from what a typical day may look like to specifics on rotations, specialty specific residency info, fellowships)?

• ACR, RSNA, SIR, AUR websites
  • Radiopaedia, Case in Point, StatDx
  • Podcasts: BackTable, Radiology Jam
  • Social media: #RadTwitter, @ACRRFS, @FutureIRDocs

Resources for Students Starting to Explore the Specialty

If you’re just beginning to research radiology, start with the professional organizations’ student sections. The American College of Radiology (ACR) offers a Medical Student Section with free membership and a comprehensive online hub(acr.org). Through the ACR, you can access webinars, a curriculum of 75+ radiology learning resources, and even a virtual Radiology-TEACHES program to learn appropriate imaging choices(acr.org)(acr.org). The Radiological Society of North America (RSNA) also provides educational materials (e.g. RadiologyInfo.org for overviews of radiologist roles and procedures). For interventional radiology (IR), the Society of Interventional Radiology (SIR) has a Resident, Fellow, and Student (RFS) Section dedicated to trainees. SIR’s resources explain “What is IR?”, offer procedure guides, and connect you with IR physicians(sirweb.org).

It’s also helpful to use general career-planning tools. The AAMC’s Careers in Medicine website and the AMA’s FREIDA specialty guide provide snapshots of diagnostic radiology (DR) and IR, including training pathways and lifestyle information(ama-assn.org). Additionally, our medical school has a Radiology Interest Group (RIG) – joining the RIG can connect you with peers and mentors. You might also explore educational sites like Radiopaedia (for case examples) or listen to radiology podcasts/blogs (e.g. The Radiology Review blog) for a student’s perspective on useful resources. In short, leverage the major radiology organizations (ACR, RSNA, SIR) and your school’s interest group to build your foundational knowledge and network early(acr.org).

What subspecialties exist with this specialty?

Diagnostic Radiology (DR) Subspecialties:

• Neuroradiology
• Musculoskeletal (MSK) Imaging
• Body Imaging (Abdomen, Chest, Pelvis)
• Breast Imaging
• Cardiothoracic Radiology
• Pediatric Radiology
• Nuclear Medicine
• Emergency Radiology
• Informatics

Interventional Radiology (IR) Subspecialties:

• Interventional Oncology
• Neurointerventional Radiology
• Peripheral Vascular Interventions
• Women’s Health IR

What does a typical workday or work week look like (hours/schedule/shifts, work setting, team based environment, acuity, etc.)?

Diagnostic Radiology:

• 8am–5pm shifts, some evening or weekend coverage.
• Reading rooms or teleradiology setups.
• Mixture of solo work and consults with referring clinicians.

Interventional Radiology:

• 7am–6pm workdays, often with home call or weekend procedures.
• Procedures performed in IR suite or hybrid OR.
• Team-based with nurses, techs, and consult teams.
• Mix of procedural time, inpatient rounds, and clinic visits.

What are the important traits, qualities, and/or considerations recommended for physicians in this specialty?

Diagnostic Radiology:

• Analytical, detail-oriented
• Comfortable working independently
• Effective communicator (written/verbal)
• Tech-savvy and adaptive

Interventional Radiology:

• Manual dexterity
• Calm under pressure
• Clinical and procedural thinker
• Strong patient communication skills
• Collaborative and resilient

How does the specialty work differ in various settings (e.g. a private vs community vs an academic environment)?

Academic Centers:

• Subspecialty practice, research, teaching
• Lower volume, higher complexity

Private Practice:

• Generalist or subspecialist depending on size
• High volume, fast pace
• Higher compensation

Community Hospitals:

• Broad scope of practice
• Mix of acute and outpatient imaging
• Close interaction with clinicians

IR Setting Variability:

• Academic: complex oncologic or neurovascular procedures
• Community: general IR (drains, ports, PAD, etc.)
• Private: often hybrid IR/DR roles

What does training for this specialty look like (how many years, is a separate prelim year needed, etc.)?

Diagnostic Radiology (DR):

• 1-year internship (medicine or surgery)
• 4-year DR residency
• Optional 1-year subspecialty fellowship

Interventional Radiology (IR):

• Integrated IR/DR: 1-year internship + 5-year IR/DR residency
• Independent IR: DR residency + 2-year IR fellowship
• ESIR Track: DR residency with extra IR training, followed by 1 IR fellowship year

What does training in radiology entail?

Diagnostic Radiology (DR) residency entails specialty training that comes after a one-year preliminary year. First, you must complete an accredited internship year (PGY-1) in a clinical field – this can be a transitional year or a prelim year in medicine or surgery. After that, DR residency is 4 years long (PGY-2 through PGY-5)(radiologyinfo.org). So, in total, radiology training is typically 5 years post-M.D. (1 prelim + 4 radiology). During those four years, residents rotate through all imaging modalities and organ systems (learning X-ray, CT, MRI, ultrasound, etc., in areas like neuroradiology, abdominal imaging, musculoskeletal, etc.). Near the end of residency (typically in the third year), residents take the ABR Core Exam, which is a comprehensive exam covering all of radiology. Many diagnostic residents then pursue an optional fellowship for 1 additional year in a subspecialty (for example, in neuroradiology or interventional radiology). While fellowship isn’t mandatory for board certification, the majority of DR residents do a fellowship to deepen expertise in one area, since modern practice is often subspecialized.

Interventional Radiology (IR) now has its own integrated training pathway. There are two main routes to become an interventional radiologist:

• Integrated IR/DR Residency: This is a residency program that integrates diagnostic and interventional radiology training from the start. It lasts 5 years after the one-year internship (so 6 years total including PGY-1)(sirweb.org). In an integrated program, the first ~3 years focus on diagnostic radiology and the last ~2 years on intensive interventional radiology training(sirweb.org). Medical students apply into integrated IR residencies through the Match, similar to other specialties. Upon completion, graduates are board-eligible in both diagnostic and interventional radiology (they earn a combined IR/DR certificate)(sirweb.org).
• Independent IR Residency: This is the newer name for the traditional pathway of doing a diagnostic radiology residency first, then an IR fellowship. After completing a 4-year DR residency, a physician can match into an independent IR residency, which is 2 years of dedicated IR training (or sometimes 1 year if they completed an “Early Specialization in IR” curriculum during DR residency)(sirweb.org)(sirweb.org). In total, the independent pathway is also about 6-7 years post-M.D. (1 year internship + 4 years DR + 1-2 years IR). Many DR programs offer an “ESIR” track where residents interested in IR can spend extra time in IR during their DR residency; those who complete ESIR are eligible for a shorter (one-year) independent IR residency(sirweb.org).

Preliminary Year: Both DR and integrated IR residencies typically require a separate prelim PGY-1 year in a clinical field. Some programs are categorical (meaning they include the internship as part of the residency offer), but most radiology positions are advanced (starting at PGY-2)(sirweb.org). That means when you apply, you’ll also need to apply to a prelim year program. Many diagnostic radiology-bound students do a prelim in medicine or a transitional year that gives a broad clinical base. IR bound students typically do a surgery preliminary year. The internship is important to develop clinical skills and satisfy the requirement of a clinical base year.

What types of experiences might strengthen my future residency application, especially in areas of service, leadership, and research? 

1. Radiology/IR research (case reports, QI, original studies)
   1. Poster/oral presentations at RSNA, AUR, SIR
   2. Leadership in radiology interest groups or student orgs
   3. Community service and teaching/tutoring roles
   4. Clinical volunteering (especially underserved settings)

Experiences to Strengthen a Radiology Residency Application

To build a strong radiology application, it’s wise to engage in service, leadership, and research activities during medical school. Here are some beneficial experiences:

• Research and Scholarly Projects: Radiology is a scientific, constantly evolving field, so showing interest in research is a plus. If possible, get involved in a radiology-related research project (for example, work with a radiology faculty on a case series, image-based research, or quality improvement in imaging). Publications or presentations demonstrate academic curiosity. In fact, with Step 1 now pass/fail, scholarly activity can help distinguish you; at more academic programs, research output “could be deciding factors now that Step 1 is pass/fail.”(medicine.tamu.edu) You don’t necessarily need a huge number of publications, but try to have at least something to list (an abstract at a conference, a journal publication, etc.) by application time. If radiology projects are hard to find early on, research in another field is still useful – it develops analytical skills and shows commitment to scholarship.
• Leadership and Involvement in Specialty Interest Groups: Taking on a leadership role or active membership in your school’s Radiology Interest Group (or IR interest group) is highly recommended. Being involved in a radiology interest group demonstrates your interest in the field and can lead to mentorship and learning opportunities. One residency director specifically advised students to get involved or take leadership roles in radiology interest groups, as it strengthens your application and network(acr.org). Leadership experience (even in other organizations or student government) also highlights interpersonal and organizational skills.
• Clinical Exposure to Radiology: Seek out opportunities to shadow radiologists or do elective rotations in radiology early. This serves two purposes: it solidifies your interest and also helps you secure strong letters of recommendation from radiologists (more on letters below). If your medical school allows, do an elective in DR or IR in your third year or early fourth year. A program director noted that once a student discovers an interest in radiology, they should arrange a rotation “as early as possible” to both ensure the specialty is a good fit and to obtain letters for the application(acr.org). Shadowing in different subspecialties (like a day in IR or an afternoon in breast imaging) as a first- or second-year can also give you talking points about why you like the field.
• Service and Volunteer Work: Maintain involvement in some form of community service or volunteering, as radiology programs do appreciate well-rounded, service-oriented applicants. Whether it’s volunteering at free clinics, participating in health screenings, or even tutoring/mentorship roles, service shows commitment to the broader mission of medicine. Some radiology applicants will have volunteer activities like being part of the Gold Humanism Honor Society’s projects or organizing community health events. These can set you apart as someone who cares about patients and community, countering any stereotype that radiologists sit in a dark room all day. In fact, residency program evaluators like to see applicants with evidence of teamwork, altruism, and good communication – things which volunteer work often provides. The “perfect applicant” profile mentioned by one radiology advisor included having “some volunteer work or previous employment of any kind” in addition to strong academics(medicine.tamu.edu).
• Teaching or Tutoring Experience: Radiology involves teaching (as a resident you’ll teach interns/med students, and in practice you teach colleagues or patients). If you enjoy teaching, engage in tutoring anatomy or serving as a TA in imaging anatomy sessions. It’s not a requirement, but it can be a nice plus to show you have mentorship and communication skills.
• Interventional Radiology Exposure (if interested in IR): If you are leaning towards IR, seek out specific experiences in that realm. This could include assisting in an IR lab research project, attending SIR student workshops, or doing an IR elective/rotation with the vascular surgery team to understand procedures. Showing you understand the clinical side of IR (e.g. rounding on patients) can strengthen your case for IR programs.
• Additional Niche Experiences: In radiology, even non-research projects like developing an educational module (perhaps creating a radiology teaching video or case blog) or participating in radiology-related hackathons (for AI in imaging, etc.) could be unique highlights. Also consider attending radiology conferences (ACR, RSNA) as a student – if you can present a poster there, it’s a great experience and networking opportunity. The ACR, for example, has an annual medical student symposium and a research fair(acr.org)(acr.org) that students can participate in.

Is there a specialty interest group?  If not, what other networking options would you recommend? Are there any specific national organizations or committees I should join?

Yes. UACOMP has a Radiology Interest Group. 

National organizations include:

• ACR (American College of Radiology)
• SIR (Society of Interventional Radiology)
• RSNA (Radiological Society of North America)
• AUR (Association of University Radiologists)

Specialty Interest Groups and Organizations to Join

Yes, there are multiple specialty interest groups and organizations for students interested in radiology and IR, and joining them is highly beneficial:

• Campus Radiology Interest Group (RIG): UACOMP has a Radiology Interest Group. You should definitely join it. RIGs provide networking with faculty, shadowing opportunities, lunch lectures on radiology topics, and often help students find research or mentors. Involvement in a RIG shows initiative and interest (and as mentioned, taking a leadership role in the group can strengthen your CV(acr.org)).
• American College of Radiology (ACR) – Medical Student Section: Nationally, the ACR is the leading organization for radiologists, and it has a dedicated Medical Student Section (ACR MSS). Over 3,000 medical students are members of ACR MSS(acr.org). As a student member of ACR, you gain free access to resources and can join student committees. The ACR Medical Student Section produces newsletters, webinars, and even offers committee positions (such as advocacy or education subcommittees for students). They also host events like the annual ACR Medical Student Symposium and networking panels at the ACR annual meeting(acr.org)(acr.org). Membership in ACR for students is typically free or very low cost and it’s a great way to stay informed and get involved nationally.
• Society of Interventional Radiology (SIR) – RFS (Resident, Fellow, Student) Section: For those interested in IR, the SIR is your go-to organization. SIR’s RFS Section explicitly includes medical students in its mission to promote IR and support trainees(sirweb.org). By joining SIR (which has a student membership category), you can access IR-specific educational materials and possibly find a mentor. SIR RFS has a Medical Student Council that organizes student webinars and an annual Medical Student Scholars program. They also have a Mentor Match program that pairs medical students with IR mentors for guidance(sirweb.org). Joining SIR gives you opportunities to connect with residents and attendings passionate about IR and to attend the annual SIR conference at a discounted student rate.
• RSNA and Other Radiology Societies: The Radiological Society of North America (RSNA) offers free membership to medical students as well. RSNA is primarily known for its big annual conference in Chicago and its research journal (Radiology), but as a student member you can attend the conference (often they have special student programming) and access educational materials. Additionally, there are subspecialty societies (e.g. American Roentgen Ray Society, Society of Breast Imaging, American Society of Neuroradiology, etc.) that often welcome trainees – but as a med student it’s most useful to focus on the broader organizations ACR and SIR first.
• American Medical Association (AMA) & Specialty Sections: While the AMA isn’t radiology-specific, being active in the AMA Medical Student Section or your state medical society can indirectly help (networking and demonstrating leadership). There isn’t a distinct AMA radiology student section, but the AMA often publishes specialty profile articles that are useful for exploration.

In short, join the ACR Medical Student Section for diagnostic radiology and SIR (RFS) for interventional radiology. These will connect you to peers nationwide and to mentors. Also UACOMP’s  Department of Radiology for mentorship. Don’t overlook local chapters – some states have ACR chapters that include resident and medical student involvement. Committees or interest groups in organizations like ACR can give you leadership experiences at a national level (for example, serving on the ACR Medical Student Advocacy subcommittee). All these memberships and group activities will show your dedication to radiology and also prepare you better for applying. As one ACR resource put it, through the Medical Student Section you’ll find “resources and connections to propel your learning and career” as you pursue radiology(acr.org).

What advice would you offer MS1s and MS2s who are interested in this specialty?

• Shadow DR and IR early
• Join specialty interest groups
• Engage in anatomy/pathology early and deeply
• Begin or seek research opportunities (case reports, QI)
• Seek mentorship and attend radiology conferences if possible

Advice for MS1s and MS2s Interested in Radiology

For first- and second-year medical students, the key is to build a strong foundation while gradually exploring radiology. Here are some pieces of advice:

• Focus on Your Core Medical Knowledge: Radiology intersects with anatomy, physiology, and pathology extensively. Doing well in your foundational courses (especially anatomy) will pay dividends. Radiologists need to know anatomy cold – consider using imaging to supplement your anatomy studies (e.g., look at CT scans to identify structures you learn in gross anatomy). Some curricula or resources like the ACR’s radiology-anatomy modules can help you learn anatomy through an imaging lens(acr.org). In general, excel in your basic science coursework; even though Step 1 is now pass/fail, a solid grasp of pathology and physiology is crucial for interpreting imaging down the line.
• Seek Early Exposure to Radiology: It’s common that the formal introduction to radiology in med school is limited. Don’t wait until third year to see what radiologists do. As an MS1/MS2, you can shadow in the radiology department – reach out to a friendly radiologist (perhaps through the interest group). Spend a few hours in a reading room to see the workflow or observe an interventional procedure. This early exposure helps confirm your interest and gives you context (plus something to talk about in future interviews). Many students “stumble upon” radiology late; by being proactive early, you put yourself ahead(acr.org).
• Join the Radiology Interest Group and Attend Events: UACOMP has a RIG, go to the meetings, even as an MS1. You’ll learn about the field (typical sessions might be “Intro to Radiology” or panels with residents) and you might meet older students who can mentor you. Through the group, you might also hear about special programs (like internships or scholarships for students in radiology).
• Use Available Resources to Start Learning Radiology Basics: The ACR offers a Medical Student Curriculum (free online) that MS1s/2s can use to get a head start(acr.org). This includes modules on basic imaging modalities, appropriate use of imaging, and classic cases. It’s not expected to have detailed radiology knowledge early, but familiarity with common imaging studies (like knowing what a normal chest X-ray looks like, or how ultrasound works) can enrich your understanding of other subjects too. Also, consider doing some self-directed learning: e.g., when you learn about a disease in class, look up its imaging findings. Radiopaedia and statDx (if your school has access) are great references for correlating pathology with imaging. This kind of integration will make your study more fun and set the stage for radiology.
• Plan for a Dedicated Radiology Elective or Research in the Summer: After MS1 year, some students do a summer research project. If you are sure about radiology, see if you can do a research project in the radiology department between MS1 and MS2. Programs like the ACR’s Pipeline Initiative for the Enrichment of Radiology (PIER) internship are targeted at MS1s (especially women and underrepresented minorities) to get a summer experience in radiology with a mentor(acr.org). Taking advantage of such opportunities early can give you a huge boost (you gain a mentor, maybe a publication, and confirmation of your interest). Even if not research, simply volunteering or working in a radiology lab or reading room over a summer can be valuable.
• Connect with Mentors: It’s never too early to find a mentor in radiology. This could be as simple as staying after a lecture given by a radiologist and expressing your interest, or emailing the radiology department asking if any faculty would meet with an MS1 curious about the field. Many radiologists are enthusiastic about mentoring students (they know radiology isn’t well understood by students). A mentor can give you tailored advice for the next few years (and later, letters of recommendation). As an MS1/2, building that relationship early is incredibly helpful.
• Excel in Clinical Skills and Teamwork: Even though you’re not on the wards yet, cultivate good communication and teamwork skills through your early clinical experiences or small group work. Radiologists work as part of teams and need good communication. Participate actively in any clinical preceptorships in MS1/2 – doing well and being professional in any context will only help later (and could yield a strong letter from a non-radiology faculty which is still valuable).
• Prepare for Step 1 (even if P/F) and Step 2: Although Step 1 is pass/fail, you still need to learn the material well for Step 2 and for your general medical knowledge. Use the flexibility that P/F provides: since you’re not chasing a score, you can allocate some time to things like research or interest group activities without jeopardizing your studies. When the time comes, you’ll want to do well on Step 2 CK (which is scored) – radiology programs will care about that. So during MS2, study hard for your foundational science exams and Step 1, as it sets you up for clinical success.

In essence, years 1 and 2 are the time to lay groundwork – academically and in exploring your interest. Do well in classes, but also take initiative to get involved with radiology early (through interest groups, shadowing, and possibly research). And don’t worry if some classmates or advisors push other specialties early on; exposure is key to know radiology is right for you. By the time you hit clinical rotations, you’ll have a clearer idea of what radiologists do, which can help you contextualize your third-year learning (for example, you’ll start noticing how often imaging is pivotal in patient care during internal medicine or surgery rotations). This early interest can then be solidified with a radiology elective in third or early fourth year, setting you up strongly for the application process. Overall, be proactive, stay curious, and find support – radiology may not be front-and-center in the preclinical curriculum, so you have to seek it out, but doing so will make you a well-prepared and confident candidate later on.

How and where can I find other mentors for this specialty?

• Ask faculty during shadowing or electives
• Through school’s interest group
• SIR mentor match program (for members)
• Conferences (e.g., RSNA, ACR) and online platforms (e.g., Twitter/X)

Is there anything else in addition to the suggestions above that could aid my future application, now that Step 1 is P/F?

• High Step 2 CK score
• Strong clerkship evaluations
• Radiology-specific research
• Enthusiastic letters of recommendation
• Away rotation performance (especially for IR)

Strengthening Your Application Now that Step 1 is Pass/Fail

With USMLE Step 1 going pass/fail, other aspects of your residency application take on greater importance to demonstrate your excellence and distinguish yourself. Here are key areas to focus on post-Step1:

• Clerkship Performance (Grades in Clinical Rotations): Your third-year clinical grades and evaluations carry more weight now. Program directors will look closely at your performance in core rotations – especially those that reflect your clinical acumen and work ethic. Aim to earn Honors or high passes in as many rotations as possible. This is important for radiology because it shows you are a solid clinician (radiologists still need strong clinical understanding) and it provides a rankable metric in absence of a Step1 score. As one advisor noted, without Step1 scores, “clerkship grades and even basic science grades will play a bigger role in your application.”(medicine.tamu.edu) So, treat each clerkship as an opportunity to impress – be proactive, study for the shelf exams, and be a team player that attendings will remember.
• Letters of Recommendation (Especially from Radiologists): Letters have always been important, but now programs might rely on them even more to differentiate applicants. A strong letter from a radiologist can significantly boost your application. Thus, during your radiology elective (or any interaction with radiology faculty), work hard and express your enthusiasm so that they can write a stellar letter. It’s wise to secure at least one (if not two) radiologist letters. Also, letters from other specialties (medicine, surgery, etc.) where you performed exceptionally are valuable to attest to your general clinical excellence. The goal is to have letters that say you are among the top students they’ve worked with – that kind of narrative can outweigh the lack of a Step1 numeric score. A radiology program advisor emphasized getting a “strong letter of recommendation from a radiologist” as one of the helpful factors now(medicine.tamu.edu). Start cultivating these relationships early (as discussed in mentorship), so by application time your letter writers know you well.
• Step 2 CK Score: Although Step1 is P/F, Step 2 CK is scored and is now the primary standardized exam on your transcript. It is expected that Step2 will be used by programs to screen applicants. Doing well on Step 2 is therefore critical. Many programs are likely to require a Step2 score available before offering interviews(arrsinpractice.org). Therefore, plan to take Step 2 CK early enough (usually by July after third year) to have your score ready. A strong Step2 (for example, a score in the high 240s or 250+ range, roughly equivalent to what a competitive Step1 used to be) will reassure programs of your medical knowledge. In essence, treat Step2 as the new Step1 – start preparing during third year and consider dedicating study time after your rotations.
• Research and Publications: As discussed, with Step1 P/F, having research publications or presentations can set you apart, especially for university programs. If you haven’t done so, engage in a research project by early fourth year and ideally have some outcome (abstract or draft manuscript) by application submission. Not every applicant will have publications, but showing scholarly productivity is more important now as a differentiator. Larger academic programs may even use research output as a filter or tiebreaker(medicine.tamu.edu). Try to aim for at least one first-author abstract or publication in any field (radiology-related is best, but others count too). The effort also reflects qualities like intellectual curiosity and persistence.
• Clinical Awards and Honors: Strive for any academic honors your school offers. For example, induction into Alpha Omega Alpha (AOA) Honor Medical Society (usually top 25% of class academically, often decided end of third year) is a huge gold star on an application(medicine.tamu.edu). Similarly, the Gold Humanism Honor Society (GHHS) is an honor recognizing compassion and service – it signals you have strong interpersonal skills and character. If your school selects for these, doing well academically and being active in service will increase your chances of selection. Being in AOA or GHHS will definitely strengthen your application (more on that in Q15). Other awards like departmental awards for excellence in a clerkship, research prizes, or leadership awards can also bolster your CV and compensate for the lack of a Step1 score to highlight.
• Extracurricular Leadership and Service: Demonstrate leadership (in student groups, committees, etc.) and service. Post-Step1, these aspects are part of the holistic review programs will do. Radiology programs often mention looking for well-rounded individuals who will contribute positively to the residency class. For example, involvement in organizations (AMSRO, SNMA, AMWA, etc.) or interesting extracurricular achievements (like prior careers, unique hobbies) can come into play more when there isn’t a Step1 number to compare everyone. In your personal statement and interviews, these experiences can help you stand out.
• Clinical Subinternships (Acting Internships): Perform very well in your fourth-year subinternship (whether it’s in medicine, surgery, or another field). These intensive rotations often carry weight in the Dean’s letter (MSPE). Program directors will see narrative comments about your ability to take on intern-level responsibility. If you ace your sub-I and get a strong summary in the MSPE, it reassures radiology programs that you have strong clinical skills and work ethic.
• Professionalism and Interpersonal Skills: With more emphasis on holistic factors, things like your MSPE comments and professionalism record matter. Always be punctual, collegial, and diligent in all rotations – radiology programs will scrutinize the qualitative evaluations in your MSPE. Any red flags (e.g., a professionalism issue or poor comment) will stand out more without Step1 overshadowing them. Conversely, a string of comments praising your teamwork, communications, and initiative will paint a very positive picture.

In summary, excel in all the areas you can control: clinical grades, Step2, research, letters, and leadership. The loss of Step1 scoring means program directors may rely on a combination of these other metrics. One radiology program director advised that without Step1, they would look more at “overall class rank, clinical performance, radiology LORs, and scholarly activity”(medicine.tamu.edu). You want to show that in each of those domains you are strong. If there are any weaker areas, address them proactively (for example, if you had an average medicine grade, maybe shine in surgery or vice versa). Also, when the time comes, consider doing a radiology “away” rotation strategically if you need to demonstrate yourself to a specific program – but away rotations are not mandatory. Finally, use your personal statement to highlight your passion for radiology and any achievements or experiences that make you a great candidate beyond scores. By focusing on these elements, you can present a compelling application even without a Step1 numeric score.

Which group and association memberships might strengthen my future residency application (e.g., AOA, GHHS, MSG, Specialty specific groups, etc.)? 

• AOA – academic excellence
• GHHS – humanism and professionalism
• MSG/Class leadership – leadership skills
• ACR, RSNA, SIR, AUR – specialty commitment

How important are Step 2 scores to this specialty?

• Very important
• Used for screening due to Step 1 P/F
• Competitive scores:
  • DR: ~250+
  • IR: ~255+

Are publications important to this specialty? Is there a general number of publications or presentations I should be aiming for?  How important is it for these to be within the specialty I am pursuing?

• Yes, especially in IR
• Matched averages:
  • DR: ~8 publications/abstracts (see below)
  • IR: ~12+ (see below)
• Quality > quantity; focus on radiology-specific work

The Role of Publications – How Many and What to Aim For

Research publications are an important aspect of many radiology applications, particularly for those aiming at academic programs, but the weight can vary by program. Here’s a breakdown:

• Are Publications Important? Yes, to an extent. Almost all radiology applicants will have at least some research experience listed, though not all will have full publications. Publications serve as evidence of academic engagement and can help set you apart, especially now that other metrics are fewer. Large academic residencies (the ones affiliated with major research institutions) often highly value research. In fact, with Step 1 P/F, some program directors have explicitly said that research output could become a more significant “deciding factor at the larger more academic institutions”(medicine.tamu.edu). This means at places like UCSF, Johns Hopkins, etc., a robust research portfolio (multiple abstracts, perhaps publications) can boost your chances. Conversely, some medium or community programs might not prioritize publications as much; one PD said at his program they are “nice to see” but not a requirement(medicine.tamu.edu).
• Typical Numbers: Based on recent data, matched diagnostic radiology applicants have on average about 3-4 research experiences and around 8-12 abstracts/presentations/publications listed(medicine.iu.edu). (These AAMC numbers count everything: abstracts, poster presentations, etc., not just peer-reviewed papers.) It’s a high number because many students count conference posters and such. For perspective, a resource noted the average matched DR applicant had ~12 research items and 4.4 research experiences(medicine.iu.edu). However, don’t be alarmed – that doesn’t mean 12 journal articles. It could be, say, 1-2 published papers + a few conference presentations + some submitted abstracts, etc.
• What You Should Aim For: Quality matters more than sheer quantity. Ideally, aim to produce at least one piece of scholarly work that you can discuss in interviews. This could be a first-author poster or oral presentation at a conference (RSNA, ARRS, your state radiology society, etc.) or a published manuscript in a journal (could be Radiology, Academic Radiology, or even a non-radiology journal if you did other research). If you can get one or two publications (even case reports) by application time, that’s great. Many successful applicants have a couple of publications. Some will have none, but perhaps had significant presentation experience or an advanced degree (MD/PhD folks obviously have more). If you’re targeting top research-heavy programs, try to have at least one publication on your CV to be competitive with those cohorts.
• Radiology-Specific vs. Other Research: It’s not mandatory that your research be in radiology, but it can carry a bit more weight if it is, since it shows interest and can get the attention of radiologist interviewers. That said, many radiology applicants’ research is in other fields (medicine, surgery, basic science) depending on what they had access to. All research is good research – what matters is the process and skills you gained. If you did an impressive project in cardiology and published in a good journal, radiology programs will still be impressed by that work. And you can tie it in by saying, for instance, how that project’s skills apply to radiology or how it sparked your interest in imaging (if applicable).
• Aim for Presentation if Not Publication: If getting a full paper published by application time is challenging, aim to at least present at a conference. RSNA and other radiology meetings have medical student poster categories – submitting an abstract in spring of third year could lead to a presentation at a meeting in fall of fourth year, which you can list on your ERAS. Even institutional research day presentations count. Ultimately, programs want to see you had the initiative to ask a question and carry through a project.
• Beyond Publications – Demonstrating Research Aptitude: In your ERAS application, you’ll list research experiences. Use that section to detail any project, even if it didn’t result in publication, and what you learned or accomplished. For example, if you worked in an AI lab developing an algorithm (but it’s still in progress), list it and maybe mention a manuscript in preparation. During interviews, be prepared to talk about any project listed. They might ask specifics to gauge your understanding and role. If you can speak intelligently about your research, that itself leaves a good impression, publication or not.
• Setting a Goal: If you’re early in med school, you have time to aim for multiple outputs. If you’re closer to applying and haven’t done much, try to get something by application season – even a case report or a letter to the editor is better than nothing as long as it’s meaningful. Radiology is moderately competitive, and while you can match without research (especially at more community-focused programs), having it broadens your options. One study of recent matches suggests most matched U.S. MD seniors in radiology had at least one publication (~86% had at least one, per Charting Outcomes data) and the mean number of publications was around 3 (yousmle.com).

In summary, publications are important but not the sole determinant. Aim to engage in research early, target at least one publication or multiple presentations by the time you apply. If you’re eyeing academic programs, push for more substantial work or high-impact research if possible. But remember, a lack of publications can be compensated by other strengths (stellar clinical performance, etc.) at many programs – especially if those programs emphasize clinical training over research. As one residency advisor put it, publications and presentations could tip the scales at academic places now that Step1 is P/F(medicine.tamu.edu). So, maximize what you can: if you have time to get an abstract out or write up an interesting case, do it. Not only does it strengthen your CV, it also gives you something to talk about passionately during interviews, showing you are academically inclined and prepared for the scholarly aspects of radiology residency.
 

Are there any special considerations when applying for residency?

DR:

• Apply to advanced and categorical programs
• Need a separate PGY-1 prelim or TY

IR:

• Apply to integrated IR/DR and DR for ESIR backup
• Emphasize clinical skill, IR letters, and rotations

Special Considerations When Applying to Radiology Residency

Applying to radiology (and IR) has a few special aspects to keep in mind, beyond the general advice for all specialties:

• Advanced vs. Categorical Positions & The Prelim Year: Diagnostic Radiology and most Integrated IR residencies are offered as advanced (A) positions in the Match. This means your radiology residency starts at the PGY-2 year, and you need to also apply for a PGY-1 preliminary year separately. When applying, you’ll create two rank order lists: one for your radiology/IR programs and one for your intern year programs. Make sure you apply broadly to prelim year programs (transitional year, or prelim medicine/surgery as per your preference) in addition to radiology programs. Only a minority of radiology programs are categorical (C), which include the intern year as part of a bundled 5-year program(sirweb.org). Similarly, a few integrated IR programs might be categorical (including a built-in surgical internship), but most integrated IR spots are advanced(sirweb.org). So a key consideration is the logistical aspect of securing a prelim year. It’s essentially like applying to two matches concurrently. Many students do prelim medicine or a transitional year if they can. Make sure your personal statements and ERAS are set up to reflect that you’re applying advanced (ERAS has a field for this). Also, budget for interviewing at prelim programs too. Neglecting the prelim applications can be disastrous – if you match radiology but not a prelim, you scramble for one. Usually that doesn’t happen since there are plenty of prelim spots, but treat it seriously.
• Applying to Both Diagnostic Radiology and IR: If you’re interested in Interventional Radiology, you have to decide whether to apply to the Integrated IR residency programs directly. Integrated IR is highly competitive (more so than DR). Many students hedging for IR will apply to both IR and DR programs. This is generally acceptable and common. You will need to tailor two separate personal statements – one emphasizing your passion for IR (for IR programs) and one more general radiology (for DR programs). Special consideration: IR programs know that many applicants also apply to DR as backup, so it’s not a negative as long as you show genuine interest in IR where you apply. If IR is your dream, go for it, but be prepared for the possibility of matching DR and doing IR via fellowship. When selecting programs, apply broadly in IR (because of fewer spots) and also apply to a solid number of DR programs so you don’t go unmatched. As data suggests, many applicants “apply to both interventional and diagnostic radiology programs” to maximize their chances(thesheriffofsodium.com). Also be aware: if you apply IR at an institution and also DR at the same place, that’s usually fine (the DR and IR programs typically coordinate or at least understand this scenario).
• Dual Certification (IR/DR) Path Implications: If you apply for Integrated IR, remember that you’re effectively committing to IR early. Some IR programs might ask about your dedication to IR vs DR in interviews. Be honest and enthusiastic about IR if you’re interviewing there. If you prefer DR but want to keep IR option, you might apply DR and plan for an independent IR residency later – that strategy can be discussed with mentors. But the special consideration is: applying to IR means fewer programs to apply to (only ~90 IR programs exist) and a separate competitive cohort.
• This is a special consideration because it’s unique to certain specialties – radiology implemented it to manage the “application fever.” Data from the first cycle showed signaled programs were far more likely to grant interviews (58% interview rate if you signaled them, vs 9% if you didn’t)(radiologybusiness.com). So you’ll want to use your signals wisely. Think about which programs are your top choices or those that might overlook you without a signal. Keep an eye on updated guidance from the Society of Chairs of Academic Radiology Departments (SCARD) or APDR on signaling each year.
• Application Volume (“Arms Race”): Radiology has seen a spike in applications per applicant – average DR applicant applied to ~72 programs in 2024(radiologybusiness.com). Be mindful of this when planning how many programs you will apply to. The special consideration is not to under-apply. With virtual interviews, many apply very broadly. Programs are aware of this trend, which is why signaling was introduced, but until it fully tempers things, you might end up applying to a lot of programs too (depending on your competitiveness). Ensure your ERAS documents (personal statement, etc.) are on point since they’ll go out widely.
• Interviews Scheduling and Conflicts: Radiology and IR interviews often occur in the same general timeframe (Oct-Jan). If you apply to both, you’ll have to juggle potentially many interview invites. One consideration: some institutions may give you an interview for DR or IR but not both, or sometimes both. If both, they might coordinate so you can meet people from each side. Just be prepared to communicate clearly – for example, if you get a DR interview at a place where you also applied IR and prefer IR, you could politely inquire if IR would consider interviewing you as well (sometimes they will if DR already did, etc.). Each program handles it differently.
• Differing Application Materials for IR: If applying to IR, you might consider obtaining at least one letter from an interventional radiologist or a surgeon who knows your procedural skills. It’s a nuance: IR programs will want to see that you are suited for a procedural career (e.g., letters attesting to manual dexterity, clinical decision-making). So a special consideration for IR applicants is tailoring letters and your personal statement to highlight relevant skills (team leadership, interest in longitudinal patient care, technical skills, etc.) in addition to the usual radiology strengths.
• Rank List Strategy: When it comes time to rank, if you applied to both IR and DR, you will rank them together in one list since IR and DR are separate matches but under the same NRMP umbrella as advanced programs. This means you should carefully decide your true preference order. Special scenario: if you only want IR if it’s at a top choice but otherwise would prefer DR at other places, you have to intermix those on one list. That can be complex – mentors can help with strategy. But be aware: if you rank an IR program, you’re saying you’d take that over any DR program lower on the list. You cannot match to both; you’ll get whichever is highest on your list that you’re ranked for.
• Personal Statement(s): As noted, crafting possibly two versions (IR vs DR) is a consideration. Make sure to upload the correct one to each program type in ERAS to avoid confusion.

Preference Signaling: A new development in recent application cycles (for DR in particular) is the use of preference signaling. In 2023-2024, radiology adopted a system where applicants can send a limited number of “signals” to programs they are especially interested in(radiologybusiness.com)(radiologybusiness.com). The vast majority of radiology programs (184 of 187) participated in signaling(radiologybusiness.com). This means you might need to strategize which programs to signal (6 gold 9 silver for DR, and 8 in IR for 2026 ( https://students-residents.aamc.org/applying-residencies-eras/program-signaling-2026-myeras-application-season))

Overall, the application process for radiology has these additional moving parts: the separate prelim application, possibly dual applying IR/DR, preference signaling, and planning for a high number of applications. It’s a complex process, so start planning early. Talk to advisors about whether you should apply to both IR and DR or just one, and ensure you don’t miss deadlines (e.g., if an IR program requires a supplemental application or something). As long as you keep these considerations in mind and stay organized, you’ll navigate the radiology match without surprises.

What is a general recommendation for how many programs to apply to (recognizing that this may vary based on student situation)?

• DR: 35–60 depending on competitiveness
• IR: 50–70 (including DR – see below)

How Many Programs to Apply To in Radiology

Determining how many programs to apply to is always a bit individualized, but given recent trends, radiology applicants have been applying to a lot of programs on average. Here are some points to consider:

• Average Numbers: In the 2024 cycle, the average number of applications submitted per applicant was about 72 for Diagnostic Radiology (DR) and 37 for Interventional Radiology (IR)(radiologybusiness.com). This reflects the “application arms race” – students are casting wide nets(radiologybusiness.com)(radiologybusiness.com). Radiology applicants typically apply broadly across many geographic regions. If you are a strong candidate (good scores, etc.), you may not need to hit the average of 72, but many do anyway due to fear of missing out.
• Competitiveness and Profile: Gauge your competitiveness: If you have above-average Step scores, some research, AOA, etc., you might scale down slightly. you should apply to more than average. Also, integrated IR being more competitive means IR-focused applicants often apply to many IR programs (which are fewer in number). Since IR average was 37, IR applicants frequently also applied to dozens of DR programs as backup. So an IR+DR applicant could end up applying to 70+ DR and, say, 20 IR, totaling near 90 in some cases.
• Recommended Range: Advisors often suggest applying to roughly 40–60 DR programs for an average US senior applicant in radiology, and maybe 40 -50 IR programs if doing IR (https://careersinmedicine.aamc.org/explore-options/specialty-profiles/interventional-radiology-integrated#competitiveness). However, the reality is many apply to more. The NRMP Charting Outcomes data shows diminishing returns after a certain point (for example, ranking about 12 programs gives a very high chance of matching). But because interviews are not guaranteed, students err on the side of applying to more programs to secure enough interviews. A commonly cited goal is to get around 10–15 interview invitations; with that, your odds of matching are excellent. To get those 10–15 invites, some students may need to apply to 60+ programs, others might get that many invites from 30 applications if they’re stellar.
• Use of Signaling and Strategy: With preference signaling now in place for DR, you have a tool to potentially reduce how many programs you apply to (or at least better target them). For this year, DR bound students will have 6 gold and 9 silver signals and IR bound students will have 8 signals. For example, let’s say you send signals to 12 programs you really like. Ideally, those signals increase your interview chances there, meaning you might not need to apply quite as widely elsewhere. Still, in the first signaling cycle, many applicants still applied broadly but used signals for top choices. We saw the average still at 72 even with signaling(radiologybusiness.com), so people didn’t drastically cut down yet. Over time, this might decrease. For now, plan on a high number.
• IR vs DR application count: If you apply to both, your total number of applications is split. You might apply to all ~90 integrated IR programs (if you’re very IR-driven and a competitive applicant) plus maybe ~50 DR programs. That could be ~140 applications, which is a lot but not unheard of. Some might be more selective – say they only apply to 40 IR and 40 DR, etc. Just ensure you have enough DR programs if IR doesn’t work out. If you’re only applying DR, somewhere in the range of 50–70 programs is common. If you’re only applying to integrated IR (a bold move unless you’re extremely competitive and IR-or-bust), you’d apply to as many as possible (there are about 95 IR programs currently). Most IR applicants still also apply DR.
• Geographic Considerations: If you have geographic limitations (e.g., you only want Northeast), you’ll need to apply to more programs in that area to compensate for the narrower range. If you’re open to anywhere in the US, you can distribute applications more broadly and maybe use fewer per region. Also, the Geographic Preferences section of the MyERAS application gives you the opportunity to communicate your preference or lack of preference for geographic divisions and urban, suburban, or rural settings (https://students-residents.aamc.org/applying-residencies-eras/publication-chapters/biographical-information ).
• Cost and Time: Remember the cost of ERAS – applying to 70+ programs can be pricey. Also, the interview season time commitment – with virtual interviews it’s easier to do many, but you still need days off rotations. Think about your stamina too; interviewing at, say, 15–20 programs is manageable, but if you somehow got 30 invites, attending all might be overkill (though a “good problem”). Most applicants won’t have that problem, but keep in mind you might not even be able to interview at every program you apply to if you apply extremely broadly and get more invites than expected.
• Historical Match Rates: Radiology has had a high match rate for US MDs (around 90%+). Unmatched cases often correlate with those who applied too narrowly. So, the goal is to not be in that <10% who don’t match. Applying broadly is your insurance. If you find yourself with fewer interview invites than hoped by late November, you might contact additional programs or ensure you apply to the new cycle’s supplemental offer (SOAP) if needed. But ideally, if you apply to enough programs initially, you won’t reach that point. Also, students will need to be communicating with the CSA throughout the interview season to ensure that they are not in this position.

As a rough guidance: apply to at least 1.5–2 times the number of programs as the number of interviews you hope to get. Since one typically needs ~10-12 interviews to be very safe in radiology (most people match by the time they’ve ranked ~10–12 programs), applying to ~20–30 might be enough for a very strong candidate. For an average candidate, that ratio might be higher – needing to apply to 50 to get 10 invites, for example. The fact that the average is 72 suggests people are overshooting to make sure they hit those invite numbers.

In practical terms, many students in recent years apply to 60-80 DR programs. While that seems high, it has become the norm due to increased competition and virtual interviewing ease. IR applicants might apply to nearly all IR programs plus a large subset of DR programs. Consult with your school’s advisor who has seen match outcomes; they have specific numbers based on your class’s experience. But given current data, don’t be shy to apply broadly – you don’t want to regret applying to too few if the field becomes more competitive that year.

To sum up: Most radiology applicants apply very broadly (dozens of programs). In 2024, “applicants have begun blanketing programs with submissions”(radiologybusiness.com) and the average DR applicant sent ~72 applications(radiologybusiness.com). You likely won’t need to go much above that, but applying to on the order of 50, 60, or even 70 programs is not overkill in the current climate. The goal is to land enough interviews to comfortably match. It’s better to err on the side of a few too many applications than too few, as long as you can handle the logistical aspects. Use strategies like signaling and targeted personal statements to maximize the return on each application. And remember, once you have about 12-15 solid interviews, statistics show your chances of matching radiology are extremely high – so your application barrage has done its job.

What letters of recommendation are recommended for this specialty (e.g. from research, physicians within this specialty, academic, etc.)

• 1–2 radiologists (IR or DR)
• 1 clinical (e.g., IM, surgery)
• Optional research mentor
• IR applicants should get an IR attending letter

If other disciplines are appropriate for letter of recommendation writers, are there specific specialties you would strongly recommend?

• Internal Medicine, Surgery, Emergency Medicine, Neurology

How competitive are the residency programs in this specialty?

• DR: Moderate to high; nearly all spots fill
• IR: Very competitive; limited spots; high Step 2 CK needed

So, if you’re asking “how competitive are the programs?”, the answer is:

• All radiology programs are filling completely; you need to be a strong candidate to match.
• The top academic programs are extremely competitive (require top scores, etc.), while there are also many mid-tier programs that solid applicants can match into if they apply smartly.
• IR programs are few and competitive; many excellent applicants end up matching DR instead because of the competition.
• Radiology’s competitiveness has increased in the 2020s, making it a sought-after specialty again(radiologybusiness.com).

The positive side: if you are an above-average student with a good application, your chances of matching radiology are high (the match rate for US MD seniors ~90%). If you are below average in some metrics, you should apply more broadly and likely still can match, perhaps in a less competitive program or location. The field is competitive, but not unforgiving – plenty of applicants do match each year, and careful planning (and backup plans like including DR if IR is your goal) can ensure you end up with a spot in this specialty.

When do programs typically offer interviews?

• October through January
• Mostly virtual since COVID-19

Timing of Residency Interviews in Radiology

Radiology residency interviews generally occur during the fall and winter of fourth year, on a timeline similar to many other specialties (but sometimes skewed a bit later into the winter). Here’s what to expect:

• Interview Season Window: Radiology interviews typically run from late October through January. According to the Alliance of Medical Student Educators in Radiology (AMSER) guide, the interview season for radiology is roughly “late October – early February, with the peak in late October/November to mid-January.”(aarad.memberclicks.net). In practice, most interviews will be scheduled in November and December, with some in January. A few programs might even interview in early February (especially if they started late or had to add dates).
• Invitations Timing: Many radiology programs start sending out interview invitations in October (some as early as the first week or two of October). Others wait until after the MSPE (Dean’s letter) is released at end of September. In recent cycles, some programs coordinate or give a heads up for invite release days (to manage the flood of responses). Typically:
  • Early-to-mid October: First waves of invites go out. Some top programs may fill their interview slots quickly after invites.
  • Late October to November: A bulk of invites are sent during this period. By end of November, most programs have sent the majority of their invitations.
  • December: Additional invites may trickle out (e.g., if people cancel, or if a program does a second wave). But by mid-December, if you haven’t heard from a program, it likely means no invite.
• Interview Dates: November and December are the busiest months for attending radiology interviews. Programs avoid Thanksgiving week and late December holidays for the most part. They may offer dates scattered through those months. Some programs cluster interviews on certain days of the week (like every Friday in Nov/Dec).
• Coordination and Signaling Impact: In 2023-2024 with preference signaling, many programs waited until they saw who signaled them (and also Step 2 scores, etc.) before issuing invites. This might bunch invites around mid-October to early November. Radiology does not have a unified Invite Release Day like some specialties (e.g., Urology has a match timeline; some others coordinate date releases). So invites can come unpredictably. It’s good to monitor your email closely through October and November.
• How Long to Respond: When an invite is issued, especially at desirable programs, slots can fill within minutes to hours. Be prepared to respond ASAP or use online scheduling immediately. This is why some programs now pre-announce when they will send invites, to make it fair. The competitiveness has made the timing critical.
• Virtual vs In-Person: Currently, most residency interviews (including radiology) are virtual (this has been the case in 2020-2024). Virtual interviews can sometimes extend scheduling later since no travel is required, but programs still stick to similar months. If in-person were to return, interviews might cluster more for convenience, but likely still Oct-Jan.
• Specific Examples: Some program websites give their interview timeframe. For instance, Duke Radiology notes “interview invites are typically extended in late October/early November” and interviews occur between November and January(radiology.duke.edu). UCSF Radiology historically notified by late October (for interviews in December/January). University of Utah’s site says invites in December with interviews in January(medicine.utah.edu) – though that seems a bit later than most (Utah might have a later schedule or that info could be dated). Most programs won't go as late as March; virtually all radiology interviews conclude by the end of January.
• Consultation with Other Schedules: Radiology is an advanced match, so you might also be interviewing for prelim year programs. Prelim (medicine or transitional) interviews often occur in a similar timeframe (Nov-Jan). You’ll need to balance those too. Many prelim interviews can be on Mondays or Fridays and can sometimes be bunched when you travel for an advanced program (though with virtual, you schedule separately). Keep an eye on not double-booking.
• Timeline Summary: In short:
  • Invites: Largely mid-October through November (some into early Dec).
  • Interviews conducted: Mostly November and December, with some January dates.
  • Peak months: November and the first half of December are the busiest for radiology interviews(aarad.memberclicks.net).
  • After mid-January, it’s usually wrapping up.

Programs that use preference signaling might wait to see all applications and signals before deciding, but still usually by late October signals are considered and invites extended.

December tends to have a bit of a break around the RSNA annual meeting (which is usually the week after Thanksgiving). Historically, radiology programs often avoided scheduling interviews during the RSNA conference (last week of November) because faculty and applicants might attend that. But with virtual interviews now, that might be less of a factor. Still, expect early December to have some busy interview days, then a lull mid-late December around Christmas/New Year.

January interviews can occur at programs that either started late or needed extra dates. Many programs finish by mid-January. A few might hold final interviews in late January or very early February if needed (since rank lists are due in late February).

So, if you’re an applicant, by mid-October to mid-November you should see interview invites rolling in (assuming your application is strong enough). If by December (although earlier recognition of a problem would be better) you have very few invites, that’s a sign the application didn’t garner much interest (at which point one might consider preparing a backup plan or SOAP ((Supplemental Offer and Acceptance Program)), but ideally it doesn’t come to that if applying broadly).

Also note, the Match Day is mid-March, but rank lists are due in late February. Radiology programs like to finish interviews by end of January or very early February to have time for deliberations and rank list meetings.

In conclusion, radiology interviews are offered and conducted in the October-January timeframe. Most interviews will be before the New Year, with only a few extending into January. You should be ready to respond to interview offers as early as October. By late January, interview season is essentially done and programs move to forming rank lists.

What is UA COM-P's history with matching in this specialty?

• Consistent DR matches, including academic centers
• 1–2 IR matches/year
• Banner, Mayo, VA offer strong radiology electives

Are away rotations required for this specialty and if so, when should I plan to do them?

• DR: Not required, but helpful for specific programs
• IR: Strongly recommended; do June–August; apply early via VSLO.

Away rotations (audition electives) are generally not required for diagnostic radiology, and their value in radiology is debated. Many radiology applicants match without doing any away rotation. Here are some considerations:

• Not Required for Most Programs: Unlike some surgical subspecialties where aways are almost expected, radiology does not require away rotations for a successful match. A radiology program director stated that an away rotation “does not help much…” and noted having heard anecdotes of away rotations sometimes even hurting candidates(medicine.tamu.edu). This implies that if you perform sub-optimally on an away, it could backfire by creating a poor impression. Many radiology residency directors primarily care about your overall application and interview, rather than whether you rotated with them.
• Potential Benefits of Aways: An away (audition) rotation can be useful if you have a strong interest in a particular program or region. It gives you a chance to network, get a letter of recommendation, and show your enthusiasm. Particularly, if your home institution doesn’t have a radiology residency or if you come from a school not as known in radiology circles, an away at a well-regarded program could put you on their radar. According to some advisors, away rotations can be “very effective at targeting specific programs” and are recommended in the early fall of fourth year for that purpose(medicine.iu.edu). For example, if you really want to match at University X’s radiology program, doing an away there lets them evaluate you over a longer period than just an interview.
• Risks of Aways: If you do an away and don’t shine (or you get a lukewarm evaluation), it could hurt your chances at that program more than if you hadn’t rotated at all. Also, radiology away rotations can be a bit hit-or-miss in terms of hands-on experience; some students report spending time observing in reading rooms without much responsibility, which may not give you a chance to stand out the way an acting internship in medicine or surgery might. That’s why some PDs think they’re not particularly helpful unless you make an unusually good impression. The TAMU radiology FAQ explicitly said they don’t think away rotations help much and they’d heard several stories of aways hurting candidates (perhaps through negative feedback or missteps)(medicine.tamu.edu).
• Interventional Radiology Exception: If you’re applying to integrated IR, an away in IR could be more beneficial, because IR is smaller and more competitive. Showing your procedural skills and interest on an IR away might help secure an IR letter or demonstrate commitment. Even so, it’s not “required,” but many IR applicants do at least one IR away rotation to bolster their experience and face-time with an IR program.
• Home Radiology Elective vs. Away: It’s crucial to do a radiology elective at your home institution (if available) to get experience and a letter. That often suffices. Programs know that not everyone can do aways (time and cost constraints). They do not penalize you for not doing one. In fact, most radiology residency slots are filled with people the program did not meet on an away rotation. Your interview is usually the first time they meet you, and that’s fine.