Fatima Elahi, DO, MHA, discusses how we can strengthen radiology education during a time of workforce shortages and financial constraints.
Interview by Alex Utano, associate editor, and Abby Faulkner, digital media strategist, ACR Press.
As the demands for radiologists across all practice types increase, the pressure to provide high-quality, high-volume care often competes with the necessity of training the next generation of radiologists.
The articles featured in the JACR February Focus Issue on Economics of Education explore a range of subjects, including radiology education funding, resident teaching while maintaining productivity, alternative approaches to resident education, trends in radiology residency applications, educational debt among U.S. medical graduates pursuing the specialty, and investing in radiology medical education in the pre-clinical years.
The JACR® spoke with Fatima Elahi, DO, MHA, who (alongside Tara M. Catanzano, MD) guest-edited the special issue, about the need to make practical changes to train residents while managing work expectations.
The Focus on Economics of Education issue was born out of a pressing need confronting radiology today — balancing the increasing demand for high-quality clinical care with the responsibility of training the next generation of radiologists. Across practice settings, educators and clinical leaders alike are pulled between maximizing productivity and dedicating time, funding and institutional resources to resident education. Despite these competing priorities, there was an opportunity to explore the economic realities underlying radiology education and the innovative, practical solutions to these challenges. This focus issue brings together thought leaders to shed light on how we can sustain and strengthen radiology education in an era of workforce pressures and financial constraints.
This focus issue brings together thought leaders to shed light on how we can sustain and strengthen radiology education in an era of workforce pressures and financial constraints.
As a recent graduate of radiology residency (2024) and fellowship (2025), and now a practicing radiologist who works with trainees, I have a front-row view of the evolving realities of radiology education. What has consistently stood out to me is that many of the challenges we face, including time constraints, productivity pressures, resource allocation and competing institutional priorities, are not confined to any one program type. They exist across both academic and community settings.
Through these experiences, I have come to appreciate that the economics of education is not an abstract or theoretical issue. It directly shapes how we teach, how trainees experience their education, and how prepared they are to enter independent practice. Recognizing this connection sparked my interest in this topic and motivated me to help foster a more intentional conversation around aligning educational value with financial realities, with the goal of supporting sustainable, high-quality training for future radiologists.
This Focus Issue features seven articles that explore a spectrum of topics at the intersection of education and economics in radiology. Each article addresses economic considerations and offers practical strategies for real-world implementation. Highlights include radiology education funding and strategies to expand training positions, balancing resident teaching with clinical productivity including models to value educational work, and incentive structures for resident education amidst financial and workforce pressures.
The issue also covers alternative educational approaches including AI simulation and flipped classrooms, trends in diagnostic radiology applications and match rates (including financial and opportunity costs), educational debt among medical graduates entering radiology with socioeconomic insights, early radiology exposure in the preclinical years, and the business case for investment in foundational radiology education.
One of the most surprising insights was the breadth and creativity of solutions for the presented challenges explored across institutions. While the financial pressures on radiology education are real and widespread, educators are leveraging technology, innovative compensation frameworks, and collaborative workflows to preserve teaching quality. I was also surprised by how much data now exists around topics like educational debt and application trends, providing evidence to guide conversation and advocacy. Contributors did not just describe problems; they offered tangible and implementable ideas.
I hope readers walk away with renewed recognition that:
The JACR continues to be a valuable forum for advancing education and leadership in our field. We are grateful to the authors who contributed their expertise and to Ruth C. Carlos, MD, MS, FACR, and Christoph Lee, MD, MS, MBA, for inviting us to serve as guest editors. We are confident this focus issue will spark meaningful dialogue and contribute to real progress in how radiology education is valued, supported and delivered.
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