April 10, 2023

Choosing a Subspecialty in Radiology

Jake Luther, MD

Jake Luther, MDAs I near the end of my first year of radiology residency, I realize I need to choose a subspecialty sooner than it seems. After watching third-year residents decide on a subspecialty, prepare their applications and complete interviews, it became clear that choosing a subspecialty in radiology is an important decision that will impact my professional and personal life in the future.

A 2017 survey of radiology trainees conducted in the United Kingdom found that personal interest, strong residency rotation, a variety of imaging modalities and direct impact on patient care were the most influential aspects of future subspecialty choices among trainees.1 Interestingly, potential private income and research were rated among the least influential aspects of choosing a subspecialty.1

A similar 2019 survey conducted in Saudi Arabia produced almost identical results to the UK study, with the addition of “favorable/flexibility of working hours and on-call commitments” identified as an important work-related factor in choosing a subspecialty.2

Obviously, training and cultural differences between the United States, United Kingdom and Saudi Arabia may lead to varied results if a similar survey were performed on U.S. residents, however, these studies do highlight some important points.

Each radiology department at a given institution varies in educational quality, attending background and case volume. Therefore, it may be important for trainees to seek out additional exposure if they feel that their experience is lacking in a certain subspecialty at their program. Setting up a rotation at an outside hospital or private practice may be a beneficial option.

Flexibility in schedule and the amount of time on-call are also important features of a future job and can vary widely between subspecialties. Additionally, it is important to consider if direct patient contact or a remote setting is preferred.

You may be asking yourself, “How do I narrow down which subspecialty is for me?” Perhaps the easiest way is to seek advice from attendings at your institution or from a mentor at an outside practice. Reaching out to faculty in private practice or at a desired fellowship location is never a bad idea and has the potential to lead to a fellowship position or job opportunity in the future.

Joining a subspecialty society, such as the ACR®, is another great way to gain more information and potentially get involved. Most societies are free for trainees, and if a fee is required, check with your residency coordinator to see if your program will cover the cost to join. For example, the ACR offers free membership to qualified residents with complementary access to all ACR member benefits until you are certified by the American Board of Radiology.

Each society has annual meetings that you can attend as a member, and members receive access to online career resources. Perhaps the best part of joining a society is the ability to explore new and upcoming research and technology in a particular field. The ACR Fellowship in Informatics, for instance, provides one-on-one mentoring in the field of informatics and introduction to initiatives of the ACR Data Science Institute® and ACR AI-LAB™.

Most radiology trainees determine their subspecialty through a fellowship, which can be a daunting and impactful experience. Fortunately, you have plenty of time and a number of pathways to explore the subspecialty best for you.


  1. Parvizi, N. and Bhuva, S. “A National UK Survey of Radiology Trainees Special Interest Choices: What and Why?,” British Journal of Radiology, 2017: Vol. 90; No. 1079; DOI: 10.1259/bjr.20170338.

  2. Alturki, S.T., Albusair, M.K., Alhumaid, F., Alsharif, S., Aljalajel, K.M., Aloufi, F., Almotairy A. “Factors Influencing the Choice of Radiology Subspecialty Among Radiology Trainees in Saudi Arabia,” Cureus, 2019: Nov 13;11(11); DOI: 10.7759/cureus.6149.