Demographic Changes in Radiology Residency Positions 1980–2007: The Divergence Between California and the Rest of the United States

Abstract

The objective of our study was to show the disparity in the expansion of radiology residency training slots over the past 27 years between California and the rest of the United States and to relate that divergent distribution to regional differences in medical school enrollment as a precursor and state-based per capita ratios of population to radiologist trainees as a consequence. Radiology positions were obtained from the annual editions of the American Medical Association's Graduate Medical Educational Directory. Population data were recorded from U.S. censuses for 1980, 1990, 2000, and 2007. Medical school matriculant data were provided by the American Association of Medical Colleges. The numbers of radiologists in practice were provided by the American College of Radiology. From 1980 to 2007, the U.S. population increased by 35%, predominantly in the South (52%) and West (65%). At the same time, the number of medical school matriculants remained relatively constant. Simultaneously diagnostic radiology positions increased by 55%, rising from 1980 to 1993, declining until 2001, and rising again since then. The greatest increases in radiology residency positions were observed in the Northeast and South, and the least increase was seen in the West. The greatest discrepancy between concomitant population growth and radiology resident positions occurred in California where training slots increased by 17% while population grew by 54%. Since 1980, a disparity between population growth and radiology residency position growth has been sustained between the West and the rest of the country. This disparity is a consequence of California's policy of restricting medical school enrollment and radiology residency positions despite continual population growth.