Radiology: Radiologys prestige problem (and solutions)

Radiology consistently ranks as a middle to low prestige medical specialty, which could deter some medical students from selecting the specialty, according to a commentary published in the August issue of Radiology. With the prestige issue likely exacerbating other challenges faced by the profession, the authors outlined the reasons behind radiology’s relative lack of prestige and solutions for combatting it.

Prestige correlates with funding and staffing. “A high prestige ranking is important for medical specialties because it may influence healthcare administrators and government officials to allocate more resources for research, education and patient care. Medical disciplines ranked higher in prestige may also find it less difficult to recruit and retain faculty, students and staff,” wrote Gary M. Glazer, MD, and Julia A. Ruiz-Wibbelsmann, MD, from the department of radiology at Stanford University School of Medicine in Palo Alto, Calif.

Although radiologists rank among the highest paid specialists, prestige often falls in the middle to low range, whether physicians or the public provide the rankings. This may discourage prospective radiologists, with approximately half of medical students identifying “a high-prestige career” as important to them.

Glazer and Ruiz-Wibbelsmann identified several factors as contributing to the low prestige ranking. These include: lack of patient contact, a perceived lack of intellectual stimulation and the public’s lack of familiarity with radiology as a medical specialty.

According to the authors, the lack of patient contact and minimal control over patient outcomes remove radiologists from the continuum of patient care, which might “create the perception that radiologists add little value to the clinical paradigm.”

In addition, many still perceive radiologists as isolated in a dark room, buried in chest films, which feeds into the perception that radiology lacks intellectual stimulation. Physicians and administrators also may perceive imaging services “as commodities distinguished by cost rather than expertise,” wrote Glazer and Ruiz-Wibbelsmann.

The authors noted that increased funding for medical school radiology departments could spark research and educational programs and build departmental infrastructure, which could “enhance the intellectual vibrancy of radiology” and attract students.

Introducing medical students to radiology earlier in medical school (before the third or fourth year) also might spur interest and help dispel negative stereotypes about the specialty.

“It is important to point out that, although we have identified several obstacles to increasing the prestige of radiology, almost all are potentially correctable,” wrote Glazer and Ruiz-Wibbelsmann.