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The mission of the Harvey L. Neiman Health Policy Institute® is to establish foundational evidence for health policy and radiology practice that promotes the effective and efficient use of health care resources and improves patient care.

August 16, 2021

Neuroimaging Growth for Radiology Trainees was Nearly Double the Growth for Radiologists between 2002 and 2018

Reston, VA – A new Harvey L. Neiman Health Policy Institute study found that between 2002 and 2018 neuroimaging exams increased 86% for radiologists and 163% for radiology trainees (residents and fellows). This means that neuroimaging services provided by radiology trainees increased disproportionately compared to radiologists—89% faster—over this period. While radiologists provide the vast majority of neuroimaging, the share provided by trainees increased from 3.7% to 5.3% between 2002 and 2018. This Academic Radiology study was based on 100% of the Medicare Part B claims submitted by physicians and other providers nationally in both academic centers and private practice.

“Whether this disproportionate growth was in response to individual institution needs, trainee needs, or broader population needs is unknown”, said Jason Allen, Associate Professor of Radiology at Emory University School of Medicine. Although the number of trainees increased over this period, at the individual trainee level, the increase in workload (wRVUs) was still 120% between 2002 and 2018 with neuroimaging accounting for 33% of trainee workload in 2018 compared to 28% in 2002. “One potential explanation for the greater rise among trainees may be the overall increased utilization of advanced neuroimaging in the emergency department, an environment often covered predominately by trainees after hours and weekends. In addition, the volume of afterhours imaging has also increased for inpatient services likely further increasing the number of neuroimaging studies interpreted by trainees.”

“While radiology training programs aim to prepare trainees for clinical practice, the relationship between trainee and national radiology workforce demands is unclear”, said Eric M. Rubin, MD, Radiology Chief at Crozer Health and Chair of the ACR Commission on Human Resources. Over the 2002-2018 period, neuroimaging claims increased for brain, head and neck, and spine imaging for both radiologists and trainees. Among radiologists, these increases were most pronounced for head and neck (159%) and spine (153%) compared to brain (54%) imaging with CT accounting for most of this growth. This same pattern held with trainees, but their imaging growth was 91%, 124%, and 78% faster than radiologists for brain, head and neck, and spine imaging, respectively. “While sub-specialization is promoted in academic settings and by the new American Board of Radiology examination schedule, multispecialty radiologists can support broader population needs. Streamlined access to supplemental educational content from professional societies for non-neuroradiology trained, multispecialty radiologists is a direction that could help meet the growing need.”

To obtain a copy of the study or to arrange an interview with a spokesperson, contact Nichole Gay at (703) 648-1665 or


About the Harvey L. Neiman Health Policy Institute

The Harvey L. Neiman Health Policy Institute® is one of the nation’s leading medical imaging socioeconomic research organizations. The Neiman Institute studies the role and value of radiology and radiologists in evolving health care delivery and payment systems and the impact of medical imaging on the cost, quality, safety and efficiency of health care.Visit us at and follow us on Twitter, LinkedIn and Facebook.


Nichole Gay
Harvey L. Neiman Health Policy Institute