Musculoskeletal Radiology Fellowship Application and Selection Process: Perceptions of Residents, Fellows, and...

This study aimed to assess resident, fellow, and fellowship director perceptions of the musculoskeletal (MSK) radiology fellowship application process.

A task group constructed three surveys with questions about current and "ideal" fellowship application and selection processes. Surveys were distributed to MSK fellowship directors, who were also asked to give separate surveys to current fellows. US and Canadian radiology residency directors were asked to distribute surveys to current R3 and R4 residents. Responses were tabulated and analyzed.

Responses were received from 47 MSK fellowship directors, 73 MSK fellows, and 147 residents. Fellowship directors and fellows reported that most fellowship offers occur between July and September of the R3 year, although 19% of directors made offers as early as the R2 year. Of the 43 director respondents, 31 (72%) noted "pressure from other programs" as the main driving force behind their policies, but 28 (65%) felt that their timelines were "too early." A formal match was supported by 55% of responding fellowship directors, 57% of fellows, and 61.9% of residents, citing "fairness" as a major justification.

MSK radiology fellowship selection occurs as early as the R2 year, before many residents have had substantial exposure to different subspecialties. An "arms race" has developed with programs moving their timelines earlier in response to the actions of other programs, presumably to avoid missing the best candidates. Although a majority of respondents would support a formalized match to increase fairness, there is not universal agreement that it would be the best approach.