200 - Attrition in Interventional Radiology Residency: A National Survey

Purpose: The integrated interventional radiology (IR) residency remains highly competitive, yet the rate of attrition of integrated IR residents into diagnostic radiology residency exceeds diagnostic radiology and is comparable to surgery {1}. This may affect the IR workforce as demand for image-guide procedures continues to grow. Surgical literature connects attrition to lifestyle, workload, and lack of support {2-4}. However, the attrition rate in IR has not yet been characterized. To address this gap, a national resident survey was conducted to assess factors influencing retention in the integrated pathway.

Materials and Methods: A national survey was distributed through the Society of Interventional Radiology Residents and Fellows Section (RFS) email list-serves from 2023 to 2024. In total, 189 residents responded, including 166 integrated IR residents. Metrics included demographics, program structure, and open-text responses. Quantitative data was analyzed with ANOVA and t-tests.

Results: Among integrated IR residents, 38% reported questioning whether to continue in IR. Key reasons included lifestyle concerns (78%), job market uncertainty (31%), and combined DR and IR call burden in residency (22%). Less common factors were pre-residency misconceptions, toxic environments, and limited early IR exposure (< 10%). Conversely, factors supporting retention included structured curricula (38%), case volume and procedural experience (35%), pre-residency IR exposure (22%), research opportunities (22%), mentorship (22%), and program camaraderie (18%). Additionally, there was no significant association between questioning IR and demographics or type of preliminary year program (p > 0.05).

Conclusion: Nearly two in five integrated IR residents have considered leaving IR, with a 3.2% attrition rate {1}. This may reflect a risk for attrition, or conversely, highlight how program support and structured training retain residents. Importantly, residents expressed continued interest in practicing IR, often in combination with DR, suggesting dissatisfaction with training structure rather than the field itself. Program design, including limited early IR exposure, disproportionate diagnostic radiology call responsibilities, and variability in training curricula influence attrition. These findings highlight the importance of protecting early IR rotations, standardizing curricula, aligning call with educational goals, and fostering a supportive culture to improve retention and ensure the sustainability of the integrated pathway.