Radiology’s much-discussed workforce shortage may not be a national problem at all, but a matter of geography. That is the suggestion of a new analysis from RadBoard.io, which studied the U.S. job market and concluded that many unfilled openings are clustered in regions that radiologists themselves consider undesirable.
Two markets layered on top of each other
Since the COVID-19 pandemic, it has become almost conventional wisdom to say radiologists are in short supply. The reasoning is familiar: exam volumes keep rising with an aging population while the workforce stays essentially flat. The new study does not deny the pressure on the field, but it challenges the notion that the strain is uniform across the map.
Researcher Kirill Lopatin examined 20,800 job postings published across the United States over 78 days. After filtering out repeats, roughly 11,000 unique ads remained — meaning at least 47% of the listings were simply re-posts of the same role, and the true figure is probably higher.
By tracking the full lifespan of each ad, from posting to deactivation, the study found a revealing pattern. About 25% of openings were filled in under a week and another 12% within two weeks. At the other end, 28% took 31 to 60 days, and 2.3% stayed open between 61 and 90 days — sometimes longer. RadBoard’s conclusion is blunt: radiology does not have a single fill rate, but “two markets layered on top of each other.”
The rise of the “zombie job”
RadBoard coined the term “zombie jobs” for listings that remain open for more than 60 days. To measure the problem, it built a “stuck rate” — the ratio of ads open longer than two months to all open ads. It is a simple metric, but it exposes a divided country.
States such as Nebraska (68%), Minnesota (41%) and Washington (35%) top the list of stuck markets. Florida (18%), Texas (15%) and New York (14%), by contrast, fill their roles quickly. The authors read this to mean the radiologist shortage is not nationwide: it is concentrated precisely in areas where physicians do not want to live, far from major hubs and the infrastructure that tends to come with them.
The contrast is striking: in the worst markets, roughly two of every three open roles are effectively stranded, while the strongest markets clear most of their listings within weeks. That gap, more than any national headcount, is what RadBoard argues should reframe the conversation around the workforce.
The pay paradox
Here lies the most counterintuitive finding of the entire report. If classic market logic held, the regions struggling most to hire would pay more to attract candidates. The opposite is true: jobs in stuck markets pay roughly US$175,000 less than those in fast-cycling markets — about US$550,000 versus US$725,000 a year.
That mismatch helps explain why so many positions simply never fill. Demand alone is not enough; salary, location and quality of life must combine into a genuinely competitive offer. In rural and remote areas, even numbers that look high by local standards cannot outweigh the pull of large metropolitan regions.
What it means in practice
For anyone running an imaging service, the message is that generic recruitment strategies tend to fail. Beating the zombie job requires packages that go beyond pay: teleradiology, hybrid models, flexible shifts and regional partnerships are usually more effective than re-posting the same ad month after month. It is no accident that adopting artificial intelligence and remote workflows is increasingly cited as part of the answer — even as it fuels the debate about the future of those who want to become radiologists.
The U.S. picture has clear parallels in other health systems. In the United Kingdom, for example, the NHS spent billions covering its radiologist shortfall in recent years, relying on outsourcing and overtime. The shared lesson is that a workforce shortage is rarely solved by more openings alone: it depends on where, how and for how much the work is offered.
For countries like Brazil, where specialists are also heavily concentrated in capital cities, the study reads as a warning. Teleradiology already helps deliver reports to towns in the interior, but retaining professionals in remote regions remains a structural challenge — one unlikely to be solved by opening new positions alone.
Outlook and study limits
The data offer a more nuanced portrait of a problem usually treated as a single block. Caveats apply, though. The analysis relies on public listings, which do not always capture hires made through referrals or headhunters, and the 78-day window is relatively short. Even so, the subtext is clear and somewhat uncomfortable: the divide between rural America and its big cities, so present across U.S. healthcare, also shapes who can — and cannot — find a radiologist to read their scans.
Source: The Imaging Wire
