Paediatric Radiology Grows Past 1,600 Members but Training Gaps Persist Across Europe

Paediatric radiology marked a symbolic and practical milestone in 2025 when the European Society of Paediatric Radiology held its 59th Annual Meeting and 45th Postgraduate Course in Bucharest, the first major international event of the subspecialty ever hosted in Romania. The venue carried historical weight: 111 years after the first radiology department was founded in a Romanian children’s hospital, the congress drew more than 550 participants from 52 countries. For the society itself, the meeting coincided with a period of remarkable growth. The organisation surpassed 1,000 members in 2025, reached more than 1,200 by the end of that year, and now counts over 1,600 members spread across roughly 70 countries, including 36 European nations.

The Bucharest congress also exposed the uneven geography of the subspecialty in Europe. Alongside 86 Romanian radiologists, only 48 participants came from nine other Central and Eastern European countries, and eleven countries in the region were not represented at all despite their relative proximity to the venue. The editorial authors suggest that economic causes and geopolitical issues may explain that absence, at least in part. The society welcomed 110 residents to the meeting, a figure the organisers acknowledged they would have liked to be higher, and 17 radiographers attended a session dedicated to their profession. Attendance at the scientific programme itself was strong, with almost 100% of registered participants joining the Postgraduate Pre-Congress Course and 75% attending the Annual Meeting across 24 educational and scientific sessions held in parallel rooms.

The decade leading up to the congress shows measurable progress in widening access to the society. Between 2015 and 2024, the proportion of residents among members rose from 3% to 12%, and the number of members from Central and Eastern Europe increased from 16 to 109. Nevertheless, the editorial argues that more remains to be done to engage members from that region, to increase the number of residents, and to involve radiographers more actively in the society’s work. The scientific highlights of the congress, selected for a special issue of the journal, spanned artificial intelligence, portal hypertension, lymphatic flow disorders, pulmonary imaging, central nervous system and head pathologies, renal transplantation, paediatric post-mortem imaging, MRI with and without sedation, and point-of-care ultrasound for fractures.

Beyond the congress itself, the planning and organisation of the event prompted a deeper examination of the subspecialty’s status. A survey conducted among society members in 2025 received 112 responses from 28 European countries, a response rate of 12%, with 14 countries providing at least four responses each. The structural picture that emerged was fragmented. Ten of the surveyed countries have a national society of paediatric radiology, a further 13 have a paediatric radiology section within their national radiological society, and the remaining five countries have neither. Most strikingly, no formal subspecialty training in paediatric radiology exists in half of the surveyed countries.

The training pathways reported by individual respondents varied widely. Twenty-nine percent said they have had, or currently have, no mandatory rotation in paediatric radiology during residency. Twenty-four percent reported an opportunity for only three months or less of paediatric radiology training during residency, while 4% reported no rotation at all. A quarter of respondents also reported no assessment in paediatric radiology during or at the end of residency, even when they had completed a dedicated rotation in the field. At the advanced level, 49% reported an opportunity to undertake a fellowship, corresponding to level 3 training, in the subspecialty.

When all levels of training were combined, 64% of respondents reported an opportunity for at least 12 months of cumulative paediatric radiology training, and almost two-thirds of those reported at least 24 months. Yet 15% reported less than six months of cumulated training opportunities across their entire careers. The authors caution that these figures are likely biased, because only society members were surveyed, meaning the respondents are radiologists already involved in the subspecialty who may have actively sought out favourable training pathways. Even so, the picture suggests considerable inconsistency in how Europe prepares its imaging specialists for work with children.

Against this backdrop, the editorial proposes concrete benchmarks. A reasonable goal, the authors argue, would be a mandatory six-month rotation in paediatric radiology for all radiology residents, with an assessment at the end of the rotation or as part of the final examination. A second goal would be to establish opportunities for level 3 training, whether as an optional residency rotation, a separate fellowship, or another form of advanced training lasting at least a further six months, and preferably twelve, for those wishing to practise in paediatric hospitals or to take responsibility for paediatric imaging in mixed hospitals. The survey also revealed considerable variability among countries in the number of university-affiliated paediatric radiology departments and full professors of radiology working in paediatric departments, ranging from none to just over one per million population, figures far below those for adult radiology. The consequence, the authors write, is that medical students are never exposed to the subspecialty, academic and scientific career opportunities are limited, and residents are less likely to be attracted to the field. They call for a proactive policy by universities, supported by the radiological community, alongside encouragement for paediatric radiologists themselves to pursue academic careers.

The case for investing in the subspecialty rests partly on demography and workload. In the European Union, about 20% of the population is of paediatric age, and children have been estimated to account for approximately 10% of all medical imaging examinations. Even a proportional workforce of one in ten radiologists dedicated to paediatrics would be insufficient, the authors note, because a hospital cannot employ a fraction of a paediatric radiologist, nor can 24/7 cover be provided by only one or two specialists. The actual workforce falls far short of that benchmark. In the United States, 3% of radiologists were reported to be paediatric radiologists in 2006, rising to 6.4% in 2016 before declining again to 4.6% in 2023. Estimates for Romania indicate 2.5% in 2026, based on professional societies’ data. Globally, only 15 to 50% of children’s imaging examinations are reported by radiologists dedicated to paediatric radiology, and in most countries the number of such specialists is not increasing, in some cases is declining, and in others is becoming increasingly concentrated in the main paediatric hospital centres.

Resource disparities compound the workforce problem. Most paediatric radiologists who responded to the survey feel that their subspecialty is less well resourced than adult radiology, while the workload is similar or even higher and reimbursement is the same or less. The editorial argues that working with children and their families takes more time and requires more resources, and therefore deserves greater recognition and reimbursement from healthcare authorities and society at large. The authors also address a related governance concern: the risk of other specialties taking over imaging from radiologists, mainly MRI, appears to be lower in paediatrics than in adult medicine, but it is not absent. Cardiologists performing MRI and CT is permitted in 8 of the 28 countries included in the survey. The editorial describes this transfer of imaging responsibilities as undesirable for two reasons: these clinicians are not radiologists, and they are almost exclusively adult specialists, therefore neither experienced in nor dedicated to paediatric practice.

The final challenge is generational. Many respondents noted a declining interest in paediatric radiology among residents, with survey comments suggesting that young radiologists do not want to foreclose the possibility of working with adults, which allows them to work in private practice and abroad without depending on a university hospital. Other comments indicated that young radiologists prefer reporting images to performing ultrasounds, prefer teleradiology to emergency or interventional radiology, and place a high value on their quality of life, making paediatric radiology an unattractive career choice by comparison. Hybrid working, split partly between on-site and remote practice, has been proposed as one possible way of addressing this challenge. The editorial closes on a note of resolve rather than celebration: the subspecialty has achieved many milestones, but others still lie ahead, and its practitioners must strive for greater visibility, stronger representation within academic and radiology communities, and fair recognition and appropriate compensation for their dedicated work.

Subject of Research: The status, training pathways and workforce challenges of paediatric radiology as a subspecialty in Europe

Article Title: The ongoing journey of paediatric radiology as a subspecialty

Article References: Olteanu, B.-S., Nievelstein, R. A. J., Twomey, E., & Granata, C. (2026). The ongoing journey of paediatric radiology as a subspecialty. Pediatric Radiology. https://doi.org/10.1007/s00247-026-06801-0

Image Credits: AI Generated

DOI: 10.1007/s00247-026-06801-0

Keywords: paediatric radiology, ESPR 2025, medical imaging, radiology training, workforce, Europe, residency, fellowship, MRI, ultrasound, health policy, ongoing