When Paul H. Ellenbogen, MD, FACR, former chair of the ACR BOC, attended medical school in the 1970s, only four students in his class were women. Just nine percent of radiologists were women. 

Paul H. Ellenbogen, MD, FACR

“Radiology has come a tremendous way in terms of diversity over the last 10 years,” he says. The ACR Commission for Women and Diversity was established in 2013, during Ellenbogen’s time as chair. Just six years later, a shift occurred beyond radiology. Medical student Christina Shehata, chair of the ACR Medical Student Section and future radiology resident, had a front-row seat. “When I applied to medical school in 2019, it was the first time more women were enrolled in U.S. medical schools than men,” says Shehata.

She and others also saw increasing diversity among ACR leadership and fellows at the 2024 ACR Annual Meeting: “The first woman CEO of the ACR was announced this year, and two of the ACR Gold Medalists were women, one of whom was also the first Black women to be awarded Fellowship of the ACR,” she says. “I’m excited for the future.” 

Creating a Spark

“When the American Association for Women in Radiology approached me about becoming more closely involved with the ACR in 2013,” says Ellenbogen, “I realized that as ACR chair I could do more than that; I could create a new commission, which would not only provide this delegation with ACR support and staff but would give other additional underrepresented minority members a larger podium from which to speak.”

The first woman CEO of the ACR was announced this year, and two of the ACR Gold Medalists were women, one of whom was also the first Black women to be awarded Fellowship of the ACR.

Katarzyna J. Macura, MD, PhD, FACR

One of the Commission’s first projects was to research and report on the state of women and underrepresented minorities in radiology, a project that continues today. “One of the ways we began moving the needle was to track the composition of our workforce. Before the Commission started its research, that wasn’t really being done at the ACR,” says Katarzyna J. Macura, MD, PhD, FACR, who first chaired the Commission. “The College was the first radiology organization to not only celebrate diversity but to be strategic about making progress toward a more diverse workforce. And to truly make movement, we must be data-driven in how we pursue our projects. Not only to establish a baseline, but to mark progress and measure our success.” 

Exposing Future Generations

Michele H. Johnson, MD, FACR

Another critical project led by the Commission and Michele H. Johnson, MD, FACR, is the Pipeline Initiative for the Enrichment of Radiology (PIER) internship, which first launched in 2017. The PIER internship gives underrepresented minorities and women medical students an opportunity to explore radiology and engage in research. Past interns have attended weekly shadowing sessions with a mentor, engaged in resident-level presentations, worked on research projects, spoken with program directors and women in radiology across the country and created Case-In-Point publications. “When we were building the Commission and implementing its agenda,” says Macura, “we knew it was critical to expose students to role models who looked like them so that the students could envision themselves in the future.” Allowing students an inside look at radiology has been successful. According to Macura, an estimated 70 percent of PIER participants have pursued radiology residencies. 

Continuing the Fight

Ellenbogen, Macura and Shehata are optimistic about the future of diversity for the specialty. “I think it’s likely that if we look at the College in another decade or two, we will not only be very diverse but representative of the patients we serve. We’re going to see more women and minorities promoted to higher levels [of leadership] and become involved in more ACR commissions,” says Ellenbogen. 

“There’s a lot to celebrate, but we still have a lot of work to do,” says Macura. Shehata notes that although the number of women and underrepresented minorities within the specialty is increasing, most radiologists are still White men. 

Christina Shehata

What to do about these issues? To grow the specialty and continue to be inclusive, the College should continue supporting medical student education, particularly in preclinical curriculums and advocate for radiology to be incorporated more in early medical school curricula, advises Shehata. “One of the best ways to increase diversity is to give students the opportunity and time to explore radiology early on,” she says. Ellenbogen stresses that continued support from leadership is critical, not only in organizations like the ACR but also academic institutions and private practices. “We need to ensure that important projects like PIER have the dedicated resources to continue making progress,” he notes.

Macura suggests that efforts should continue at the state level, where members are most directly impacted. “There, we can not only engage young people to participate in the specialty but also to be involved, run for office and affect the policy of the future,” she says. “To enhance our future, we must empower the next generation with the tools to move forward.”