PURPOSE: Rising RVU targets and clinical workloads in academic neuroradiology raise concerns about diagnostic accuracy, patient safety, faculty burnout, and erosion of education/research missions. This national survey of division chiefs characterized current practice patterns, effort models, moonlighting, operational factors, compensation, protected time, grant support, and perceptions of sustainable productivity. MATERIALS AND METHODS: Web-based survey of academic neuroradiology division chiefs (American Society of Neuroradiology directory), with up to three reminders. 51 responses were collected anonymously and analyzed descriptively in Microsoft Excel. Questions covered workforce, clinical effort models, workload exceedance drivers, moonlighting, leadership protected time, and grant support. RESULTS: Divisions had median 11 FTE (25th-75th: 7-17.25); faculty were mostly full-time (median 90% at 1.0 FTE). Retirement risk was low short-term (median 0% in 2 years, 10% in 5 years); median 2 hires/year. Median clinical effort was 74% cFTE. Effort models split between shift-based (47%) and RVU-target (45%; typically, 40th-70th percentile AAARAD); volume caps used in only 8%. Targets were frequently exceeded, mainly due to moonlighting/financial incentives (49%) and voluntary work (32%). Moonlighting was offered in 52% of divisions (median 50% participation), yielding typical additional income of $26K-$100K/year. Protected effort medians: 20% (division chiefs), 10% (fellowship directors). Grant support was commensurate with funding in most divisions; 62% received "cap gap" support for federal grants. CONCLUSION: Academic neuroradiology faces intense clinical demands, and relies heavily on voluntary and incentivized faculty moonlighting. These findings highlight the need for accurate productivity benchmarks, operational improvements, and stronger institutional protections to sustain quality, safety, faculty satisfaction, and the academic mission.
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Wintermark et al. (2026) studied this question.
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