Radiology faces structural, cultural, and systemic challenges that threaten the sustainability and quality of its research. This article critically examines the complex factors shaping radiological research engagement, emphasizing the need to redefine academic value systems within the specialty. Radiology training remains largely generalist, limiting disease-specific clinical insight, while rapid technological advances have shifted research toward engineering and computational fields, eroding radiology's clinical ownership of imaging innovation. Multidisciplinary collaboration among radiologists, clinicians, physicists, and data scientists is essential to maintain clinically meaningful and translational research. Establishing disease-focused groups within professional societies will surely promote subspecialized expertise and guidance. Training and mentorship gaps further impede progress. Traditional curricula provide limited research exposure, while early subspecialization, structured mentorship, and integrated research training during residency are proposed to foster clinical excellence and scientific engagement. Increasing productivity demands, together with unprecedented digital workflow pressures, contribute to cognitive overload and burnout. These factors discourage participation in research. Institutional reforms ensuring protected research time, equitable recognition of academic work, and improved cognitive ergonomics are vital for innovation. Funding constraints and limited grant-writing skills reduce competitiveness, as imaging research often struggles against therapeutic fields. Developing collaborative research networks and scientific writing training can enhance funding success. Finally, quantity-driven academic metrics promote low-value publications. A shift toward value-based evaluation-prioritizing clinical relevance, methodological rigor, and collaboration-is therefore needed. Radiology must realign its academic structures to sustain high-quality research and reaffirm its dual role as a clinical cornerstone and scientific innovator. The Cancer Image Europe (EUCAIM) infrastructure facilitates collaboration among radiologists, clinicians, researchers, and innovators, representing a valuable opportunity for radiologists in training to engage in research. CRITICAL RELEVANCE STATEMENT: Radiology faces structural, cultural, and systemic challenges that threaten the sustainability and quality of its research. This article critically examines the complex factors shaping radiological research engagement, emphasizing the need to redefine academic value systems within the specialty. KEY POINTS: Radiology must overcome structural and cultural barriers to sustain impactful research. Multidisciplinary collaboration and disease-focused training are key to clinical innovation. Reforming evaluation systems and protecting research time are essential for progress.
Martí-Bonmatí et al. (Fri,) studied this question.