Abstract
This study assessed national trends and the geographic distribution of neuroradiology fellowship positions in the United States from 2009 to 2025. The Accreditation Council for Graduate Medical Education-accredited programs increased from 86 to 94 (9%), with the number of active fellows in training increasing from 250 to 262 (+5%). National Residency Match Program positions grew from 190 to 316 (66%), and fill rates improved from 67% to 91%. International Medical Graduates increased from 18.8% to 27.1%, whereas US medical doctor representation declined slightly. In 2025, 94 programs across 33 states and the District of Columbia offered 385 positions; 11 states had none. Despite national growth, programs remain concentrated, with California, New York, and Massachusetts hosting more than one-quarter of all positions. Awareness of the pipeline and its correlation with the market demand for subspecialist neuroradiologists is important for policy planning and addressing workforce needs to preserve patient access to care.