Abstract / Summary
This review aimed to systematically review changes in radiology trainee training quality and workload before, during, and after the COVID-19 pandemic, assessing its impact on educational experiences, clinical and procedural exposure, workload demands, trainee wellbeing, and the adoption of adaptive educational strategies such as virtual learning and simulation-based training. A systematic review was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Electronic databases, including PubMed, Elsevier ScienceDirect and Web of Science, were searched for studies evaluating the impact of the COVID-19 pandemic on radiology trainee workload, education, and training quality. Supplementary searches of Google Scholar and relevant professional organisation websites, including the Royal College of Radiologists, were conducted, alongside targeted searches of Clinical Radiology and other relevant radiology publications. Although studies from multiple countries were included, findings were interpreted in the context of the UK radiology training curriculum and changes to radiology training and service provision during the COVID-19 pandemic. Eligible studies were analysed using narrative synthesis. The COVID-19 pandemic significantly affected radiology trainee workload and training quality across multiple domains. Common findings included reduced clinical exposure, decreased reporting opportunities, loss of face-to-face teaching, reduced procedural experience, and concerns regarding competency attainment. Imaging volumes declined substantially because of the postponement of elective imaging and outpatient services, resulting in reduced exposure to radiographs, computed tomography (CT), magnetic resonance imaging (MRI), ultrasound, and interventional radiology procedures. Training progression was further affected by examination delays, rota disruptions, redeployment, and reduced consultant supervision. Increased psychological burden, including stress, anxiety, and burnout, was also reported across multiple studies. Despite these challenges, radiology training programmes demonstrated adaptability through the rapid adoption of virtual learning, remote reporting, simulation-based teaching, and digital educational platforms, improving accessibility and flexibility. These adaptations contributed to the development of increasingly hybrid training models combining virtual and face-to-face learning. The COVID-19 pandemic substantially disrupted radiology trainee workload, training quality, clinical exposure, and procedural experience. However, it also accelerated the adoption of virtual learning, digital platforms, remote working, and simulation-based education. The post-pandemic period has therefore seen continued integration of these approaches alongside traditional apprenticeship-based training, with potential implications for the future delivery of radiology education and training.