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Objective:
The study aims to investigate which characteristics are deemed the most and least important by program directors from various diagnostic radiology subspecialty fellowship programs when selecting a fellowship candidate.

Materials and Methods:
An online survey of radiology fellowship program directors in the United States was conducted. A total of 6 different radiology subspecialties were surveyed, including abdominal/body/cross-sectional imaging, breast/women’s imaging, cardiothoracic imaging, musculoskeletal imaging, neuroradiology imaging, and pediatric imaging. A total of 22 questions were grouped into four general categories of demographics, personal characteristics, extracurricular activities, and educational accomplishments. A standard 10-point Likert scale was used to rank each applicant’s characteristics, with 10 being the most important and 1 being the least important characteristic.

Results:
A total of 119 responses were collected from the invitation, corresponding to an overall response rate of 26.2% (119 of 455). A relatively balanced response was collected from different subspecialty program directors. An aggregate analysis of all the subspecialties showed interview performance, letters of recommendation, and residency program attended as the three most important factors considered by the program directors when selecting a candidate for their fellowship program. In contrast, the three least important factors were gender, prior subspecialty training, and minority status. The applicant's visa status, personal statement, and USMLE step 3 performance were the only statistically significant (p < 0.05) differences between the subspecialties. Women’s and body imaging rated the personal statement as more important than musculoskeletal imaging and neuroradiology. Cardiothoracic and musculoskeletal imaging rated the applicant's visa status as more important than neuroradiology. Women’s and cardiothoracic imaging rated USMLE Step 3 performance as more important than musculoskeletal imaging.

Conclusion:
Selecting the ideal candidate for a fellowship in radiology can be a difficult task. Our findings outline which applicant characteristics program directors believe are the most and least important when selecting an ideal candidate. For instance, personal characteristics such as interview performance and letters of recommendation are more valued than extracurricular activities such as research experience. Our findings are similar to a study conducted in 2012, which showed interview performance and letters of recommendation as the most important subjective applicant characteristics and residency performance and residency program prestige as the most important objective characteristics. Identifying these characteristics provides a better understanding of the fellowship application process and may guide future applicants.