Why is MSK competitive?
There have been many new applications developed for MR, recently. People with experience in the use these newer MR sequences and their applications are in high demand, and can get their pick of the best jobs.
Fellowships that include a lot of MR training include MSK, Neuroradiology, and body MR.
General MRI fellowships which offer a mix of neuro, body, and msk MR training are cropping up and these are becoming quite competitive, as well.
Why is interventional not competitive?
1) Bad lifestyle:
The trend across all specialties, is toward a better lifestyle. The near-surgical schedule turns a lot of residents off, and a lot of IR fellowship spots are going unfilled.
2) No real financial incentive for sacrifice in lifestyle
Radiology partners are essentially paid equally (at least in the south). That means the diagnostic rad who reads films from 8-5 gets paid about the same as the IR who has to be on his feet all day sweating under a lead apron from 8-6pm, and has to round on his patients before and after.
3) Losing turf to vasc surg
Vascular surgeons and to some extent interventional cards are now doing a lot of the arterial interventions once done by the IR. A lot of residents believe that IR is on the losing side of a turf war, since the vascular surgeons and cards get first dibs on theses patients.
The bread and butter of IR is now venous access, and non-vascular (billiary, biopsies, abcess drainage). Any arterial work that IR does are the difficult cases or on-call trauma cases (angiogram and embolize any bleeders) or acute arterial occlusions (which also have a propensity for happening after-hours.
OK, you still wanna do interventional radiology?