One of the most infectious maladies humans as social animals are at risk of suffering is excessive, misplaced optimism. An exuberantly affirming view of the near and medium term is exploited by the cunning and enthusiastic to excite the naïve. And no matter how sophisticated we might appear to be the lure of the prize is an ever present susceptibility ready to snare us when our guard is down.

Just think of how irrational we become when a national lottery revs up to provide an award of $100 million or more. Nearly everyone wants to buy a ticket- Hey, you never know-even when the odds of winning are infinitesimally low.

And it is not just games of chance that intrigue us. Excessive speculation can intrude into commerce and investing. Remember the dot.com bubble that broke in 2000? Can you forget the housing bubble that burst in 2007 and 2008? Currently we are in a global commodity bubble with the price of copper, for example, never higher because of the unreasonable assumption that the Chinese economy will continue to grow fast and indefinitely or at least until it surpasses the U.S. in total wealth and later in GNP per individual. But the early dotcoms generated no profits, houses were overvalued and the Chinese economy is now slowing so we should expect commodity prices to fall soon as demand recedes.

Well, radiology is not bubble proof either. We are now just starting to experience the effects of one we initiated back in 1999. The adverse consequences of the unrealistic estimations and actions that informed it are now being felt in many ways. We enlarged our residencies beginning 13 years ago in anticipation of unremitting expansion of imaging under Radiology’s purview, led by the heightened capabilities and expanding utilization of CT and MR. Yet now, for the past several years imaging volume has fallen, putting the lie to the notion that because of increasing population, especially of the elderly, and a permissive reimbursement system, unfettered growth will remain a thing of the present and a certainity for the future.

Well, it isn’t any longer. The job market for newly minted radiologists is drying up; the number of senior students interested in our specialty is decreasing year by year. In the last match, vacancies increased to about 8 % of offered slots, Medicare continues to attempt to ratchet down payments per case and insurance companies are insisting on more denials. And yet, despite these worrying signals, the cadre of radiology residents keeps expanding [1].