.

IR is hot right now. I think with the new boards format it will become a stronger field. I actually think the new boards format is bad for DR ultimately.

But since IR's focus is significantly different, it is helpful to have a "mini-fellowship" in PGY-5 year to either hone in on basic technical training so you are ready to rock starting fellowship, OR more importantly learn more about the clinical aspect of IR by rotating in the ICU, NeuroICU, vascular surgery, GI etc.

The more IR guys that we churn out who take an active role in patient care, the stronger and more dominant the field will become. IR varies so much right now, from being a simple "mahukar service" at some places to a high end clinical specialty that takes care of dialysis care in addition to high end oncology, vascular disease, women's health,msk and neuro cases.

So it's no secret IR is a pretty popular fellowship as it seems about 20% of residents in DR apply (1000 rads residents and 200 apply IR). Over the last 3 years the number of applicants has doubled from 109 in 2009 to 205 in 2011. The number of positions offered has increased from 185 to 216 over that same period.

So I have 3 questions:
1. What has been everyone's take or what have you heard via word of mouth on the number of rads residents interested in IR these days? Note and correct me if I'm wrong I have also heard that applicants overall to DR are down about 15%??

2. Do you guys see IR fellowships expanding in the future to meet the growing demand for fellowship spots?

3. Also I realize that you do not necessarily have to do an IR fellowship to do some of the more basic interventional procedures. So you do guys see the training in fellowships changing in the future by length and/or procedures done?

I think there are quite a few fellowship spots out there, but there are a handful of IR fellowships that offer comprehensive training in all that a true clinical IR will require.

Also, there are more IR fellowship spots been taken away by the integrated training programs such as the DIRECT and CLINICAL pathway.

I agree with VIRads that the clinical component of the training may be the most important and the integration of clinical rotations during your residency is a great idea.

Rotations such as vascular surgery, surgical oncology, ICU, stroke neurology , cardiology, hepatology etc would all be invaluable to furthering your clinical knowledge base.

The field of IR is far greater than I would have expected when I was applying for residency and now as many of the IR practices become more clinical it has become critical to get that comprehensive training in the 3 pillars of IR (clinical, technical, and imaging).