Considering a surgical career? Take a look at Interventional Radiology

[DocIR]

For those thinking of a career in surgery, you owe it to yourself to also take a look at Interventional Radiology. As someone who is both a surgeon and IR, I can tell you that the field of IR is not only exciting but also the most technologically advanced field in medicine. If you like playing with cool toys, this is your field.

Most students (and even physicians) don't have any idea about the kinds of high end cases IR does. From stroke to aortic aneurysms to PAD to cancer to uterine fibroids to deep vein thrombosis to pulmonary embolism to hepatobiliary disease....IR really covers a large variety of disease conditions.

Take a look at the link above for a great video that takes a deeper look at the field of IR. Even if you are not interested in IR, I encourage students to spend even a couple days shadowing IR so that you can learn about the kinds of things we do so that maybe one day you may be able to help your patient. Finally, if anyone is serious about learning about IR at one of the leading programs in the country, consider applying for our IR elective.

http://www.pennmedicine.org/interventional-radiology/academics.html


Deepak Sudheendra, MD, RPVI
Assistant Professor of Clinical Radiology & Surgery
Hospital of the University of Pennsylvania - Perelman School of Medicine

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[Siggy]

Downside? Brain cancer.

 

[DocIR]

Actually that is incorrect. Cancer in IRs is not significantly higher than the general population. However musculoskeletal problems are from wearing lead.

 

[Mad Jack]

Actually that is incorrect. Cancer in IRs is not significantly higher than the general population. However musculoskeletal problems are from wearing lead.

Just make sure to wear eye protection, because cataracts...

 

[Winged Scapula]

Downside? If you want to be a surgeon, doing procedures rather than actual operative cases may not be satisfactory.

By way of clarification, despite Dr Subheendra's impressive resume, he appears to have only finished 3 years of surgical residency and then switched into Radiology and therefore describing himself as a surgeon is a bit misleading.

 

[DocIR]

Winged Scapula is right. I am not a board certified surgeon. However I do work as a cardiothoracic surgical critical care attending so I am still very involved in the various aspects of surgical care.

 

[Winged Scapula]

Winged Scapula is right. I am not a board certified surgeon. However I do work as a cardiothoracic surgical critical care attending so I am still very involved in the various aspects of surgical care.

I'm intrigued: I've worked with anesthesiologists, emergency medicine physicians, internists and of course surgeons as SICU attendings. I've never seen a radiologist, even an interventional one, serve in that capacity. How common would you say this is?

 

[Psai]

nvm

 

[Pisiform]

I am interested in a lot of things but my board scores say otherwise

 

[seminoma]

I am interested in a lot of things but my board scores say otherwise

So what you mean is your board score says you're only allowed to be interested in Derm?

 

[Pisiform]

So what you mean is your board score says you're only allowed to be interested in Derm?

Haha nice one!

 

[DocIR]

Here is the link to the video (). Click on the watch vimeo and it should work

Winged Scapula, it is not common at all for an IR to work in the SICU. I may be one of the only ones in the country but I don't know. The only reason I can do this is because of the surgical training and in my surgical residency we got an amazing amount of critical care experience. What does make different as an IR is that I admit and manage all of my own complications. Our IR service is pretty progressive and we admit all of our own patients. However I also admit my own patients when they have complications and I am the only IR attending that admits patients to the ICU under my own name and not a surgeon/internist's name.

 

[yanks26dmb]

Whats the competitiveness for getting into IR like? Any real benefit to having an IR physician in the family?

 

[Gastrapathy]

Whats the national IR market like? Its pretty saturated in my neck of the woods.

How much call does a typical IR take? Weekends?

I also think playing up your surgical training is a little ridiculous. The last half of their training is pretty darn important. I did 6 weeks of OB as a medical student but I sure didn't want to deliver my kids.

 

[scoKraz4]

Embolization of arteries is pretty cool too

 

[Kaustikos]

Embolization of arteries is pretty cool too

Seriously. Especially chemo-embolization.

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[DocIR]

The job market for IR is competitive and depending on where you live it may be saturated. Overall, IR fellowships are extremely competitive. IR is needed in every hospital big or small and so there is a lot of room to grow IR in many practice settings. Many hospitals are not scratching the surface of high end cases that IR can offer.

As for as call, I would say on average IR call is every 4th-5th night and weekend in private practice. It depends on how many IRs are in the group but that is average. IR call can be very busy depending on how many hospitals one is covering and if the hospital is a trauma center.

I am in academics so things are a bit different. I am on call one weekend every 3 months and once every 14 weeknights as there are 14 IR attendings in our group. I do tons of chemembolization, radioembolization, tumor ablation, DVT thrombectomy, IVC recanalization, TIPS, and saphenous vein ablation. Our practice does a lot of high end IR and we have a robust out patient clinic which makes for a very rich IR experience.

 

[Senor Pez]

IR seems super cool. DR is interesting too, but I'm not really a dark room all day kind of person. I like the idea of lots of patients and procedures

Which is why I am interested in these new IR residencies. Does anybody have insight towards their competitiveness and where the programs are? I am only an MS1, but I'd like to start pursuing this cool field early. Maybe consider looking into both IR and DR at the same time?

 

[Gambler 101]

Just a few thoughts out of curiosity. How would one decide between this and Vascular? Which of those options offers the most job security?

 

[SLUser11]

Downside? If you want to be a surgeon, doing procedures rather than actual operative cases may not be satisfactory.

By way of clarification, despite Dr Subheendra's impressive resume, he appears to have only finished 3 years of surgical residency and then switched into Radiology and therefore describing himself as a surgeon is a bit misleading.

Agree with WS. There's definitely nothing wrong with preferring radiology over surgery, but it should be made clear that the OP is not a surgeon, so his opinions don't represent that of a surgeon.

The two fields are very different from eachother, not only in pathway but also in daily life. If a student is having a hard time deciding which way to go, then shadowing both specialties is a good idea.

On a side note, I would second the OP's comments that the IR job market is saturated in many urban areas, including my own.

 

[irwarrior]

Yes. The field of interventional radiology is relatively new. It truly began in 1964 when Charles T. Dotter percutaneously opened up a femoral artery on a lady who had no surgical options and refused an amputation. In a brief 50 years , the field has rapidly involved to treat various conditions from symptomatic fibroids, cancer (ablations and trans arterial therapy), vascular conditions (DVT/PE/peripheral arterial disease/varicose veins/aneurysms), acute stroke therapy /intracranial AVMs and aneurysms and general IR (biliary, GU,GI conditions). It is becoming an integral part of health care and we are also involved in post partum hemorrhage (to try to preserve the uterus but also to save a new mother's life), traumatic conditions (solid organ) .

The scope and breadth of IR has grown and has required much more intrinsic clinical training then was historically allotted (conventional training is 28/72 months) with the new allotted time being 40 out of the 72 months. Due to the extensive knowledge needed to learn the anatomy and pathology of head to toe it requires 3 years of radiologic study. The American Board of Medical Specialties recognized the importance of IR and in fact has made it a separate discipline and granted it a primary certificate status in September of 2012. It is now available for medical students who would otherwise be interested in surgical fields for consideration and a handful of programs are now available. When practiced the right way the existence is more like a surgical field. i.e. morning rounds, hospital admissions, surgical days, outpatient clinic and evening rounds. Call can be busy as we can get called in for a host of emergent conditions from gi bleeds, hemoptysis, trauma, abscesses, biliary sepsis, acute hydronephrosis, DVT/PE, stroke , acute limb ischemia, pseudo aneurysms etc. I do think it is worthy of exploration or consideration as you go through your medical school years.

 

[Ischemia1032]

Maybe consider looking into both IR and DR at the same time?

Just an FYI, you cannot do IR and DR separately. The new system is a combined DR/IR 6 year residency. You cannot do IR unless you are good at IR. This is not even looking at INR in which you also need to do a fellowship in NR. Radiology is not such an easy lifestyle specialty as it used to be, especially if you are doing IR or INR.

 

[pd1112]

Just an FYI, you cannot do IR and DR separately. The new system is a combined DR/IR 6 year residency. You cannot do IR unless you are good at IR. This is not even looking at INR in which you also need to do a fellowship in NR. Radiology is not such an easy lifestyle specialty as it used to be, especially if you are doing IR or INR.

wut