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Interventional Radiology

Discussion in 'Radiology' started by Crusher, May 30, 2002.

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  1. Crusher

    Crusher Member

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    Tons of questions...

    Anyone know what the lifestyle of interventional radiology is say compared to one of the "better" surgical subspecialities like ENT or Opthamology? I know they have to actually come in on call as opposed to a regular radiologist who might be able to read films from home...

    Also, what is the compensation like. I'm assuming its higher than standard radiologist. Is it along the lines of the surgical subspecialities mentioned above, more, less?

    Is obtaining a fellowship hard? Are there problems finding jobs in this field? Prediction for the future in this field??

    Thanks for your time!
  2. xraydoc

    xraydoc

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    Good questions. I suggest that you think about shadowing a interventional radiologist for a day or so.

    I almost went into interventional radiology but just decided that being on call ever 3-4 nights and weekends and staying later than 5-6 just wasn't for me.

    IR is an incredible speciality that is growing in leaps and bounds. Much of the IR procedures are now therapeutic ones, because CT and MRI have taken away the diagnostic angiography. When I did my rotations we spent most of the day putting in stents, filters, pic lines, doing biopsies, embolizing tumors and bleeders and clearing dialysis ports etc... Some of the time is spent doing diagnostic work like cerebral angios, run-offs and aortograms.

    If you are considering IR you must make sure that you like general radiology!! Because unless you are going to work at an academic medical center, you will probably do about 25-50% general rad (plain films, CT, MRI etc...) with the other in interventional.

    It can be a greuling lifestyle, much the same as some surgical specialities, but it is very exciting and rewarding. The hours are usually less than the main surg specialities due to the fact that you generally don't follow patients for a long period of time.

    The fellowships last 1 or 2 years. One year for general IR and 2 for neuro IR, although most IR do neuro as well even if they have not had the extra year, they just don't do embolizations of cerebral aneurysms and other complicated head stuff.

    The job market for IR is as stron or stronger than general rad right now. The salaries are amazing. Depending on what area of the country you want to go you could end up starting at 400-500K. In general the differential between the IR and the general rad in salary depends on the group you join. Many groups pay partners all the same. Some groups give production bonuses. Statistically the average IR does make maybe 20-30K more than the average general rad. This may be due to some IR who have solo practices or do a lot of locums work. So the average IR salary would be much the same as general rad--about 310K in 2000, but probably about 350 right now because of the tight job market.

    Sooo if you like general rad and enjoy helping people and saving lives on an immediate basis like an IR can, then maybe this field is for you.
  3. analu

    analu Senior Member

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    Sorry, just checking...so is that a 4 year residency in Diagnostic Radiology and then a 1-2 year fellowship in IR? Or is a surgical residency required?

    And was the q3-4 call because of the limited number of people doing IR in their group?

    Thanks in advance!
  4. xraydoc

    xraydoc

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    Yes, 4 year residency in radiology (or five if you do an internship) then 1-2 years in IR fellowship. The call is higher because there are fewer in the group usually and general radiologists usually don't take IR call.

    Another thing, IR call is usually less intense and busy than say surgical call. Of course there are the exceptional calls where you are up all night, but unless you are part of a very busy group, I think these would be the exception. I think that although you would work harder than your general rad colleagues, the work load is quite doable and in general less work and stress than in the surgical specialities.
  5. analu

    analu Senior Member

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    Thanks a lot, xraydoc, sounds like IR is perfect for someone who enjoys procedural medicine but doesn't want the workload of one of the surgical subs...
  6. fife

    fife Junior Member

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    Don't be fooled, IR is not a lifestyle field. The call schedule is MUCH more demanding than ophtho, ENT, or Urology. Granted, you don't follow patients, but they are in the hospital A LOT. Many residents in Radiology don't even try for IR simply because the schedule.

    There is a fundamental difference between surgery and "procedures." Doing surgery in the OR is a completely different experience than putting in a stent. I find the IR procedures to be somewhat boring, but that's just me. As a surgeon, there is a great variety in what you do.

    I also have a problem with the IR docs not following patients at all. Basically, a patient is brought into the room, a procedure is done, and the patient leaves. That's it. Personally, this just doesn't do it for me.

    The salaries are very high right now. I wouldn't count on them staying so high forever. Managed care will eventually have an impact here, unfortunately.
  7. xraydoc

    xraydoc

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    Most IR do follow patients to some degree. Many have their own clinics and see patients in the hospital that they have done procedures on until they are discharged. That is the way it was at both of the institutions that I have been at. We did the initial admits saw them wrote notes and discharged them. We even fielded calls on our procedure patients over the weekends and managed their pain and such. Granted it is not as rigerous as general surgery but that is a plus that I see. It is simple as asking an IR and a surgeon about their jobs and having them tell you what they think are the advantages and disadvantages, don't take my word for it. Again it is a personal preferance wether you like IR or surgery. I personally found general surgery more boring and monotonous than IR. Most IR procedures are less than an hour then I could get on with another one. Most of the time you can see immediate results as well. But that is why there are different specialities for different personalities.

    As far as salaries go it is more a factor of supply and demand. The supply of radiologists and specialists is low now and will probably remain so for some time. The penetration of managed care is actually decreasing especially here in the midwest. This also makes it favorable for salary increases for specialities such as radiology. The future is difficult to predict, but I think that due to the supply and demand as well as the aging population and the general publics want for high tech procedures the radiology salaries should be way above the median of physician salaries for some time to come.
  8. analu

    analu Senior Member

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    fife, you hit the nail on the head...I got a chance to spend some time in IR, and the workload is INTENSE! There is lots of call (the group I visited had three guys doing IR, three guys doing DR full-time, and a couple of retired rads coming in on a part-time basis), and the hours are DEFINITELY NOT laid back like some other subspecialties. The IR guys also spent a fair amount of time picking up the regular radiology workload as well.

    Guess I had to see it to believe it!
  9. standoc

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  10. hopefulmed

    hopefulmed

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    Digging up an old thread:

    So everyone talks about the grueling hrs, but no one really give a realistic example. What is the TYPICAL week like for a private IR doc 3 years out? I've seen a lot of job listings asking for DR with 25% IR (or some variant). For someone like myself who probably would enjoy some mix of DR and procedure with minimal, but intense and focused patient contact, this sounds like a perfect combination.

    How safe is IR in term of radiation exposure? Can't seem to find any studies that look at long term outcomes.

    Thanks
  11. hans19

    hans19 I'm back... Moderator Emeritus

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    http://bjr.birjournals.org/cgi/content/abstract/71/849/954

    It would be similar to interventional cardiology or an orthopod or vascular surgeon who does a lot of fluoroscopic work. There is a risk of dose dependent cataracts. Make sure you always wear leaded goggles.

    At least as a radiologist you understand the principals of ionizing radiation and can utilize techniques to minimize exposure.

    As far as risks go, I would be more concerned about driving to and from work every day.
  12. hopefulmed

    hopefulmed

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    thanks for the reply Hans.

    One more general question, when applying for radiology spot, is it a "taboo" to explicitly express an interest in IR in personal statement and interview?
  13. hans19

    hans19 I'm back... Moderator Emeritus

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    If you are applying to a DIRECT pathway spot, absolutely. I don't think mentioning an interest in IR would hurt, just don't make statements that pigeon hole you to IR. Your interviewers will be from all different subspecialties and might be turned off if you are too gung ho IR from the start.
  14. jeffreyfrog

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    In general, interventional radiology is largely procedure-oriented with some interpretation of CT and MR angiography; institution dependent, sometimes body radiologists read these. VIRs also interpret the conventional angios they perform, however, it's becoming more common for Vascular Surgeons to do their own angios/runoffs, a lot of endovascular work and stenting. mountain view radiation oncologist
  15. Gallix23

    Gallix23

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    I don't think this is universally true. The IR that my mother works with (she's a CCRN) works a 9-4:30 shift like four days a week, gets 12 weeks vacation a year, and gets to do a mix of relatively "easy" procedures and reading films. He said himself that he wouldn't have been able to handle the hectic lifestyle of surgical specialties outside of rads.
  16. MasterShakeDO

    MasterShakeDO The Drizzle

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    Gotta love the 5 year thread bump.
    Why Not MD? likes this.
  17. buccsmf1

    buccsmf1

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    From the other side... my dad works 7-5, 5 days a week with call once every 4 weeks. Says some days he doesnt have enough free time to check email, let alone eat lunch.
  18. Kitra101

    Kitra101 Senior Member

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    :confused::confused:

    That is a good schedule!
  19. MossPoh

    MossPoh Textures intrigue me

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    Nothing is universally true. For every person you have with a nice 4 day a week schedule you run into someone like my dad that worked 72 to 80 hours a week with q2 or q3 call. Ok, maybe not for every person but it can go both ways.
  20. ioncell

    ioncell Erad

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    these threads just dont die !
    because :

    residents still "hide" their passion to interventional procedures (and $$$,no patient follow-up,fast ,getting some high-yield procedures i.e: verterbroplasty) untill they finish their boards !

    nobody wants to be "tagged" in their early residency by PDs , they think he just ignore the main bulk of radiology teaching by just focusing of IR,

    Realistically speaking : how can you be really assured getting IR fellowship spot ?

    i am sure our fellows got a lot of stories , HANS ?
  21. hans19

    hans19 I'm back... Moderator Emeritus

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    If you work hard, get the right letters, know the right people, you will get the fellowship spot that you want.

    I agree. For those that like working with their hands,
    IR is great. Most procedures are quick compared to most surgeries with instant results. Most cases are not too involved in the way of follow-up. Even for big cases, we follow patients for just a few days tops. I think part of the reason IR is well compensated, is that the procedures are short. Also you get paid more for doing procedures than clinic visits. If you do full time IR you will be doing procedures most days with maybe a day tops for clinic. Compare that to surgeons who operate 2 days or 3 days a week, the rest of the time is clinic for preop and post op follow up.

    I am out of the IR suite this week and I miss it already.
  22. inamem

    inamem

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    I am also interested in interventional radiology. I don't care too much about the schedule but I am a little worried how I can find out whether I have the manual skills to do it really well. When I did my MS4 electives in IR I worked with attendings which were excellent and other which were not - just based how successfully they did procedures. All of them should have gone through almost the same training, I guess. As a student I got to assist but of course did not find out to which group I would belong. Did anyone worry about that, too? Did you rotate through IR during residency - or didn't you do that to avoid the "tagging"?

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