Interventional radiology

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.

shark2000

Full Member
10+ Year Member
Joined
Dec 9, 2011
Messages
1,368
Reaction score
530
This is my personal opinion and you may or may not agree.

Few facts about IR:


1- These days it has become almost a surgical type field. Its hours is worse than half of surgical fields. If you are really interested in it, always think about other surgical subspecialties.


2- Its practice model is totally diffrent in academic center and community. In academics it is high end procedures like TACE, Y 90, coiling of pulmonary AVM, ... In an average community hospital these are not done.


3- It has become a trash can of community hospitals. That is the reason fo its high job demand. Every community hospital need a trash can.


4- you can do high end IR in pp, but it is difficult to break into market controlled by cards and vasc surgeons. It is possible for sure, but with lots of energy and time. If you spend that energy in some other field, the reward will be much higher.


5- Its job market is good bacause first nobody wants to do it. Even previous IR people kiss it goodbye after 7-10 years and switch back to DR. Also every hospital needs trash can.
Its good job market does not mean anything per se,For example the job market for Primary care or hospitalist is much better than retinal surgeon.​


6- there are few only IR groups out there. Most jobs are 50-50 and u have to do DR. Usually these jobs are light IR, as most groups need somebody to do drains, biopsies and vasc access and partners don't want to do it. If you hate DR, don't do it.


7-There will always be demand for IR, the same as hospitalist, general surgeons or family doctors. With the new generation of hospitalists somebody should take care of minor procdures like thora, para, linea, tubes, .... So you will always have a job.


8- Hours are bad.think about it twice. You can do Urology, ENT, Plastics, Bariatrics, Ophtho, Mohs Surgery, even GI with much better hours and much less turf issues.


9- At the end of the day if you like it, do it with accepting all the pros and cons. But make sure you know all its aspects.




Good luck

Members don't see this ad.
 
I am in a surgical residency and I must tell you that I wouldn't do IR if it was offered to me.

2 hours long uterine fibroids embolizations aint that exciting, especially when you need to wear the heavy lead coat.

And having worse hours than GS or vasc on top of that? bleh.
 
Members don't see this ad :)
I am in a surgical residency and I must tell you that I wouldn't do IR if it was offered to me.

2 hours long uterine fibroids embolizations aint that exciting, especially when you need to wear the heavy lead coat.

And having worse hours than GS or vasc on top of that? bleh.

GS itself is the true trash can of the hospital more than IR.
 
That's something I've noticed about you shark. You always feel like you need to be right and have the last say. It's my way and that's it. Did you feel that you have to post something after the IR guys called you out?
 
That's something I've noticed about you shark. You always feel like you need to be right and have the last say. It's my way and that's it. Did you feel that you have to post something after the IR guys called you out?

Could you please read the first line of my post?


And nobody called me out from IR forum if that is what you mean. At my program the IR director always wanted me to do IR fellowship with them despite having many applicants.
You may or may not believe it.


And now I feel lucky, as my fellow residents who did IR fellowship are doing 50 percent general DR and 50 percent thoras, paras and lines. I do 90 percent DR which is both geneal and subspecialty and 10-20 percent biopsies and light procedures.
 
I do like procedures, and I in fact considered surgical subspecialties along with DR/IR, but in the end, I realized that I just find IR procedures plain more interesting.

I am in a surgical residency and I must tell you that I wouldn't do IR if it was offered to me.

2 hours long uterine fibroids embolizations aint that exciting, especially when you need to wear the heavy lead coat.

And having worse hours than GS or vasc on top of that? bleh.

2 hour UFEs? I haven't seen one yet that went past an hour. Maybe you weren't watching a very experienced IR doc.
 
MSK. But I do more and more body and lung biopsies, either CT guided or US guided as I had more than enough training for that in my 4th year electives.
 
I do like procedures, and I in fact considered surgical subspecialties along with DR/IR, but in the end, I realized that I just find IR procedures plain more interesting.



2 hour UFEs? I haven't seen one yet that went past an hour. Maybe you weren't watching a very experienced IR doc.

Good luck with doing UFE in community. If you try your best, you willget 1-2 cases per week at best. What you want to do the rest of your time?


UFE should come from Gyn as the alternative to hysterectomy. It means they have to forget about hysterectomy money and refer it to you. Though it should be the case in the ideal world, it never happens.
 
hows the MSK market looking shark? I've only seen it briefly, but it looks like an awesome subspecialty
 
hows the MSK market looking shark? I've only seen it briefly, but it looks like an awesome subspecialty

Fully saturated right now. 5 years ago was very hot. Still IMO if you come from a top program you can find a good job.
 
Probably both.Or you need connections. Nothing beats knowing someone in the local group. This may be the graduate of your residency, being in the town for 5 years of residency and fellowship and making connection including moonlighting for them, or your Dad may be in the group.


One advantage of big programs is that by the end of graduation you will know at least 200 people. There are 10 in each class and big programs have about 30-40 fellows a year and also there are 60-100 faculty that each know tons of people around the country.


So I really don't know whether a top program will prepare you better, or it is more marketable or only it is because of knowing tons of people. I myself found a good job just through the word of mouth and half of my group are graduates of my program. This job never got advertised and if I were in a different program probably I would have never got it. (or who knows, I may have got a better one??).
 
Are the hours really worse? Seems like 8-5 with no call from my experience. Not too many emergencies unless you are neuro IR it seems like.
 
Are the hours really worse? Seems like 8-5 with no call from my experience. Not too many emergencies unless you are neuro IR it seems like.

Good Luck. Are you serious or you are just kidding?
 
I hope the people reading this thread find a clinician IR mentor and see what they have to say (http://directory.sirweb.org/mentors/)...Or you can just go over to the IR forum and ask a practicing IR attending/fellows...or contact any one of the private practice docs with a high-end practice.

Just a few:
http://www.endovascularsurgery.com/patient-physicians.html
http://www.endovascularassociatesny...t=practice,main&CFID=1973344&CFTOKEN=30656525
http://www.goldcoastmedspa.com/
http://www.riversiderad.com/
http://www.daytonir.com/

There are SO many other examples of IR docs who are wildly successful on their own after splitting from the toxic DR point of view stated above. Some even join multi-disciplinary groups.

The other thing that bothers me is that the views shark espouses here are those that fundamentally represent a diagnostic radiologist's view. That's why IRs are so different. Those that actually put in the work can build any practice they want. Those that don't want to put in the work- I can't wait for them to leave because not only will they hurt IR, but just as importantly b/c they're not doing right by their patients. And frankly, those diagnostic radiologists that disparage IR as shark does are only hurting their own job prospects as without boots on the ground (i.e. a strong IR department), a DR group is easily replaceable.

To be clear, DR is interesting but IR is amazing. It's the most dynamic field in medicine and has an streak of innovation not found anywhere else in medicine. You get to be a doctor, inventor, and even entrepreneur if you want. I personally will be doing 100% IR because I'll build my practice with like-minded IRs. I can't wait.
 
Last edited:
I hope the people reading this thread find a clinician IR mentor and see what they have to say (http://directory.sirweb.org/mentors/)...Or you can just go over to the IR forum and ask a practicing IR attending/fellows...or contact any one of the private practice docs with a high-end practice.

Just a few:
http://www.endovascularsurgery.com/patient-physicians.html
http://www.endovascularassociatesny...t=practice,main&CFID=1973344&CFTOKEN=30656525
http://www.goldcoastmedspa.com/
http://www.riversiderad.com/
http://www.daytonir.com/

There are SO many other examples of IR docs who are wildly successful on their own after splitting from the toxic DR point of view stated above. Some even join multi-disciplinary groups.

The other thing that bothers me is that the views shark espouses here are those that fundamentally represent a diagnostic radiologist's view. That's why IRs are so different. Those that actually put in the work can build any practice they want. Those that don't want to put in the work- I can't wait for them to leave because not only will they hurt IR, but just as importantly b/c they're not doing right by their patients. And frankly, those diagnostic radiologists that disparage IR as shark does are only hurting their own job prospects as without boots on the ground (i.e. a strong IR department), a DR group is easily replaceable.

To be clear, DR is interesting but IR is amazing. It's the most dynamic field in medicine and has an streak of innovation not found anywhere else in medicine. You get to be a doctor, inventor, and even entrepreneur if you want. I personally will be doing 100% IR because I'll build my practice with like-minded IRs. I can't wait.

1- Totally agree that they have to go to a practicing IR. But not in their Ivy Tower medical school, but in community.

2- I also believe that IR should separate from DR. DR people can do their diagnostic work + mammo + light procedures including all body biopsies, drains, tubes and other US and CT guided procedures, spinal pain work and peripheral joint injection as most MSK and body programs are doing (refer to Mass General Body fellowship or UCLA). Then let's see how much work will remain for IR.

3- I clearly stated that if you put a lot of time and energy you can have a good IR practice. But it is not as easy as you think. If you put the same energy in something else the result is much better. It is very difficult to break into a market already controlled by other groups esp vasc surgeons. There are always exceptions for sure.

4- I did not see any comment on your post on hours of IR which is worse than at least half of medical specialties. This is to clarify the situation for those who think it is an 8-5 job.

Good Luck.
 
Top