There will continue to be turf battles with Cards and VSx (and NSx for neuroangio), however IR is in huge demand, and you will have tons of work no matter how you enter it. The key to deciding whether to do Rads-IR is to determine whether you enjoy diagnostic radiology. If your dream job includes a couple days of IR (+/- a very small or interdisciplinary clinic) and a couple days of DR, Rads is the way to go. If your dream job includes some OR and some IR, you obviously should pursue surgery. Cards is a slow way to do IR, and ultimately your focus will be on heart cath (even though some do periph), and angiocardiography is a separate gig from IR. If you want IR only, you currently have to choose which specialty you like the most for the first 5-6 yrs of training. Also IR offers a slightly different case mix, including angio, biopsy, tube placement and drainages etc. compared to other specialties that are mainly vasc.
It is not foolish to enter rads to pursue IR, however the training in DR is long and intense -- you owe it to yourself to make sure you like the diagnostics since most IR will only come later. I should add that in my opinion as a mere MS4 entering rads, IR adds more hard work and patient care but also a lot of satisfaction to a radiologists' practice.
Parenthetically, I think it is sad that we spend so much time building walls in medicine. As a result of the walls, we get drawn into divisive turf wars with each other, and then lose ground to anciliary providers who have a united front. We need a new training pathway that better reflects the needs of an IR specialist, but this has been discussed at length and the turf boundaries are too "hot."
Good luck deciding.
