Anyone have experience w not being selected for ESIR?

[GoPelicans]

Hi all I'm an R2. My residency has had ESIR for 4 years at this point, and at most two people each eyar have applied for the two available spots.. My class will likely be the first that more than two apply (four of us are pretty focused on doing IR). That means two of us will nto be selected. I'm just thinking ahead in case I face this possibility in a year. ANyone have experience or stories about people who didn't match ESIR and what they did next? I know the 2 year fellowship is stil lavailable, but I don't know how reliable that route will be given basically every program will internally fill with integrated IR and ESIR.

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[GoPelicans]

Bumping. Likely five of us (ie half the class) is applying for 2 spots. It's a disaster.

 

[bobjonesbob]

Hi all I'm an R2. My residency has had ESIR for 4 years at this point, and at most two people each eyar have applied for the two available spots.. My class will likely be the first that more than two apply (four of us are pretty focused on doing IR). That means two of us will nto be selected. I'm just thinking ahead in case I face this possibility in a year. ANyone have experience or stories about people who didn't match ESIR and what they did next? I know the 2 year fellowship is stil lavailable, but I don't know how reliable that route will be given basically every program will internally fill with integrated IR and ESIR.

Are you ok going elsewhere if you have to? We're likely still a couple years away from seeing the full effect of the restructuring of the IR training pathways but the 2019 match data was still pretty favorable. 84% match rate into IR and that includes all comers (US IMG, foreign grads, etc). Seems like if you're a US MD in a decent DR program you'll be able to find a spot somewhere.

 

[GoPelicans]

Are you ok going elsewhere if you have to?

LIke transferring programs? I never considered that. I don't know if program leadership would help me do that :-/

 

[irwarrior]

What year do they select ESIR? What are their criteria to select ESIR?
IR research? In -service scores? IR rotation evaluations? DR rotation evaluations? SIR involvement?

This will give you guidance on how to get one of the coveted spots. Also, consider shadowing the VIR service after your diagnostic shift and on weekends and that will give you more exposure and potentially an upper hand to that spot.

 

[irwarrior]

If you have the ability to do some of your ESIR/clinical blocks early (ICU/NeuroIR/ additional IR blocks) ,it would be a good idea to track all of this so that when you go to interview at independent IR residency spots you will have a leg up on your competition as the traditional ESIR happens mostly PGY5 and they often will only have done 2 or 3 months of IR in PGY2-4. A busy surgical internship with several vascular surgery rotations that gives you some clinical vascular and endovascular experience is also helpful (should track your cases even as an intern especially endovascular cases). As the independent residency has limited spots, anything you can do to distinguish and separate yourself from the rest of the applicants will be key.

 

[GoPelicans]

What year do they select ESIR? What are their criteria to select ESIR?
IR research? In -service scores? IR rotation evaluations? DR rotation evaluations? SIR involvement?

This will give you guidance on how to get one of the coveted spots. Also, consider shadowing the VIR service after your diagnostic shift and on weekends and that will give you more exposure and potentially an upper hand to that spot.

They select ESIR around December of PGY3. I don't know what the criteria is; in the past only 1-2 people have ever applied for the two abailable spots, so they always got selected by default. My class will be the first time in my program's history there will be too many people with IR interest. I am a resident in good standing, high board scores, research, etc. But that is basically everyone in the program.

I only get two weeks of IR rotations before the selection occurs. A few of the other interested people get up to 5-6 weeks. It is basically impossible that I can stand out in comparison. I also did a transitional year whereas 4 of the other people who will apply did surgical prelims. The TY I did was a fairly competitive program with 4 months of surgery, but they won't care about that. I am sort of resigned to my fate at this point and a little depressed about it. I really don't love DR as much as I thought I would and likely I now won't be able to do IR. I am feeling lost.

 

[irwarrior]

The rest of the ESIR applicants all did surgical internships?
Yes, It sounds like a bit of a struggle and one of the challenges of having so many ESIR spots but potentially not enough IR independent residency spots. Things that you can do include going to the IR suites after your diagnostic rotation and going to assist in seeing consults or assisting in procedures. Go, before your diagnostic rotation and round with the IR fellows and faculty. Volunteer to cover IR weekend call. Get involved in IR research projects as well as SIR trainee section. These are ways to make yourself potentially more marketable as an ESIR.

Alternatively , if you do not get a position in ESIR, you could even consider applying for neuroIR spots , pediatric interventional, pain fellowships or other imaging fellowships that are procedure heavy (Body, MSK, Mammography).

 

[Yellow345]

If you can’t get the ESIR position isn’t the 2 year independent residency still an option?

 

[irwarrior]

Yes. The 2 year pathway does exist, but from what I have heard there just are not too many of these 2 year programs currently available. But, it is an option. alternatively some have gone on to do neuroIR or even pediatric IR after DR residency as well. Some who obtained ESIR but did not match also consider doing Neuro IR or peds IR.

 

[cybermed2424]

I thought you needed interventional radiology training before neuroIR?

 

[irwarrior]

You can do a 2 to 3 year post radiology neurointerventional training. 2 years of neurointerventional and 1 year of neurodiagnostics. Alternatively you can do a combined VIR/DR/INR pathway as well. So there are a few options. The VIR skillset with microcatheters and embolizations and coiling and the neuroimaging learned in radiology are very helpful for neurointerventional. But, need to get comfortable with neuro exam and neuro icu dealing with ICP, blood pressure medications and EVD/ ICP etc

 

[Yellow345]

You can do a 2 to 3 year post radiology neurointerventional training. 2 years of neurointerventional and 1 year of neurodiagnostics. Alternatively you can do a combined VIR/DR/INR pathway as well. So there are a few options. The VIR skillset with microcatheters and embolizations and coiling and the neuroimaging learned in radiology are very helpful for neurointerventional. But, need to get comfortable with neuro exam and neuro icu dealing with ICP, blood pressure medications and EVD/ ICP etc

Will this continue to be a feasible option in the future? I was told by a radiology attending that NIR is more and more neuro/neurosurg trained and NIR might not be an option

 

[irwarrior]

At least for the near future, there are quite a few neuro IR divisions training peripheral VIR. In the community many peripheral IR are covering stroke interventional call

 

[bobjonesbob]

Yes. The 2 year pathway does exist, but from what I have heard there just are not too many of these 2 year programs currently available. But, it is an option. alternatively some have gone on to do neuroIR or even pediatric IR after DR residency as well. Some who obtained ESIR but did not match also consider doing Neuro IR or peds IR.

Do you have any insight on how competitive getting a Neuro IR fellowship spot is as a radiologist (say from an average academic DR program)? I know the field is small, but it doesn't seem like there is much interest from the DR resident side. And without a match, the application process seems like a bit of a black box.

Also @Neurointerventionalist if you have any insight on US fellowships

 

[GoPelicans]

Hey just bumping this thread 1+ year later. For anyone who googles this in the future wondering what happens when you don't get selected for ESIR - the answer is I don't know. Because I got picked for one of the spots in my class.

 

[Neopolymath]

Hey just bumping this thread 1+ year later. For anyone who googles this in the future wondering what happens when you don't get selected for ESIR - the answer is I don't know. Because I got picked for one of the spots in my class.

Congrats. How are you feeling about radiology in general now that you are further along?

What made you choose IR versus doing a procedurally oriented DR fellowship like body, breast, or MSK?

What did you do to set yourself up to be selected? What set you apart from the other residents in your opinion?

 

[GoPelicans]

Congrats. How are you feeling about radiology in general now that you are further along?

What made you choose IR versus doing a procedurally oriented DR fellowship like body, breast, or MSK?

What did you do to set yourself up to be selected? What set you apart from the other residents in your opinion?

I helped one of the IR attendings with his research and I busted my ass whenever I rotated on IR. Honestly, diagnostic radiology is also fun. I enjoy it way more now than I did as a first year, and I feel it is a specialty in general that grows on you a lot over time as your comfort level with the pathology increases. The only thing that stresses me is seeing something I've never encountered before, and as that now happens less and less I find my comfort level with going to work is much better than it was this time last year. I don't think I would've been too heartbroken to do body or MSK. The lifestyle certaintly would be 100% better. But I'm happy I ended up in IR.

 

[irwarrior]

What were the criteria they used to select ESIR at your institute and is the PGY 5 year the same as the independent training paradigm?