Clarification about Lifestyle in IR

[asdfjkl;245]

I've seen some conflicting things about lifestyle in IR. From what I understand, if you work full time IR you have a terrible lifestyle. If you do 60/40 IR/DR are things better? Are there options that allow you to do part time IR while still getting involved in other areas (e.g. industry)? Is this still going to be an option with the integrated residency? I'm very much interested in the procedural aspect of IR (was previously all in on a surgical subspecialty), but lifestyle considerations are also very important (part of why I am making the change).

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[Konkurro]

I've seen some conflicting things about lifestyle in IR. From what I understand, if you work full time IR you have a terrible lifestyle. If you do 60/40 IR/DR are things better? Are there options that allow you to do part time IR while still getting involved in other areas (e.g. industry)? Is this still going to be an option with the integrated residency? I'm very much interested in the procedural aspect of IR (was previously all in on a surgical subspecialty), but lifestyle considerations are also very important (part of why I am making the change).

Im just an incoming student, but what was the specialty that you are abandoning and why, just curious.

 

[irwarrior]

IR physicians are covering more and more emergencies and that in of itself makes the lifestyle worse than even many surgical subspecialties. GI bleeds, epistaxis, hemoptysis, PE lysis, IVC filters, nephrostomy, abcess drains, cholecystostomy tubes for cholecystitis, symptomatic compression fractures, thoracentesis, lp, paracentesis, chest tubes etc. Then the hospital also wants to get patients discharged and so G tubes and biopsies etc become more urgent for discharge purposes. If you have an outpatient lab, your schedule can be more predictable as you don't deal with the inefficiencies of a hospital setting.

 

[Norick13]

A lot of services want IR to come in, do some procedure in the middle of the night in order to stabilize the patient for more perminent intervention TBD in the AM.

If you want to do procedures in radiology without doing IR go into private practice and do a body fellowship if you want to maintain your lifestyel

 

[irwarrior]

Yes, with more IR doing stroke work and at level I trauma centers the urgency of IR coming in is becoming more important. There are metrics that joint commission sets for comprehensive stroke centers for door to recanalization times and 30 minute response to trauma calls. Some IR physician groups are responding by late shifts and living closer to the hospitals that require these services.

 

[Dave1980]

Yes, with more IR doing stroke work and at level I trauma centers the urgency of IR coming in is becoming more important. There are metrics that joint commission sets for comprehensive stroke centers for door to recanalization times and 30 minute response to trauma calls. Some IR physician groups are responding by late shifts and living closer to the hospitals that require these services.

NeuroIR is a whole different ballgame with a completely separate fellowship and the lifestyle is worse than traditional IR. I don't know any VIR trained people doing neuro procedures (but maybe some are out there?).

 

[irwarrior]

Since they are limited number of neuro interventionists and the stroke volume has gone up (with the extended criteria (DAWN/DEFUSEIII), the peripheral IR in some centers share stroke call with the neuro IR and primarily do LVO of M1/ICA. But, this has certainly made the peripheral IR lifestyle even busier than before.

 

[tco]

NeuroIR is a whole different ballgame with a completely separate fellowship and the lifestyle is worse than traditional IR. I don't know any VIR trained people doing neuro procedures (but maybe some are out there?).

It's extremely common for VIR to do stroke, at least in my area. A simple stroke with traditional anatomy is considered one of the easiest of the neuro IR procedures, and the volume is far too high for only Neuro IR to cover it. A lot of the practices I've been talking to want their guys to cover stroke...Probably because of the pay I guess?

 

[Dave1980]

Learn something new everyday. Must be a bitter pill to swallow as a VIR guy to be told you are now covering strokes. Hopefully they are well compensated.

 

[irwarrior]

Considering the dramatic improvement in patients after stroke embolectomy and the low number needed to treat. It is one of the most impactful things that VIR physicians can provide along with all of the other life saving treatments for bleeding, cancer and vascular conditions.

 

[Tiredsuperheroine]

NeuroIR is a whole different ballgame with a completely separate fellowship and the lifestyle is worse than traditional IR. I don't know any VIR trained people doing neuro procedures (but maybe some are out there?).

I did residency at Brown, where the IR fellowship included NIR experience. All those guys left thrombectomy capable.

As to IR lifestyle: this widely varies based on the job you choose. I went into private practice out of fellowship in an area/ practice lacking adequate coverage. For 2-3 years, the call schedule was relentless, and I could be on call around the clock for 21 days straight. This was at a level II trauma center with 380 beds and an average call back rate of once per week on weeknights, up to 5 hours of work on the weekends, mostly sitting around waiting for cases and room turnaround. But the experience was great. Doing cases is how you learn. And I've negotiated over and over again to better my pay associated with the occasional longer hours and the amount of time I wanted off.

Long story short, I now have a toddler, take off 12 weeks per year, and have time to do whatever I want, whether it's conferences on topics outside of medicine, traveling, or starting a blog.

 

[Tiger100]

To the OP:

Some information here is not accurate or at least is a generalisation. You are not obligated to practice in a certain way. You can choose the way you want to practice with some limitations.

I know general surgeons who don't take call at all and I know some who are oncall every other night and working all night.

Similarly, you can go and have your 100% IR practice and working round the clock or you can join a DR group and do 50% DR and the rest IR and have a better lufestyle. Right now, finding the latter is easier but things may change.
And not all hospitals are level 1 stroke or level 1 trauma. Many IR jobs have a better life style than what has been described here and not all IRs do angio round the clock. You have to be on call but you may need to come in once per 3-4 calls at the middle of the night.

 

[NDcienporciento100]

I think this mentality of IR wanting 50% IR 50% DR, “oh and I don’t want take any call” is “part” of the reason why so many of the procedures that where pioneered by IR’s have been picked off by other specialty’s. I’m not saying wanting a good lifestyle is a bad thing it’s not, but far to often these IR’s are the same ones complaining when the Angio room time is being taken by vascular surgeons to do procedures they used to do. Here’s an idea, why not hire enough IR’s to share the call pool maybe take a little less money for a while to build the service up, and be available and willing to perform the procedures that IR was meant to do. I know many places that split the call 3-4 ways, yes they work harder then an average DR but they own there angio rooms no cardiologist or vascular surgeon is coming in and running over them, and they practice the full spectrum of IR. Look I believe that if you don’t want to perform a job someone else will do it, those splenic embos that docs used to beg you to do Vascular surgery will say “screw it” “I’ll do It”.

 

[xqcx]

I think this mentality of IR wanting 50% IR 50% DR, “oh and I don’t want take any call” is “part” of the reason why so many of the procedures that where pioneered by IR’s have been picked off by other specialty’s. I’m not saying wanting a good lifestyle is a bad thing it’s not, but far to often these IR’s are the same ones complaining when the Angio room time is being taken by vascular surgeons to do procedures they used to do. Here’s an idea, why not hire enough IR’s to share the call pool maybe take a little less money for a while to build the service up, and be available and willing to perform the procedures that IR was meant to do. I know many places that split the call 3-4 ways, yes they work harder then an average DR but they own there angio rooms no cardiologist or vascular surgeon is coming in and running over them, and they practice the full spectrum of IR. Look I believe that if you don’t want to perform a job someone else will do it, those splenic embos that docs used to beg you to do Vascular surgery will say “screw it” “I’ll do It”.

No one is willing to think long term.