Competitiveness of ESIR

[JPSmyth]

I’m an M2 in the class of 2021 interested in going into IR. I’ve heard that the integrated IR residency is now the most competitive one due to the relatively small number of spots and high level of interest in the field in recent years.

I plan on dual applying to IR integrated as well as DR residencies, but my plan would be to aim for DR residency w/ ESIR. My question is how competitive is it to get an ESIR spot? It seems like a lot of programs in the country offer ESIR.

Are you told that you will be selected for an ESIR spot before you start residency?

I’m perfectly fine with doing a mix of DR/IR in an ESIR track but I think pure DR for 4 years might be a bit much for me. I don’t dislike radiology I just think reading basically non-stop all day for 4 years will wear me out.

I go to a P/F preclinical school, and I am slightly above average usually so I don’t think I’m going to be the type to score above a 250 on step, but I will aim for somewhere in the 240s which I think is a reasonable goal. I only have one research experience and one abstract so far, will do more during third year. Not a super competitive applicant thus far so I know integrated IR will be a reach, but it would offer me some peace of mind knowing that ESIR tracks are not as competitive and I have a decent chance of getting into one of them.

Thank you!

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[maxxor]

1. You have internship for 1 year. DR is 3-4 years if ESIR. IR is 1-2 years after that.
2. Your desire to do pure IR may change after 3rd year / your anticipated dislike of DR may evaporate once you experience hospital medicine.
3. Study as much as you can for Step1. There's no point in aiming to score worse; just get the highest score you can.
4. You should focus on getting amazing grades third year rather than research pubs.
5. There's so many variables based on ESIR like how many in your class are interested in IR. At my institution, there are 3 ESIR spots. If 3 or fewer want to do it, it's guaranteed.

 

[guytakingboards]

I’m an M2 in the class of 2021 interested in going into IR. I’ve heard that the integrated IR residency is now the most competitive one due to the relatively small number of spots and high level of interest in the field in recent years.

I plan on dual applying to IR integrated as well as DR residencies, but my plan would be to aim for DR residency w/ ESIR. My question is how competitive is it to get an ESIR spot? It seems like a lot of programs in the country offer ESIR.

Are you told that you will be selected for an ESIR spot before you start residency?

I’m perfectly fine with doing a mix of DR/IR in an ESIR track but I think pure DR for 5 years might be a bit much for me. I don’t dislike radiology I just think reading basically non-stop all day for 5 years will wear me out.

I go to a P/F preclinical school, and I am slightly above average usually so I don’t think I’m going to be the type to score above a 250 on step, but I will aim for somewhere in the 240s which I think is a reasonable goal. I only have one research experience and one abstract so far, will do more during third year. Not a super competitive applicant thus far so I know integrated IR will be a reach, but it would offer me some peace of mind knowing that ESIR tracks are not as competitive and I have a decent chance of getting into one of them.

Thank you!

Your perception of the diagnostic radiology residency is incomplete at best. "pure DR" as you're describing it is a 4 year residency following a 1 year clinical internship, not 5 years of DR. There's a lot of reasons why residents aren't just "reading non-stop all day" every day for the duration of their residency.

-There are intervention months built into residency curriculum. Granted I ended up doing more than others in my program, but I did 5 months total of vascular or body interventions (3 VIR/2 BIR) in four years.
-Nearly every sub-specialty of radiology has procedures or some other reason for direct patient contact. MSK does joint injections/aspirations, Mammo does US/Stereo/MR-guided breast biopsies, Neuro does LP's and occasionally image-guided pain injections (MSK does these too), body has image-guided biopsies and aspirations. Even nucs has thyroid 'clinic' visits. At my residency it was not uncommon to do upwards of 6-8 procedures on MSK while also reading diagnostic imaging. Or 2-4 US-guided breast biopsies and a butt load of screening mammograms.

 

[JPSmyth]

Your perception of the diagnostic radiology residency is incomplete at best. "pure DR" as you're describing it is a 4 year residency following a 1 year clinical internship, not 5 years of DR. There's a lot of reasons why residents aren't just "reading non-stop all day" every day for the duration of their residency.

-There are intervention months built into residency curriculum. Granted I ended up doing more than others in my program, but I did 5 months total of vascular or body interventions (3 VIR/2 BIR) in four years.
-Nearly every sub-specialty of radiology has procedures or some other reason for direct patient contact. MSK does joint injections/aspirations, Mammo does US/Stereo/MR-guided breast biopsies, Neuro does LP's and occasionally image-guided pain injections (MSK does these too), body has image-guided biopsies and aspirations. Even nucs has thyroid 'clinic' visits. At my residency it was not uncommon to do upwards of 6-8 procedures on MSK while also reading diagnostic imaging. Or 2-4 US-guided breast biopsies and a butt load of screening mammograms.

Thank you! My mistake w the 4 vs 5 year thing, I am aware DR is 4 plus an intern year. I have read a ton on DR residency/attending lifestyle online (albeit who knows how accurate of a representation it is) and shadowed a fair amount at my home program. I know that radiologists don't actually sit in a dark room all the day... In DR most time is spent reading, and the procedures and patient interactions are a minority of the time, is it safe to say that's accurate at most hospitals? The patient interaction in DR pales in comparison to IR, correct?

 

[JPSmyth]

1. You have internship for 1 year. DR is 3-4 years if ESIR. IR is 1-2 years after that.
2. Your desire to do pure IR may change after 3rd year / your anticipated dislike of DR may evaporate once you experience hospital medicine.
3. Study as much as you can for Step1. There's no point in aiming to score worse; just get the highest score you can.
4. You should focus on getting amazing grades third year rather than research pubs.
5. There's so many variables based on ESIR like how many in your class are interested in IR. At my institution, there are 3 ESIR spots. If 3 or fewer want to do it, it's guaranteed.

Thank you! I'll focus on 3rd year grades. However I did want to avoid taking a research year if possible (I am already "old" for my class), and I thought having one/very few publications was frowned upon for radiology.

 

[Cognovi]

In DR most time is spent reading, and the procedures and patient interactions are a minority of the time, is it safe to say that's accurate at most hospitals? The patient interaction in DR pales in comparison to IR, correct?

Yes.

 

[MinosoTheFool]

Yes.

Also true of the DR/IR path. You will spend more than half of your time learning the ins and outs of diagnostics. However you slice it, ESIR with independent residency and integrated programs offer 24 months of IR of the 60 total post-intern months you have.