Confused about IR

[garoldee]

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curious MS3:

how is it that in one year of IR fellowship one can learn all necessary procedures for IR? It seems awfully short to make one confident enough to perform these procedures independently. There may be a simple answer but i would love to hear from those that have done it.

 

[GMDMD]

you will likely do quite a bit of IR during residency training

 

[garoldee]

ok fair enough.

other questions: how is the IR fellowship in terms of competitiveness?

do practicing IRs do any diagnostics also (i'm sure some do, the question is is this the norm.

thx

 

[gluon999]

ok fair enough.

other questions: how is the IR fellowship in terms of competitiveness?

do practicing IRs do any diagnostics also (i'm sure some do, the question is is this the norm.

thx

IR is somewhat competitive depending on where you want to go. But it is less competitve than say applying for a radiology residency. In short, if u want IR, you will probably get it if you show interest and get good letters.

Some of them also do diagnostics on the side which mostly revolves around body CT. If you work in a private group, they definitely look for IRs who can help out with diagnostics when needed.

 

[raddar]

You got that right! It is very difficult to learn it all in one year. There is a definite learning curve for IR during the first few years of private practice. I am an IR working in sunny socal. I recently hired an IR fresh out of fellowship. He will start in July. I anticipate that it will take him at least a year to feel comfortable, and then another several years to learn the business aspect of radiology.

Most IR's done some diagnostic radiology. I do very little, but enjoy what little I have time to do.

IR is the best subspecialty in all of medicine in my opinion, but I am biased.

 

[deuce924]

You got that right! It is very difficult to learn it all in one year. There is a definite learning curve for IR during the first few years of private practice. I am an IR working in sunny socal. I recently hired an IR fresh out of fellowship. He will start in July. I anticipate that it will take him at least a year to feel comfortable, and then another several years to learn the business aspect of radiology.

Most IR's done some diagnostic radiology. I do very little, but enjoy what little I have time to do.

IR is the best subspecialty in all of medicine in my opinion, but I am biased.

In your opinion, what makes IR the best specialty? Also were you considering any other specialties than Radiology during Medical School. Thanks.

 

[TheRadiologist]

I am not an IR, but we have two IRs in my group. You learn some stuff while you are a resident and you learn quite a bit in one year of fellowship, but you continue to learn on the job. One year appears to be enough get started on your own, but you need a job that has a good volume of cases to develop your skills. In our group, the IRs are expected to do every thing else including mammography. In a private practice setting we can not afford to have them do only IR. If you want to do only IR, you will have to go to large groups at tertiary hospitals or academic centers. At our 240 bed community hospital, the Cardiologists have stolen a good part of IR and our guys get dumped with cases that Cardiologists do not want to do. At least in our group, the IR guys are not too happy with the situation and we have had 4 IRs leave in the last 18 years. We have had only one non IR leave the group in the last 18 years.

You may want to consider Cardiology if you want to do vascular procedures. In our area they have taken over almost all peripheral vascular interventions. It is very difficult for IRs to compete with the Cardiologists because they already have the patients.

 

[colbgw02]

I am not an IR, but we have two IRs in my group. You learn some stuff while you are a resident and you learn quite a bit in one year of fellowship, but you continue to learn on the job. One year appears to be enough get started on your own, but you need a job that has a good volume of cases to develop your skills. In our group, the IRs are expected to do every thing else including mammography. In a private practice setting we can not afford to have them do only IR. If you want to do only IR, you will have to go to large groups at tertiary hospitals or academic centers. At our 240 bed community hospital, the Cardiologists have stolen a good part of IR and our guys get dumped with cases that Cardiologists do not want to do. At least in our group, the IR guys are not too happy with the situation and we have had 4 IRs leave in the last 18 years. We have had only one non IR leave the group in the last 18 years.

You may want to consider Cardiology if you want to do vascular procedures. In our area they have taken over almost all peripheral vascular interventions. It is very difficult for IRs to compete with the Cardiologists because they already have the patients.

It was my understanding that vascular surgeons are the ones taking over the peripheral vascular cases. That's certainly the case at my hospital. Interesting that it's the cardiologists doing it at your center.

 

[flip26]

It was my understanding that vascular surgeons are the ones taking over the peripheral vascular cases. That's certainly the case at my hospital. Interesting that it's the cardiologists doing it at your center.

Be very careful who you take advice from...PM me if you want more info.

 

[TheRadiologist]

Flip26 incorrectly thinks I am a troll because I am a very sloppy poster. I can not say I blame him because some of my posts were very, very sloppy and full of typos. Please read my posts in this Radiology forum and decide for your self. If you pay attention to the content and not get hung up on my proof reading skills , I think that you will find flip26 is wrong.

 

[Law2Doc]

Flip26 incorrectly thinks I am a troll because I am a very sloppy poster. I can not say I blame him because some of my posts were very, very sloppy and full of typos. Please read my posts in this Radiology forum and decide for your self. If you pay attention to the content and not get hung up on my proof reading skills , I think that you will find flip26 is wrong.

But if you read his posts in pre-allo, you might in turn agree that flip has a point. I'm just saying.

At the hospital I'm at, like colbgw noted, it's the vascular surgeons who handle peripheral vascular cases, placement of IVC filters, and the like. Cardiologists (EP guys) exclusively do the coronary artery stuff. Was the same at the hospital I did med school rotations in. Probably the most common way stuff is divided from what I've seen/heard.

 

[TheRadiologist]

If you do not believe that Cardiologists are doing peripheral interventions, try a Google search of "cardiologists peripheral vascular intervention".

http://www.google.com/search?hl=en&...tnG=Google+Search&aq=f&aqi=&aql=&oq=&gs_rfai=

I am aware the Vascular Surgeons are also doing the stuff, but at my place it is the Cardiologists. As the Google search will show, it is not the only place that this is happening.

 

[Law2Doc]

... at my place it is the Cardiologists. As the Google search will show, it is not the only place that this is happening.

As I said on the other thread, where you duplicated your post, "But that's a far cry from suggesting that they "will eventually take over all of the peripheral vascular arterial intervention". It's rare that they are even involved in this business and you are projecting, based on a fairly unrepresentative data set, that they are going to "take over". They are currently third in line for this turf, and their market share isn't getting anybody concerned right now."

 

[TheRadiologist]

I did not realize that my hospital was the exception. I would be interested to see real market share data from a reliable source. If you have such a source please share it with us.

 

[TheRadiologist]

Well , I found an article and I am shocked that the Vascular Surgeons have such a huge market share. I am not sure how objective the data is, since it is from Vascular Surgeons, but it looks very bad for Radiologists. Even the cardiologists have more market share than the IRs. This quote from the article speaks for itself:

“…The number of cases identified was 23,825. From 1998 to 2005, IR's market share decreased six-fold (1998: 33% to 2005: 5.6%) whereas VS market share increased from 27% to 43% and IC from 10% to 29% (P < .05). A similar but more pronounced trend was observed at teaching hospitals. In-hospital mortality rate was highest for IR (2.1 IR% vs 1.2% VS and 0.6% IC; P < .001). Post-procedure IAI was highest in the IC group (1.3% vs IR 0.9% and 0.5% VS; P < .05). Compared with VS, the mortality rate was 1.62 times higher for IR patients (odds ratio [OR]: 1.62, 95% confidence interval [CI]: 1.16-2.24) and IAI was 2.44 times higher for IC (OR: 2.44, 95% CI: 1.63-3.66) and 1.75 times higher for IR (OR: 1.75, 95% CI: 1.08-2.81) patients…”

Here is the link to the abstract for the article:

http://www.ncbi.nlm.nih.gov/pubmed/19703759

 

[TheRadiologist]

It's rare that they are even involved in this business and you are projecting, based on a fairly unrepresentative data set, that they are going to "take over". They are currently third in line for this turf, and their market share isn't getting anybody concerned right now."

Based on the source above, it looks like the Cardiologists have 5 times the market share of IR. The Cardiologists share is probably not as insignificant as you seem to think.

 

[flip26]

Based on the source above, it looks like the Cardiologists have 5 times the market share of IR. The Cardiologists share is probably not as insignificant as you seem to think.

Sometimes it is the little things that tip you off to question the bonafides of a poster.

In this thread and elsewhere, notice how this guy capitalizes Cardiologist, Vascular Surgeon, etc.

Dude, these are not proper nouns. I guess you haven't gotten to that rule in your HS sophomore English class, huh?

The mods have been made aware of this guy, yet they have done nothing about it. SDN is little more than Thunderdome when it comes to trusting other posters, I guess. So beware...

 

[Law2Doc]

Based on the source above, it looks like the Cardiologists have 5 times the market share of IR. The Cardiologists share is probably not as insignificant as you seem to think.

A lot happened from 2005 to 2010. IR was at its infancy when that article was written. Cards is now #3.

 

[TheRadiologist]

A lot happened from 2005 to 2010. IR was at its infancy when that article was written. Cards is now #3.

You have a very good point.

Five years is a long time for these kind of things and market share can change very rapidly. Is IR #2 now?

If you happen to have more recent data, please post a link.