Direct pathway vs traditional pathway

[MedicineMike]

I've done some research on the new DIRECT pathway to IR but am still a bit confused on how it differs from the traditional route.

The direct pathway allows you to do 2yrs in some other field and then switch over to a 4yr crash course through DR and IR correct?

If both paths take 6 years, I don't really get the advantage in going the direct pathway vs the traditional 1 yr intern, 4 yrs, DR, 1 yr IR fellowship

Thx in advance

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[nick_carraway]

The DIRECT pathway is a route meant for surgical residents (or medicine residents) who had an epiphany and wanted to become interventional radiologists. The pathway is designed so that these career switchers could have their PGY 1-2 years count towards radiology. The advantage is that they wouldn't have to add extra years to their training, and they could finish in 6 years, just like everyone else.

 

[MedicineMike]

Well that clears it up. Thanks! Looks like there is only one route to IR if you are starting from the brginning

 

[tco]

The DIRECT pathway is a route meant for surgical residents (or medicine residents) who had an epiphany and wanted to become interventional radiologists. The pathway is designed so that these career switchers could have their PGY 1-2 years count towards radiology. The advantage is that they wouldn't have to add extra years to their training, and they could finish in 6 years, just like everyone else.

This isn't exactly true. Both Penn and Arkansas offer a DIRECT path that includes 2 years of a surgical residency within the match. I don't personally like this pathway, as I feel that it shortens your DR training too much.

There is a new(er) pathway that a few programs offer that I, personally, feel are superior to the DIRECT pathway. Some places, like UVA, call it the "Clinical Pathway." This path provides you with more IR time, clinical responsibilities, and research opportunities. I know that Michigan, UVA, and Colorado offer this program. Michigan and Colorado are new this year.

Here's UVA's site:

http://www.medicine.virginia.edu/cl...ology/divisions/angiography/clinical-training

 

[Puff-of-Snow Sign]

Most places are closing their DIRECT and similar pathways in preparation for the new IR residency, which will look similar, but apparently not all of the details are ironed out just yet. For example, Penn and UNC are no longer accepting applications for their DIRECT pathways. Instead, they plan to be in the first wave or so of programs that go through the ACGME approval process for the new IR residency. Any residents going through the DR program who are interested in IR will be allowed to do a lateral transfer into the new program once it is approved (provided there are enough spots for everyone who's interested). In the mean time, these programs insist that the mini-fellowship structure will allow people extra IR time before their fellowship, if they desire.

For those who haven't heard the schtick about this new residency, it will be a 6-year pathway to a dual-certificate in DR and IR. Again, the details are not all in place yet and I don't remember a whole lot more about what was described by the PDs at a few of the programs I visited, but more info will be coming along in the near future.

However, tco is correct in that UVA still offers their IR clinical pathway.

 

[tco]

Most places are closing their DIRECT and similar pathways in preparation for the new IR residency, which will look similar, but apparently not all of the details are ironed out just yet. For example, Penn and UNC are no longer accepting applications for their DIRECT pathways. Instead, they plan to be in the first wave or so of programs that go through the ACGME approval process for the new IR residency. Any residents going through the DR program who are interested in IR will be allowed to do a lateral transfer into the new program once it is approved (provided there are enough spots for everyone who's interested). In the mean time, these programs insist that the mini-fellowship structure will allow people extra IR time before their fellowship, if they desire.

For those who haven't heard the schtick about this new residency, it will be a 6-year pathway to a dual-certificate in DR and IR. Again, the details are not all in place yet and I don't remember a whole lot more about what was described by the PDs at a few of the programs I visited, but more info will be coming along in the near future.

However, tco is correct in that UVA still offers their IR clinical pathway.

I didn't go into this because it will not be available for a couple of years. You are accurate, however, in stating that lateral transfers will be permitted.

There's a YouTube video from the SIR (Society of Interventional Radiology) that has a nice breakdown of the different pathways.

 

[DrBowtie]

Just keep in mind many jobs are not 100% IR so you can't sacrifice your DR training.

 

[Puff-of-Snow Sign]

I didn't go into this because it will not be available for a couple of years. You are accurate, however, in stating that lateral transfers will be permitted.

There's a YouTube video from the SIR (Society of Interventional Radiology) that has a nice breakdown of the different pathways.

I don't think I implied it would not be available for a couple of years. And I should have added that I know nothing about the pathways at Michigan or Colorado. However, the webinar you referenced clearly states that there's a lot more regulatory stuff to be done before the IR residencies will be open for applicants and lateral transfers.

To paraphrase, the ACGME's Radiology RRC won't be releasing the Task Force's program requirements until at least Jan 2014, at which time, there will be a several-months period of public comment/concerns before the ACGME will approve the program requirements (the final? barrier to program's applying for accreditation - a process which could take a while).

So, yeah, while there are still some DIRECT pathways and clinical pathways to IR available out there, a lot of programs (in my limited experience on the trail this year) are saying that they're closing their pathways (except for the traditional pathway) in preparation for the IR residency.

 

[tco]

Just keep in mind many jobs are not 100% IR so you can't sacrifice your DR training.

Absolutely. This is something that I'm considering strongly, and is the reason I did not apply DIRECT this year. I actually would like to get a job that is not 100% IR, but I'm not sure how often that's done in the academic setting.

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[wheewer]

Thanks for sharing such a wealth of information on this thread. I've given great thought to pursuing IR and I'm trying to get a sense of what kind of Step 1 score it takes to match at a place like Cornell or Penn for their direct IR programs nowadays in 2015? I understand that obviously "the higher the better" and "Step 1 is important but isn't everything" but I'd appreciate any numerical input you had beyond that - thanks!

 

[slicknick5k]

I'm interested in pursuing IR as a career but I have no intentions of doing 100% IR. Anyone have any input on how comfortable people who come out of these pathway programs are or will be as practicing diagnosticians? I can see myself doing 50/50 DR/IR. It would be nice to get into a pathway because I want to get a fellowship in something else in addition to IR....possibly MSK, Neuro or Body.

 

[shark2000]

I'm interested in pursuing IR as a career but I have no intentions of doing 100% IR. Anyone have any input on how comfortable people who come out of these pathway programs are or will be as practicing diagnosticians? I can see myself doing 50/50 DR/IR. It would be nice to get into a pathway because I want to get a fellowship in something else in addition to IR....possibly MSK, Neuro or Body.

There is no point in doing it. If you do 50 IR 50 DR you should be fine with just doing IR fellowship or whatever pathway it is called.

Don't assume that if you do IR and neuro fellowships you will be doing 50% IR and 50% Neuro MRI. No. This is not how it works. Most of medical imaging is X-ray, CT, US and bread and butter brain and spine MRI. If you join a group, no matter what fellowship you do, you have to have your share of portable CXRs, RUQ US, ED bone X-rays and long list of head CTs, abdominal CTs and chest CTs for lung nodules.

 

[slicknick5k]

I've heard of people getting 2 fellowships, some getting IR and another fellowship, so I assumed there was some added benefit. I wanted to hear from anyone who has done this to see what their rationale was. My original question was whether a direct pathway which focuses less on DR will make an IR doc a less competent diagnostician. From what I've seen most pathways spend about 2 years of IR and 2 years of DR, while traditional DR residency is 3+ years of DR and 1 year of IR possibly more if you do a mini fellowship type thing. I hope Im making sense here. I mean IR residents have to pass the radiology boards so I suppose they get the minimum required to be competent in bread and butter diagnostics.