Few questions about IR

[ace07doc]

Hey everyone, as an upcoming MS interested in doing something hands on like surgery/IR I just had a few questions regarding the field.

1. Are IR procedures fun? Do you feel like a badass? Are catheter based interventions as rewarding as using your hands in surgical disciplines?

2. How is the learning curve for mastering catheter based interventions? Are they technically challenging?

3. What is the future of IR like with regards to being well known among patients and referring doctors? Will the efforts of SIR and the integrated IR/DR residencies bear fruit in terms of being recognized as a standalone clinical specialty being distinct from the DR work ethic, mindset etc.

4. I read an article on the SIR website about IR rebranding itself with talks of there being a possible change in the name of the specialty. From what my IR attending told me the average joe and even some MD's still perceive IR's as radiologists cos of 'radiology' in the name. Not that I care much but what do you folks think about that?

5. Lastly, hate to ask this, but how does IR compare in terms of 'lifestyle' to Uro/ENT/Gsurg? I know the IR personality inherently has a surgical bent, but how brutal is call compared to the above mentioned surgical specialties? Will I know the names of my kids by the time I am practicing as a dedicated interventionalist?

I guess there is some overlap between the questions, would love to know more about the field from those in training/attendings. Thanks.

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[badasshairday]

Hey everyone, as an upcoming MS interested in doing something hands on like surgery/IR I just had a few questions regarding the field.

1. Are IR procedures fun? Do you feel like a badass? Are catheter based interventions as rewarding as using your hands in surgical disciplines?

2. How is the learning curve for mastering catheter based interventions? Are they technically challenging?

3. What is the future of IR like with regards to being well known among patients and referring doctors? Will the efforts of SIR and the integrated IR/DR residencies bear fruit in terms of being recognized as a standalone clinical specialty being distinct from the DR work ethic, mindset etc.

4. I read an article on the SIR website about IR rebranding itself with talks of there being a possible change in the name of the specialty. From what my IR attending told me the average joe and even some MD's still perceive IR's as radiologists cos of 'radiology' in the name. Not that I care much but what do you folks think about that?

5. Lastly, hate to ask this, but how does IR compare in terms of 'lifestyle' to Uro/ENT/Gsurg? I know the IR personality inherently has a surgical bent, but how brutal is call compared to the above mentioned surgical specialties? Will I know the names of my kids by the time I am practicing as a dedicated interventionalist?

I guess there is some overlap between the questions, would love to know more about the field from those in training/attendings. Thanks.

1. IR procedures can vary from mundane to very rewarding. We provide procedures that can be considered heroic, such as embolization of traumatic life threatening bleeding. Other patient centered and rewarding procedures include interventional oncology procedures in which we are treating cancer. To me, catheter based procedures are great, however to my friend who is a general surgeon, he could care less about it and is all about large exposure surgery. Different strokes for different folks.

2. There is a learning curve and it is technically challenging. Arteries can be unforgiving, they can dissect and rupture. Going into the aortic arch and carotids always brings up the possibilty of stroke. Navigating a microcatheter to subselectively chemoembolize a hepatoma can be difficult.

3. IR is well known among referring doctors. We are known to our patients as well. However to the average layman we are not known and I find myself describing myself as an "endovascular specialist" or "vascular interventional physician" after they shrug when I say "interventional radiology". The IR residency is 20 years overdue, it should have happened a long time ago. It will make IR more clinical and grow.

4. See above. IR's are radiologists so that is perfectly fine that 'average joe's and even some MD's percieve IR's as radiologists'.

5. Depends on your practice environment. But generally it is busy. If you are at a medium to large trauma center and doing big cases, expect to work similar hours as general surgery. If you are at a small place and doing low end cases, expect to have hours similar to your diagnostic radiology brethren. In general though, you will work more than diagnostic radiologists and hold a pager for call with occasional after hours emergencies requiring you to come in.

 

[Radz123]

I'd strongly suggest you shadow Interventionalists from multiple practice settings including big academic and small private groups. That'll give you an idea of what the job is like. Make sure you start and stop the day the same time as the attending you're following. Don't let them send you home early only to find out that he/she was still around til 8 pm that night. It'll skew your view of the speciality.

 

[irwarrior]

I personally enjoy catheter based interventions, but some other people prefer the open approach, laparascopic approach , endoscopic approach. My main gratification is that I feel it is minimally invasive and potentially maximally effective. We make small incisions on conscious patients with reasonable results that are progressively more and more durable.

As with any skill,the more you do the better you get. And you will continue to hone your skills over the course of your career.


question 3 is a challenge. I have noticed a growing number of IR that are coming out that are much more aggressive and realize that we do not have banker's hours. The days are starting to reflect a general surgeon's life . I have elective operative days , outpatient clinic days and inpatient consultative days.


Depends on where you are working and how many partners you have. The call can be pretty busy as there are a ton of IR emergencies (GI bleeder, obstructive uropathy, DVT/PE, aortic dissection, acute limb ischemia, abscesses, post partum hemorrhage, strokes etc).