Future of rads->INR?

[goremachine]

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So, after seeing some INR procedures, I think it's pretty cool and want to do it. In my off time, I would rather read than be in the OR, so I'd rather do it through radiology than through neurosurgery. However, it seems that the trend is that neurologists and neurosurgeons are progressively taking over the field. I'm currently an M3, so it'll be 6 years before I start my INR fellowship (assuming I do a 3 year integrated program after 5 years of rads)

So, do you think in 6 years radiology->INR will still be a viable path to take? I've talked to one of the INR attendings and he says that they've been filling most of their positions with neurologists and neuroradiologists, mostly because radiologists don't want to do INR. Which makes sense, and maybe I won't feel like doing INR after 5 years of cushiness, but I don't want to be potentially locked out of it, and forced into just diagnostic neurorads. Any thoughts on the matter? Right now, radiology -> INR is certainly viable because most INR programs are still run by radiology, but what about in 5 years?

 

[Dimoak]

It's difficult to accurately predict what the outlook on INR will be 6 years from now. As you mentioned in your post, one of the reasons INR isn't filling with radiologists is because many of the people who went in to radiology would rather read than do procedures! At the same time, INR is having trouble holding their ground in the turf war because of rather low numbers, and the ability of the other specialties to control patient flow (similarly to how intercards are holding the cards (no pun intended!) for VIR procedures). INR is becoming a lot like MIS for neurosurgery and procedural neurology, so they can control the patient flow. In certain places, this creates a trickle-down effect where neurosurgery (and potentially neurology) pick their cases, and the cases they "didn't want" trickle down to INR. Also, if a high risk INR case is blown (bAVMs, DAFs, CCFs), the Neurosurgeon is qualified to open up the case, while the INR would have to emergently consult the case out. This certainly doesn't mean the INR is certain to die out or become a highly undesirable field, but there are many parameters that would suggest that access to the field for radiologists may not have the greatest outlook for the near future.