IR has waxing and waning competitiveness. There are always jobs in IR. When, the job market for radiology is tough, IR becomes far more competitive. A large number of medical students do rotations in IR and enter radiology strongly considering IR. Of my coresidents over 1/2 entered thinking they would do IR but only I entered the field.
The market forces recently were such that the amount of money from diagnostics and job opportunity was great. However, this is changing as is evidenced by the significant increase in IR fellowship applicants the past couple of years. The job market is shrinking for many diagnostic sub speciaties as fewer docs are retiring or in fact coming back to the workforce because of the decreasing 401ks etc.
Now, there are not that many really good IR fellowships but the competitive ones often get filled internally.
The average medcal student entering into radiology may not have the surgical mentality that IR may require and so that is part of the rationale for a separate residency.
The beauty of IR is you can control patients and recruit patients directly. You can become a disease specialist. Focus on oncology, peripheral vascular disease, aortic pathology, pain interventional, stroke interventions , vein therapy. If one does pure diagnostic imaging, in general there is no patient control . There is more likelihood of dayhawk services, teleradiology companies, and other specialties (who have patient control) ordering and interpreting their own imaging.
So, I think it would have been best if radiology maintained radiation oncology (It would have been a stronger house). We all know how competitive radonc is. I think it is best for radiology for IR to stay in the house of radiology and that is the goal of the SIR.
