Help with independent IR rank list

[toopak]

Was hoping to get people's thoughts on this rank list. I am trying to balance name brand of associated hospital (will this help with job prospects or opening up my own practice someday?) with the strength of the IR program. The exception is MCVI, which I don't think has much name recognition outside of IR. In my opinion though, this place is IR Disneyland and the ideal that all other programs should strive to be.

PAD is a big plus, but I keep hearing you can learn this after training. Also, if the city/state place I ultimately end up settling down (family reasons, will be geographically locked) is limited in IR, I will want to start my own OBL. So I am looking to learn how to be a strong, clinical IR, who can compete with IC and vascular. Looking to hear opinions on this as well.

1. MCVI
2. Brown
3. Columbia
4. Northwestern
5. Beth Israel
6. Columbia
7. UVA
8. MCW
9. UCSF
10. Duke
11. U of Michigan
12. Loma Linda
13. Wash U
14. Georgetown
15. Emory
16. UNC
17. Baylor
18. University of Illinois Peoria
19. Indiana
20. UT Southwestern
21. Mayo Arizona
22. Brigham
23. MD Anderson

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[irwarrior]

MCVI is probably the Mecca of clinical VIR training. MCW and U of I Peoria are also strong training programs. The key is can you independently build service lines and compete with other specialties for referrals. You can theoretically learn anything including stroke and PAD, but it gets harder if you don't learn it during training.

 

[shadowhustle]

MCVI used to be the mecca. Old news now IMHO. No Bennanati, they barely do Aortas now, handful of PAE, no UFE, and not much hepatobiliary work (few TIPS a year maybe)?. IO and PAD is relatively strong there but the lack of other strong service lines does not justify the 100+ hours a week you have to work for 1-2 years. UVA NW Brown and MCW all offer more comprehensive training vs MCVI.

Why do you have Columbia and Beth Israel so high but MD anderson so low? Also where is Sinai? Easily a top 5 program.

 

[irwarrior]

MCVI is still one of the best training grounds for clinical VIR. Agree losing arguably one of the premier program directors ever may have hurt their training. But, they have run a clinic for over 30 years and that kind of knowledge acquisition in VIR is rare. The clinical skillset that you obtain at MCVI is hard to replicate at most programs. The historic weakness of VIR when it comes to building and establishing a successful practice has been strong clinical skills. At MCVI you will get some of the best clinical training in the world.

 

[irwarrior]

The question is are you able to build a service line from scratch and get direct referrals. Most centers get referrals from a specialist so you never learn how to evaluate or manage patients. This is why most graduates struggle after graduation. You need to be a clinical specialist who can market directly to PCP or patients.

 

[shadowhustle]

I respectfully disagree with your insight into MCVI. You should ask one of their current or recent fellows how much time they actually spend in clinic - it is non-existent - they spend any free time clearing their vascular studies list, which does not exactly fall in line with being the best clinical training in the world.

That being said, the clinical insight and mindset that they instill on their fellows during rounds and within the inpatient setting should be commended. Unfortunately, this is not enough for them to be considered even top 5 of all programs because they lack a comprehensive training program. To your point about building service lines, any graduate from MCVI would have trouble building a service line right after graduation besides PAD. They are simply not comprehensive enough.

IMHO the best training programs are clinically oriented with ACTUAL clinic time (not post-call optional clinic that no one goes to), have very good autonomy, and offer comprehensive training for all (or at least 90%) of what all IRs can do.

 

[irwarrior]

I respectfully disagree with your insight into MCVI. You should ask one of their current or recent fellows how much time they actually spend in clinic - it is non-existent - they spend any free time clearing their vascular studies list, which does not exactly fall in line with being the best clinical training in the world.

That being said, the clinical insight and mindset that they instill on their fellows during rounds and within the inpatient setting should be commended. Unfortunately, this is not enough for them to be considered even top 5 of all programs because they lack a comprehensive training program. To your point about building service lines, any graduate from MCVI would have trouble building a service line right after graduation besides PAD. They are simply not comprehensive enough.

IMHO the best training programs are clinically oriented with ACTUAL clinic time (not post-call optional clinic that no one goes to), have very good autonomy, and offer comprehensive training for all (or at least 90%) of what all IRs can do.

Their graduates continue to excel in jobs after fellowship and are some of the more aggressive VIR that come out of modern day training. Few programs have graduates ready to come out and do well, but MCVI is one of the few that I have seen do it.