Medical How do I apply DR/IR/ESIR with a disability?

[MusicDOc124]

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Hey ya'll,

I'm a 3rd year medical student that's most likely applying DR in the fall. I've been on the DR train for a while now, but I found out on my OB rotation that I do love procedures and I really liked Cath lab whenever I've rotated through there. I particularly like interventional rad/neurorad.

My issue is I've got a disability in my left hand, and I have difficulty with opposing my 3rd,4th, 5th fingers- I was diagnosed with abnormal vasculature in my right parietal lobe leading to my deficits. I've worked around this deficit fairly easily my whole life, I simply type slow and find myself severely right hand dominant. I just want to make sure I can really do whatever my job will require, and I want to do it well.

Would It be best for me to apply DR, and then take electives to see if I can really do something interventional? Also, what's the best way to talk about this deficit when applying to residencies/fellowships.

I've spoken to a few people about this, and I've honestly gotten mixed reviews, a few interventionists say I could work around it no problem, but the IR guy at my school was somewhat skeptical, and understandably so.

Although some will be unrelated, have you had chances to do anything procedural at all yet? I+Ds, lac repairs, suturing after a surgery, etc? If so, how was it. The issues at hand - have you talked to your provider(s) about the potential for progression, and have you noticed any progression yourself or has it been consistent?

Numerous factors are at play that we dont have the details here. DR--> electives and possibly fellowship is certainly the safe way in that there isn't much risk initially, and it's something solid that you are interested in to fall back on. Going into something procedural from the get-go may be more difficult to recover from if your condition progresses or you find it difficult to do day to day.

Can you do a 3rd year elective or early 4th year elective to explore this more? Even shadowing in-system where they know you're a student and thus can probably do more than shadowing someone random out of system.

People with various disabilities do all sorts of things, and I don't think it will be an issue save for possible progression, but you need to see where your baseline is now/soon, and have a discussion at more depth if you haven't already about the road your condition will bring you down.

 

[MusicDOc124]

Thanks for responding. This is great advice

As for procedures- they went okay- I was able to do some suturing and first assist on quite a few c sections. When I sutured, I had best luck doing 1 handed knots. I noticed an issue clamping using the left hand and I had issues manipulating a cauterizer with my left hand. I found myself tying to cross hands a lot, which I know is not ideal. In the IR suite, I was able to help loading dilators onto the wire with no real issue.

One issue is I had to push back my surgery rotation to the end of the year in order to do a radiology elective this year, so I guess I should reach out to them and shadow some to get more of a baseline.

As for disease progression- there is none really, it's been stable since I was 2- It's not getting any worse but it's also not getting any better

I have to pick between an IR elective my 4th year and a DR elective and I'm trying to pick which one to do soon.

I know IR has a lot of residencies now compared to once being only through fellowships. I'm not in DR or IR, so I dont know the layout of the field overall, but if IR is still a viable fellowship as opposed to being purely an integrated residency, then I'd say do your elective in DR and aim for that initially while doing IR shadowing in some spare time. It's a little longer, but it's safer, less competitive to deal with, and still available to you while giving you additional time without feeling rushed. You'll have time in residency to do procedures at a higher level and will truly give you time and insight into the direction you want to go. This is just my opinion, and of course you must do what you want to do. I just feel this is a solid way to meet in the middle, be safe, and have the time you need to make solid career decision without any additional time in the end (both require internship. DR is 4 years after that whereas integrated IR is 5 years after that. IR fellowship is 1 year - overall time in either case is 6 years).

 

[MusicDOc124]

This site contains some info on the pathways to get there. 3 of the 4 listed pathways are 6 years (include directly going into integrated). Only 1 of the 4 is 7 years.

I hope this helps some.

Again, though, this is my opinion and along the line of how I would approach this personally.

IR Residency Pathways

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www.sirweb.org