How to prepare to apply for ESIR? What should someone on the fence about IR do?

[deleted674723]

I know there is information about the changes to DR/IR programs in various forms all over the internet and I've read most of them. I am trying to understand what the correct choices are for a student who is interested in radiology and possibly IR but not ready to commit fully to an integrated IR residency.

I like DR and I also like procedures so I can see my end game being a 50/50 split or some variation of that. However, I bailed on a surgical sub specialty because I couldn't imagine thriving in that environment so I am hesitant to commit to IR.

This leaves me thinking of pursuing ESIR programs. It is hard to understand from the resources I've found how this all works. I believe that the point of ESIR is for DR residents to have a pathway to IR. However, I am seeing that at least some programs are enrolling applicants into their ESIR programs from the get go? I thought the point was to be able to make your decision after having some experience with IR at the resident level.

My main question is... as an MS3/4 which sub-i should I complete to keep my options for IR open? Must I do a surgical subinternship? Will it hurt me later on if I pursue IR through ESIR if I did a medicine sub-i? The same question applies for my prelim years. If I am interested in ESIR, do I need to do a surgical prelim year before my DR residency begins?

Any insight is hugely appreciated. Thank you so much!

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[irwarrior]

IR is becoming more and more surgical in nature and many IR PD (especially newer ones) are advocating for surgical internship. Those who do surgical internships may have a slight advantage over others if all things are being equal.

But, certainly during your residency training your commitment to IR based on IR research, IR meetings you attend and present at , IR clinic you attend and clinical rotations you do during residency (Vascular surgery/ICU/trauma/transplant etc) will be as important for securing an integrated IR spot.

If you have any uncertainty about pursuing IR, I agree with your approach of going the DR/ESIR route and giving some time to think about it. The last thing you want is buyer's remorse and be unhappy 20 year from now, when you have to get up at 2 am to treat someone with massive Pulmonary embolus or an active gi bleed etc.

 

[SeldingerFan78]

Hey Tankstah, a DR residency with the availability of ESIR would be perfect for you. You're having trouble finding clear info because all of this is still new and variable. Generally, ESIR enrolls during residency. There's quite a few current interns/early residents who are accepted to a DR program and were told that they would be great for ESIR and are calling themselves IR residents even though it's not really official yet. Don't let this discourage you! ESIR was designed for exactly your situation!

As irwarrior mentioned, surgical training is in vogue in IR right now, so the common advice would be to do a surgical sub-I and internship. Personally, I don't think this is right for everyone. I think it all depends how you present yourself/spin things. If you like medicine, great! The clinical value of IR procedures is rooted in clinical medicine. If you hate medicine and love surgery, great! IR is a procedural specialty and surgery will help you strengthen your suturing and peri-op management skills. Personally, I like both. I'm an integrated IR res at a top program and I did a medicine sub-I and a TY year that was 50/50 medicine/ICU and surgery - no regrets.

 

[deleted674723]

Hey Tankstah, a DR residency with the availability of ESIR would be perfect for you. You're having trouble finding clear info because all of this is still new and variable. Generally, ESIR enrolls during residency. There's quite a few current interns/early residents who are accepted to a DR program and were told that they would be great for ESIR and are calling themselves IR residents even though it's not really official yet. Don't let this discourage you! ESIR was designed for exactly your situation!

As irwarrior mentioned, surgical training is in vogue in IR right now, so the common advice would be to do a surgical sub-I and internship. Personally, I don't think this is right for everyone. I think it all depends how you present yourself/spin things. If you like medicine, great! The clinical value of IR procedures is rooted in clinical medicine. If you hate medicine and love surgery, great! IR is a procedural specialty and surgery will help you strengthen your suturing and peri-op management skills. Personally, I like both. I'm an integrated IR res at a top program and I did a medicine sub-I and a TY year that was 50/50 medicine/ICU and surgery - no regrets.

Awesome. Thanks for the advice. I feel much more confident about my path. Can I ask how you went about finding a good TY year? I think a mix of medicine and surgery is ideal for me.

 

[SeldingerFan78]

Awesome. Thanks for the advice. I feel much more confident about my path. Can I ask how you went about finding a good TY year? I think a mix of medicine and surgery is ideal for me.

No problem! It took a lot of searching. Most TY programs are pretty laidback and are often medicine prelims in disguise. I shopped around online for ones that didn't require a ton of medicine wards and gave you a lot of flexibility. Most people use the flexibility for easy rotations or research time, which there's nothing wrong with. I filled it with surgery/ICU. The nice thing is most TY programs are at community hospitals where there's few if any fellows, so all lines, intubations, etc are done by residents. Ultimately, you'll have to try to get a sense of the program at the interview. I think it's a good sign when they seem very supportive of their residents but also emphasize that it's not a cush TY. Happy to share details about the one I did via private messenging.