Integrated IR and the Future of DR Curriculums

[Mad Jack]

So, just a few questions-

How much interventional radiology is included in current diagnostic radiology programs? I've seen some with up to 16 months of required vascular and interventional, such as UCLA's program. Are others lighter than this?

Second, with interventional radiology splitting off into its own integrated specialty and the closure of fellowship options from diagnostic rads to interventional, do you think that this required interventional radiology time will fade out of current programs so that they can focus on diagnostic skills instead? I mean, if you're not going to be doing interventional fellowships down the line, why waste over a year learning interventional skills?

Really just asking to get a feel for where the future of DR residencies is going- I have zero interests in procedures, and would really prefer to spare myself over a year of radiation and wasted time in the IR suite if DR seems up my alley. If the focus of those months is more vascular imaging and less procedure oriented, I guess the whole question is kind of moot, so how procedure heavy are IR months in residency as things currently stand?

Thanks, and sorry for the stream of garbage- I'm just trying to sort out whether rads is becoming a more appealing field from my perspective, given recent the recent changes.

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[Gadofosveset]

The IR experience in residency varies quite a bit from program to program, from virtually nothing to a fair amount of scut work with a few interesting procedures thrown your way every now and then. Currently, most rads residents are more concerned about not getting enough procedures rather than too many.

With the transition to separate residencies, the exposure of DR residents to procedures can only decrease... and the complexity of cases a DR resident would be exposed to would only decrease, but it will vary depending on how closely the two departments work together in general. It's hard to imagine DR residents volunteering for an elective in IR scut (or vice versa), and DR residents rotating in IR probably won't last long if there's a clear discrepancy is case quality and scut duties... but again, it's going to vary quite a bit based on deals cut with IR residents taking DR call, etc.

How vascular imaging (nonvascular CTA and MRA) will be covered is anyone's guess. Currently, it's not part of the rad resident experience on IR in most places, and really isn't covered in an organized manner in most residencies.

Keeping in mind that some proficiency in basic procedures is considered valuable in the job search... if you want to maximize DR and minimize IR, it should be easy to do, both now and in the future.

 

[DrBowtie]

It really depends on the department. Some places IR does only vascular procedures while Body does the rest.

Other places IR are the only people touching any needle. These programs will be more affected by ESIR and IR residency.

 

[shark2000]

I think it will be very variable among different programs.

Let me clarify something. IR is not equal to procedures and vice versa. Also the fact that IR is going to be its own residency doesn't mean that DR won't do bread and butter nonvascular procedures.

For example, body imagers regularly do CT and US guided biopsies and in some places drains and tubes. Or breast imagers do breast biopsies. If IR split from DR, it does not mean that you won't do US guided and CT guided procedures during residency and also you are not expected to do some basic procedures in your future job.

Having said that, I think all the vascular procedures will be done in the IR department and DR residents probably won't do that much vascular procedures. For nonvascular procedures, I don't think US and CT guided biopsies and other nonvascular procedures will be shifted to the IR department.

Since currently most IR doctors in practice are the ones that were trained in the traditional pathway, I don't think in the foreseeable future IR and DR will be separate groups in private practice in the way that radiology and urology are separate.

 

[agolden1]

Another question. In the next 6-7 years, will IR be completely its own specialty without a fellowship entry points from DR similar to how Radiation Oncology split off from DR in the past, or will it be more like the Vascular and Cardiothoracic surgery in that people can do a "traditional" pathway like General Surgery -> Vascular OR a Direct Vascular residency? In other words, will there still be an IR fellowship option down the line or will it be completely phased out?

I know in the immediate future there will still be some IR fellowships, but I didn't know if the future plan was to completely eliminate all of them, and I hadn't been able to find an answer on like the SIRS website.

 

[Mad Jack]

Another question. In the next 6-7 years, will IR be completely its own specialty without a fellowship entry points from DR similar to how Radiation Oncology split off from DR in the past, or will it be more like the Vascular and Cardiothoracic surgery in that people can do a "traditional" pathway like General Surgery -> Vascular OR a Direct Vascular residency? In other words, will there still be an IR fellowship option down the line or will it be completely phased out?

I know in the immediate future there will still be some IR fellowships, but I didn't know if the future plan was to completely eliminate all of them, and I hadn't been able to find an answer on like the SIRS website.

http://rfs.sirweb.org/wordpressnstall/4787-2/

 

[Radz123]

There will still be training available to interested DR residents. The ones who obviously hate procedures will likely fall through the cracks.

 

[Doctor D]

My program is heavily reliant on residents. Typical resident procedures includes central venous access, chemo ports, tube changes, abscess drains, body/chest biospies, paracentesis, thoracentesis, etc. The more advanced IR cases such as arterial work or biliary tube placements are attending cases.

 

[qwerty89]

My program is heavily reliant on residents. Typical resident procedures includes central venous access, chemo ports, tube changes, abscess drains, body/chest biospies, paracentesis, thoracentesis, etc. The more advanced IR cases such as arterial work or biliary tube placements are attending cases.

What program is this.

 

[NurWollen]

Why are they doing away with the DR-->IR pathway?

 

[Radz123]

They're making IR a separate residency with longer IR training which most DR Residencies can't match. I image they will keep an IR fellowship for DR applicants that'll be 2 years long for those who realized they liked IR after it was too late.

 

[Resident2015]

http://www.sirweb.org/clinical/IR_DR_cert.shtml