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Interventional radiologist vs radiation oncologist

Discussion in 'Clinical Rotations' started by coop, Feb 12, 2002.

  1. coop

    coop Senior Member
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    what are the similiarities and differences between these 2 fields?

    I'm pretty sure you do a 5 yr diag radiology residency then a 1yr vascular/interventional fellowship and then you are an interventional radiologist. And a 5 yr rad onc residency and you are a radiation oncologist. Do rad oncs work exclusively on cancer? Do IRs to everything interventional that is not cancer?

    I know there's a lot of rads people out there, anyone wanna help me out with this one?
     
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  3. Whisker Barrel Cortex

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    Coop,

    I am a MS4 going into radiology and doing a radiation oncology rotation right now. The two fields are actually pretty different.

    Interventional radiology is, as you said, 5 years diagnostic radiology residency followed by 1-2 years of fellowship. The do a variety of procedures, with the majority being vascular cases, meaning they insert a long catheter into an artery and go from there. The vascular procedures include angiography, stenting of blood vessels (except in the heart), embolization of uterine fibroids, insertion of filters into the aorta to prevent pulmonary emboli, delivery of chemotherapy directly to tumors (liver, cervical, etc), and others. They also do kidney procedures with a needle and catheter, insert PICC lines, and probably others which I am forgetting. Very few interventional radiologists have a clinic, they are consulted by a clinician to do a procedure, do a very short history, and do the procedure. Most follow up is done by the clinician.

    Rad onc is a completely different residency and is EXTREMELY competitive right now because there are less than 100 spots open in the country. Radiation oncologists use radiation therapy to treat mostly cancer. Many types of cancer can be treated, some for a cure and some for palliation. They also occasionally see people with graves eye disease, and some other benign conditions. Much of their work is clinical. They see patients in clinic, do a full history and physical exam if indicated, then recommend or don't recommend treatment. The patients then come in for several weeks to get treatment. The actual treatment is done by techs. It is the planning of the treatment that is done by the rad onc. Most rad oncs follow their patients in clinic at certain set intervals (every 3 months, 6 months, yearly, etc.) They work closely with cancer surgeons and medical oncologists to treat patients. They do very few procedures, but do need to know a lot of physics and treatment planning. There are lots of advances recently with CT planning of radiation therapy.

    Similarities include knowledge of physics and use of technology, and the fact that they both treat disease. Otherwise, they are pretty different fields.
     
  4. coop

    coop Senior Member
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    thanks for the info barrel cortex,
    it seems like IR is pretty far away from the main push of DR residency. Anyone else have insight into these fields? Do rad oncs have lifestyle much more like procedure/surgery based fields as opposed to DR? anyone else like to share their thoughts on these fields? thanks.
     
  5. Whisker Barrel Cortex

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    IR is very different from the rest of diagnostic radiology. However, in most private practice radiology groups, IR guys don't just do interventions. They usually do a certain percentage of their time with interventions (some only 30-40%) and the rest of the time read films. This is different in academic centers with highly specialized subspecialties. Most of them only do inteventional. It is quite a different set of skills and mind-set. There has been talk of setting up a separate residency or track for IR.

    Rad Oncs lifestyle is usually pretty good in terms of hours. They have one of the most predictable schedules because there are basically no emergency rad onc procedures. If one of their patients is in the hospital, the heme/onc docs or surgeons generally look after them. It is mostly outpatient therapy. The only procedures they do are brachytherapy, where they insert a radioactive source at the tumor site. They can do this directly in the case of cervical or uterine cancer, or with the help of a surgeon, who puts catheters in the tumor site through which the radioactive source is inserted.
     

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