I have a slightly different take as I trained at a residency that was solid in DR but not clinical in IR (as we think of clinical IR today). We did not admit patients or do formal consults or have robust outpatient clinics. A lot of radiology you can learn in books, videos, statdx and from hours and hours of studying.
I was lucky enough to go to a fellowship where there was very aggressive clinical IR doc who admitted their own patients , accepted transfers and had an extremely busy clinic. They were also was able to compete successfully for vascular cases as they were great clinically.
I think the quality of the IR is paramount for integrated IR residencies. Certainly you want to make sure you get the gamut of technical experience (i.e. cerebral angiograms and stroke interventions as well as carotid stents, lower extremity revascularizations, aortic interventions, trans arterial treatments of liver cancer, ablation of various tumors throughout the body, fibroid therapy, vertebral compression fracture treatment etc).
It is more important to learn how to be an aggressive clinical interventional physician. You need to learn how to compete for referrals and how to build a practice. If a place is not even trying to build a vascular practice, to me that is a red flag as they are not willing or capable of competing for referrals.
You want to be able to see diabetic wounds in the clinic as well as undifferentiated leg pain patients in the clinic and be able to render an opinion. You also want to make sure you have true integrated IR training (i.e. not just 3 total months of IR for 3 years (PGY2,3,4)). A minimum of 2 to 3 months of IR /clinical rotations including vascular surgery and ICU should be incorporated in the PGY2,3,4 to get adequate clinical exposure to be a reasonable clinician coming out of a 6 year training program.
2 year IR fellowships used to exist over a decade ago, though they were better equipped technically they were still not good clinicians and thus were unable to build robust practices. It is most important to go to a program that has busy outpatient clinics, give numerous talks and CME to other physicians (primary care etc) and has aggressive marketing strategy. Also, you want to go to a place that admits their own patients and does formal useful consults and does not have order entry for invasive procedures.
I was lucky enough to go to a fellowship where there was very aggressive clinical IR doc who admitted their own patients , accepted transfers and had an extremely busy clinic. They were also was able to compete successfully for vascular cases as they were great clinically.
I think the quality of the IR is paramount for integrated IR residencies. Certainly you want to make sure you get the gamut of technical experience (i.e. cerebral angiograms and stroke interventions as well as carotid stents, lower extremity revascularizations, aortic interventions, trans arterial treatments of liver cancer, ablation of various tumors throughout the body, fibroid therapy, vertebral compression fracture treatment etc).
It is more important to learn how to be an aggressive clinical interventional physician. You need to learn how to compete for referrals and how to build a practice. If a place is not even trying to build a vascular practice, to me that is a red flag as they are not willing or capable of competing for referrals.
You want to be able to see diabetic wounds in the clinic as well as undifferentiated leg pain patients in the clinic and be able to render an opinion. You also want to make sure you have true integrated IR training (i.e. not just 3 total months of IR for 3 years (PGY2,3,4)). A minimum of 2 to 3 months of IR /clinical rotations including vascular surgery and ICU should be incorporated in the PGY2,3,4 to get adequate clinical exposure to be a reasonable clinician coming out of a 6 year training program.
2 year IR fellowships used to exist over a decade ago, though they were better equipped technically they were still not good clinicians and thus were unable to build robust practices. It is most important to go to a program that has busy outpatient clinics, give numerous talks and CME to other physicians (primary care etc) and has aggressive marketing strategy. Also, you want to go to a place that admits their own patients and does formal useful consults and does not have order entry for invasive procedures.
