Interventional rads ?s

[GammaRay]

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Hey guys,

I'm thinking seriously about doing IR after residency. Any advice on the following:

1. Impressions of DIRECT pathway residency format. Anyone doing it/considering it?

2. Which IR fellowship programs are known for being aggressive in PAD interventions (i.e. not all done by vascular surgery or cardiology)?

3. Has IR as a field really made an effort to become more clinically oriented as outlined by the Society for IR in 2003? I only have the POV from my medical school, which is a large academic institution and may have some bias built in as a result (they're becoming much more clinical).

Thanks! 😀

 

[f_w]

> 2. Which IR fellowship programs are known for being aggressive
> in PAD interventions (i.e. not all done by vascular surgery or cardiology)?

BCVI

> 3. Has IR as a field really made an effort to become more clinically
> oriented as outlined by the Society for IR in 2003?

Yes.

 

[Carb Addict]

Well, I haven't even started rads residency, but I can tell you what I understand from my interviews and sundry knowledge.

1. The DIRECT pathway is best designed for those who change their minds after having started another traditional clinical specialty, generally surgical, though not necessarily. So, if you want to approach IR from that direction, decide whether you want to do those years first of all. The extra clinical time you would get during your rads residency as a part of a DIRECT program are also helpful for future practice but not necessary - obviously many have developed the requisite clinical skills needed in IR without a pathway program.

2. There are a lot of programs that have maintained strong peripheral arterial programs. They are often private programs as opposed to those traditionally considered to be "powerhouse" academic institutions. But if you haven't interviewed for or even started residency yet, I would suggest not worrying about this. That is, unless you must stay in the same city for both residency and fellowship, it should not be a big issue. You can look into a good fellowship during residency and decide from there. The turf will change over the next several years, to be certain.

3. Yes, SIR has been working hard to help IR's become more clinically oriented. The next generation of docs will almost certainly continue in that vein.

 

[mysophobe]

The next generation of docs will almost certainly continue in that vein.

No pun intended, of course.

 

[Carb Addict]

No pun intended, of course.

Haha...I didn't catch that! Well, I do fantasize about sticking large bore IVs into bulging arm veins. Ok - I'm not that crazy, but I do like sticking needles into people (probably from my days as a phlebotomist). Radiology was made for me. 😀

 

[factoid]

any ideas on which programs are moving towards the clinical route? i'm just starting radiology in july, but i want to pursue IR, esp after having finished a surgery prelim year. the only way to survive in IR now as a radiologist though is via the clinical route (yes, stating the obvious here). any info on that?

thanks

 

[Carb Addict]

any ideas on which programs are moving towards the clinical route? i'm just starting radiology in july, but i want to pursue IR, esp after having finished a surgery prelim year. the only way to survive in IR now as a radiologist though is via the clinical route (yes, stating the obvious here). any info on that?

thanks

Congrats on finishing your prelim year! I hope it didn't suck too much. lol

I suggest you try searching the AuntMinnie resident forums for this answer, or you could just repeat the question there. I recall one dude who said his recent fellowship at Mallinckrodt was clinically oriented. I would also say these are among the best clinical programs, in no order: Inova Alexandria, UVa, Univ of WA (presently working on developing their clinical pathway, tho not strongest program now), Univ of CO, Northwestern, MCW, UPenn, Dotter Institute, Hartford Hospital, Brown, Baptist Cardiac and Vascular Institute, and definitely Univ of IL-Peoria. Lots and lots of programs run clinics now, so it may just be a matter of degree that you must determine for yourself. Any place that offers a clinical or DIRECT pathway is clinically strong, at least I would certainly hope so. Also, remember that each program has its strengths and weaknesses, so you may not truly get a full gamut of training at one place vs. another (e.g., Univ of IL-Peoria has just about everything you could want in a good IR program, but it's in Peoria 😛 ).

 

[factoid]

thanks for that reply carb addict. you listed a good number of programs. too late to do the Direct pathway; i hadn't really heard of that as a med student.


prelim year was awesome! i would recommend a surgical prelim yr to any aspiring radiologist, esp IR minded.

 

[GammaRay]

prelim year was awesome! i would recommend a surgical prelim yr to any aspiring radiologist, esp IR minded.

Really?? I've been told the exact opposite... that a prelim year in surgery is not very useful because all you do is manage patients on the floor (precious little OR time). And if given the choice between managing patients in medicine or surgery, I've been told to go with medicine b/c the training is better. I'm curious to know why you recommend a surgery prelim. Thanks.

 

[f_w]

If you do IR, most of your inpatients will be 'surgically sick' as opposed to 'medically sick'. Nobody learns to operate during surgical internship, but you sure as hell learn how to manage small bowel obstruction/ileus, hemorrhage or post-op pain and nausea.

 

[factoid]

well it sorta depends where you do your prelim year i guess. i was in the OR every single day that my attending was in the OR; i did quite a few cases and it was really fun. i was not a scut monkey. furthermore, you are in the radiology dept alot, reviewing films, etc. also, if you do vascular during your prelim yr, you're going to get a lot of IR experience. plus, surgery is just more palatable than medicine...30 min rounds vs 3 hrs (with attendings)...*shudder*

 

[mysophobe]

Plus, the vascular lab is orgasmic.

 

[GammaRay]

Good points. Would any of you recommend doing a vascular surgery rotation as a medical student? I've got some free time at the end of this year that I'd like to fill.

 

[f_w]

Yes!

 

[flux=rad]

Good points. Would any of you recommend doing a vascular surgery rotation as a medical student? I've got some free time at the end of this year that I'd like to fill.

Definitely, and the end of the year is a good time to do it. I was able to set up a rotation where I essentially shadowed one vascular surgeon who did plenty of endovascular work. After he determined that I could differentiate between an ass and an elbow, I had plenty of opportunities to get involved in the OR and it was a great experience.

He gave me the requisite amount of good-natured ridicule for going into radiology, but it was a chance to gain a lot of perspective regarding IR and the challenges it faces with vascular work. It certainly helped me to understand the shift toward a more clinical model. As compared to other late 4th years I put in a lot of time on the rotation, including rounding solo on his post-op patients some weekend mornings, writing notes for his covering attending to co-sign, etc. I thought the trade-off was more than fair considering the amount of involvement I had during procedures. It was one of my favorite rotations.