IR and current rad residents

[stochastic2]

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With all this talk about the future of IR as a separate specialty, what does that mean for the current junior radiology residents who are still determining a focus. Is obtaining IR certification for current radiology residents likely to become an impossibility in the next few years?

 

[reedgw]

I'm a 3rd year interested in IR, and I've looked a lot into this issue.

IR is looking to offer a primary certificate pathway that allows medical students to apply right out of med school and match into IR. This would be a 5 year program (1 year transitional/IM/surg, about a year of DR and the rest IR). This option isn't available yet but it could be as early as next year (likely pilot programs). My understanding is that the other options for getting into IR will still be available and will be the main ways of getting into IR for at least the near future. This new pathway will be an additional option. I don't think this would close the door for anyone doing DR hoping to do IR as a fellowship.

With this certificate pathway, there would be a few options for how to go about entering IR. You could get in right out of medical school, do 2 years of general surgery and then get into IR (the DIRECT pathway), do a DR residency with special emphasis on IR (the clinical pathway), or a typical DR residency and IR fellowship (most do this). I personally think it's in the best interest of IR to keep all of these pathways as options, as it'll attract the most number of candidates and more spots will fill. That's especially important for the field to grow in the future. Let me know if I'm missing anything, but I think I'm on target with this.

 

[irwarrior]

reedgw, you are pretty much dead on.

The goal is to have many avenues to enter IR. As a society they want to be inclusive not exclusive.

Why change the way we train IR?

Well IR today is fundamentally different than IR was even 5 years ago as more and more IR see and admit patients like any other sub-specialty we are undergoing a paradigm shift. However, the people we would prefer to recruit would be those who would otherwise do urology, ENT, ortho etc. The majority who go into diagnostics are weary of patient related activities and the lifestyle that IR may portend (not as predictable as a DR job). So, IR wants to recruit directly from medical school people who will advance the field of SIR (Minimally invasive specialists)

The ABR is changing the amount of time that one can spend during residency on a single section from 12 months to 16 months. So, for those highly motivated individuals who can get good fundamentals in imaging, I would strongly encourage you to consider doing this. This would include a few months of vascular surgery , surgical oncology, stroke neurology, cardiology during your radiology residency. And more months of IR where you are acting as primary and doing cases.

The new 1 +3+1 algorithm will also be interesting . In this scenario you can do 3 months of IR in your first 3 years and then your final year can be dedicated to IR at your parent institute and then an IR fellowship elsewhere.

IR is far too complicated (not the procedures) to learn and set up shop after a single year of fellowship. To learn the evaluation and management of vascular disease, pain patients, oncology is sometimes tougher than the acual prcedures themselves.

Hope that helps