IR - ideal preparation, and comparing different tracks and programs

[JabsterL]

i'm a first year med student at UF College of Med who is at this point highly interested at the prospect of pursing a career in IR...do you think I should be lookin at the DIRECT or Clinical pathway (the latter seems better to me) if i wanna be the best IR i can be...if my interest stays in IR, should i do vascular surgery rotations and a surgery PGY-1 at a small/community hospital or would you recommend i do the direct or clinical pathway (i wanna be a private-practice IR) at UF-Jax (most likely since i'm at UF now and can -- in fact am required to -- do "home" rotations at UF-Jax during the clinical years)? I will be shadowing the IR PD at UF-Gainesville and possibly the IR PD at UF-Jax (jax is only an hour and half away from gainesville) this summer before school starts up too, but just wondering what you all think is ideal prep to get a good rads residency geared toward a career in IR, whether traditional, direct (more for people who start out doing something else first and then change their mind to rads right?), or clinical (seems to me the best way to go)? also, from what you know, which places are great for IR (esp. would like your opinion on Brigham and women's vs. northwestern vs. UF-jax vs. new mexico vs. georgetown vs. dartmouth hitchcock -- the 6 programs with a clinical IR track, vs. UF-gainesville vs. not sure which are the top programs - can someone please enlighten me as to what they heard/know?

thanks so much!

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[hans19]

The disadvantage of the DIRECT track is that you get less months of diagnostic radiology, making it that much harder for you to pass your boards, they are plenty hard to begin with. Additionally you are obligated to do IR at the same place, so make sure they are doing the kind of work that you are ultimately interested in.. Of the programs you've mentioned, only one is consistently (but subjectively) named as a top place for IR-- Northwestern. IR fellowships have tightened somewhat, but very strong programs are still wide open. In other words you could probably match a fellowship at an equivalent or stronger IR program than the rest of the places you've mentioned. What if it turns out you really like MSK or neurointerventional? - you're stuck doing IR.

The advantage of DIRECT/Clinical is that you don't have to deal with the hassle of fellowship interviews and you get more clinical experience.

Think hard about why you like interventional radiology before you commit to DIRECT or Clinical pathway. I love IR and I am still torn between IR and NIR, fortunately for me great fellowships in either of these fields are wide open.

Good luck....

 

[f_w]

I think it is key to keep your options open as long as possible. Locking yourself in on a subspecialty that early on is not necessarily the best idea.

If you are so dead-set on IR, consider one of the 3+3 vascular surgery residencies under development at this time. Seing the writing on the wall, VS has decided to throw all their energy into the acquisition of IR techniques (which they conveniently call 'endovascular surgery'). The 3+3 tracks are designed to give their trainees 2 years of IR experience. Yes, IR is much broader than PVD intervention, but if you have an interest in the other areas of IR (e.g. oncologic intervention or neurointerventional), it is up to you to expand your skills in that area.

In my humble opinion, it is a good idea to do your fellowship at a place different from your residency to gain broader exposure to the way how people do things. You might realize that some of the strategies used by the people at your residency might be quite archaic.

The other aspect, as hans mentioned, is the issue of getting enough diagnostic radiology skills. Not only to pass the boards (that was the easy part) but in order to function as a radiologist. I am glad I had 4 years of training, my current practice requires me to cover the entire field of radiology including stuff like nuclear medicine and pediatric radiology. I am more confident in some areas than in others, but I would be scared if I had gotten any less exposure in the subspecialties than I did.

So, consider the following: Do a surgical internship at a good program that doesn't only scut out the interns and gives them some teaching experience. Then follow it with a radiology residency at a very good program that is strong in IR (and has a good teaching culture). Close it off with the best IR fellowship you can find.

 

[Carb Addict]

It is very rare that someone sticks with a specialty choice from the first day of medical school until the end, let alone choosing a subspecialty. If you were asking which diagnostic radiology program is good/bad or has this or that, I'd understand more. But, worrying about the details of the Clinical and DIRECT pathways at this stage in your game should not be on your radar screen. Things will likely be fairly different when you're in your 4th year of med school, not to mention during your residency & the rest of your nonmedical life, such that you may have completely unforseeable circumstances to weigh in choosing your career path. Please just stick to getting the most of out med school with an open mind about your specialty choice.

I should also note that the pathways are not the only ways to become the best IR you can be. Plenty of docs have and will continue to do the traditional, separate fellowship after residency and will prosper. I've never understood why people would want to choose to lock themselves into a course in life for several years, especially when it involves something as important as a career (I can only stand to lock myself into a friggin 2-yr mobile phone contract!).

 

[JabsterL]

Hey guys,
Thank you so much for all your invaluable responses -- you all make fantastic points. Now I'm wondering, how do I get a great rads residency, besides good grades and step 1? What do you rads residency and practicing docs recommend I do for the next four years so I get the best possible prelim surgery/transitional year and rads residency I can? I'm thinking of doing the research track at UF, which will allow me to graduate with Honors/Certificate in Research. Would this be very helpful to my application, and what sort of research projects could I work on in radiology (esp. regarding fields with a clinical bend like IR or INR?)

Thanks so much!

 

[JabsterL]

Hey guys, I was wondering for prelim surg/transitional year and rads residency (esp. IR dept.), what are the best rads programs in the south? right now from what ya'll have said thusfar i'm thinkin emory, vandy, wake forest, duke, UNC, and baylor...am i missing any? how are UF gainesville and jax regarded nationally? my gf lives in atlanta so i really really hope to match into emory for prelim surg/TY and rads...what do ya'll suggest i do to try to max my chances for getting into emory rads?

thanks guys!

 

[f_w]

What do you rads residency and practicing docs recommend I do for the next four years

Study, study a lot.

I'm thinking of doing the research track at UF, which will allow me to graduate with Honors/Certificate in Research.

You mean a research track during medschool ? If you can find a worthwhile project within radiology, that could be a good use of your time.

what are the best rads programs in the south?

Ask in 3 years.
The 'best' can mean a lot of things. The most NIH money, the highest oral boards pass rate, best fellowship opportunities etc. These parameters tend to change over time and as other posters mentioned, you are probably ahead of yourself here.

 

[Wallachia]

. . .
So, consider the following: Do a surgical internship at a good program that doesn't only scut out the interns and gives them some teaching experience. Then follow it with a radiology residency at a very good program that is strong in IR (and has a good teaching culture). Close it off with the best IR fellowship you can find.

agree with this point, as you will always have your diagnostic background to fall back upon when you are older and don't want to intervene at 3am