IR procedures

[Dr. USMLE]

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Is there an app to keep track of IR procedures I do? Are there any good IR procedure logs out there, esp with goals for a rads resident? Is keeping track of this stuff pointless?

 

[shark2000]

Some programs wants you to keep a track of your procedures in a log book.
Other than that, IMO, there is no point in having a log book.

 

[omarsaleh66]

there is an app u can use on iphone but I didnt like it and felt it was too tedious. I just logged my procedures on excel. I think it is helpful to log your procedures because I was asked for my log when I was getting credentialed for my new job. If you want to apply for priveleges u need to show how much u have done. They even asked me how many plain films I have read, which I didnt log but I just gave them a rough estimate.

 

[shark2000]

there is an app u can use on iphone but I didnt like it and felt it was too tedious. I just logged my procedures on excel. I think it is helpful to log your procedures because I was asked for my log when I was getting credentialed for my new job. If you want to apply for priveleges u need to show how much u have done. They even asked me how many plain films I have read, which I didnt log but I just gave them a rough estimate.

Your post does not really make sense, sorry to say that.
So you say that if as a board certified radiologist you have not read certain number of studies, then you will not have the privilege to read them?
The only discipline that is strict about it is mammo. Also for Nucs, in order to become authorized user, you need a certain number of Iodine treatments. Other than that, I have not heard that you need your residency records to have privilege at a hospital. At least I did not need that in my current practice in which I do some bread and butter procedures like biopsies and drains.

 

[omarsaleh66]

Your post does not really make sense, sorry to say that.
So you say that if as a board certified radiologist you have not read certain number of studies, then you will not have the privilege to read them?
The only discipline that is strict about it is mammo. Also for Nucs, in order to become authorized user, you need a certain number of Iodine treatments. Other than that, I have not heard that you need your residency records to have privilege at a hospital. At least I did not need that in my current practice in which I do some bread and butter procedures like biopsies and drains.

I totally agree with you except in my case I was asked for procedure logs and estimates on how many plain films and CTs and MR I have read in my whole residency in addition to the Nucs and Mammo requirements. I am going out to california after my fellowship and maybe its more strict out there. I had to get a license for flouroscopy to practice out there which is unheard of where I am right now (in the south)

 

[Dr. USMLE]

I totally agree with you except in my case I was asked for procedure logs and estimates on how many plain films and CTs and MR I have read in my whole residency in addition to the Nucs and Mammo requirements. I am going out to california after my fellowship and maybe its more strict out there. I had to get a license for flouroscopy to practice out there which is unheard of where I am right now (in the south)

So when you report these numbers, do they just take your word for it? Does your PD or fellowship director have to sign off on it? Also, do you document cases where you were the first assist or even observing (an EVAR, e.g.)?

 

[omarsaleh66]

So when you report these numbers, do they just take your word for it? Does your PD or fellowship director have to sign off on it? Also, do you document cases where you were the first assist or even observing (an EVAR, e.g.)?

I am no expert in this area by any means. I was just asked for my procedure log from residency when getting credentialed for my job which I will start in July 2013. I am assuming they are taking my word for it but I have the cases to back me up if there are any issues for when it comes to getting privileges that I want. My residency also have records of all the procedures I have done and all the studies I have read if there was some question because I think they are able to get all the info off the PACS if any of these issues arise, but that is more in the case of getting the numbers for I-131 treatments for Nucs, etc.. (and it would be a major pain doing that )

I would document first assist. I dont know about observing cases like EVAR (i didnt document those and I think mostly in my case I documented primary operator. )

To my shock i learned that u can lose privileges if u dont do enough procedures per year. For example, in 2 jobs i talked to, the IR guys told me that they dont do enough angio per year so they didnt get there privileges renewed so they dont do angio anymore. It was crazy. So to my limited understanding, there are various ways to getting privileges for certain procedures. U can take a course and get permission to do certain procedures. For example, if I wanted to do EVAR I would have to take a course, because I dont do EVARS in my fellowship.

U can get preceptored in. For example, I didnt do that many stereotactic breast biopsies so at my new job, Im sure they will have my costaff do like 5 with me, and then I can get permission to do them solo.

Or if I were to do Y90 at my new job, an IR would have to come in and do or observe me do it until I became Authorized User to give my own Y90 therapy.

The other way is do enough procedures in residency/fellowship to get credentials to do it. All this stuff is hospital dependent and varies alot based on the hospital and practices to my understanding.

It is probably in your best case to keep a log in residency and fellowship just in case. Also if u want to get IR CAQ in the future, I heard they want to see your case log as well so u have to keep records for that too (according to one my attendings who just took the CAQ)

later

 

[Dr. USMLE]

I am no expert in this area by any means. I was just asked for my procedure log from residency when getting credentialed for my job which I will start in July 2013. I am assuming they are taking my word for it but I have the cases to back me up if there are any issues for when it comes to getting privileges that I want. My residency also have records of all the procedures I have done and all the studies I have read if there was some question because I think they are able to get all the info off the PACS if any of these issues arise, but that is more in the case of getting the numbers for I-131 treatments for Nucs, etc.. (and it would be a major pain doing that )

I would document first assist. I dont know about observing cases like EVAR (i didnt document those and I think mostly in my case I documented primary operator. )

To my shock i learned that u can lose privileges if u dont do enough procedures per year. For example, in 2 jobs i talked to, the IR guys told me that they dont do enough angio per year so they didnt get there privileges renewed so they dont do angio anymore. It was crazy. So to my limited understanding, there are various ways to getting privileges for certain procedures. U can take a course and get permission to do certain procedures. For example, if I wanted to do EVAR I would have to take a course, because I dont do EVARS in my fellowship.

U can get preceptored in. For example, I didnt do that many stereotactic breast biopsies so at my new job, Im sure they will have my costaff do like 5 with me, and then I can get permission to do them solo.

Or if I were to do Y90 at my new job, an IR would have to come in and do or observe me do it until I became Authorized User to give my own Y90 therapy.

The other way is do enough procedures in residency/fellowship to get credentials to do it. All this stuff is hospital dependent and varies alot based on the hospital and practices to my understanding.

It is probably in your best case to keep a log in residency and fellowship just in case. Also if u want to get IR CAQ in the future, I heard they want to see your case log as well so u have to keep records for that too (according to one my attendings who just took the CAQ)

later

Thanks man...that was really helpful. What do you think of this IR case log? Apparently it's an actual UWash IR fellow's log [attached]. I'm trying to get a good sense of what I should be seeing and in what proportion since I am doing a lot of IR in my TY. Also, how important is it to be doing central lines and a-lines on the floors? Is there anything else I should try to master? The IR dept here is surprisingly robust and do things like EVARs, chemoembo, and RFA pretty commonly...should I try to go to as much of this as possible or is it too esoteric in private practice to spend much time training for it?

 

[Gvataken]

I think it is a decent list. I would consider looking at the ABR forms.

http://www.theabr.org/sites/all/themes/abr-media/pdf/ic-vir-app_2.pdf

This is the list that I use and use for my residents and fellows. It breaks it down into
1) vascular diagnoiss
2) vascular interventions
3) non-vascular interventions
4) clinical non procedural activities

The more you document especially primary operator the better. It can't hurt and I think long term it can be of benefit, if you look to get credentialed at a hospital. I think it is great to get as much procedural competence as possible. The skill sets will not hurt to be learned and can only make you a better proceduralist no matter what you end up doing long term. Try to be primary on as many cases a possible and be proactive. Good luck