is IR a dying sub-specialty??

[plugger410]

Hey everyone, i could use some advice. i have been interested in interventional radiology for a few years and will be starting into my 3rd year clerkships next year. i got some doom and gloom advice for a neuro IR doc who told me i should look into something else because it is too hard for them to find work due to other fields taking their procedures. i'm an older student (38 with 5 kids), so my situation is unique. i want to do surgical procedures but love the fallback option on radiology if i get the shakes when i get older. i know a couple of IR docs and they love it, but i'd like to get some opinions maybe outside of utah about IR, its lifestyle, and future. thanks!

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[tco]

Hey everyone, i could use some advice. i have been interested in interventional radiology for a few years and will be starting into my 3rd year clerkships next year. i got some doom and gloom advice for a neuro IR doc who told me i should look into something else because it is too hard for them to find work due to other fields taking their procedures. i'm an older student (38 with 5 kids), so my situation is unique. i want to do surgical procedures but love the fallback option on radiology if i get the shakes when i get older. i know a couple of IR docs and they love it, but i'd like to get some opinions maybe outside of utah about IR, its lifestyle, and future. thanks!

It's hard for neuro IR docs to find work. That field is super-saturated.

Disclaimer: This is what I want to do, so I'm biased.

IMO, IR is not a dying field. I don't know how to provide objective evidence for this, it's just my feeling after hanging out in IR departments for the past few months. The departments I've been in are extremely busy, and one of them is actively trying to find more attendings.

As far as lifestyle, I'm sure you realize it's not the same as radiology since you've been interested in it for a while. Also, you have to consider that there's a shelf life for IR attendings, and yours might be shorter given the fact that you're starting later. One doesn't really see IR attendings practice in their late 50's, early 60's.

With that said, I feel it's the best field in medicine. If I were you, and were considering doing IR, I'd probably go the traditional route to have enough DR training to fall back on in a few years in case my prediction holds true. Don't forget that you could always do something like MSK and still do plenty of procedures.

 

[Whatstheverb]

There is an IR subforum.

 

[tco]

There is an IR subforum.

Solid first post. I hope this indicates the amount of contribution you'll make to these forums.

 

[Dral]

Solid first post. I hope this indicates the amount of contribution you'll make to these forums.

They're obviously gunning for mod status.

 

[cowme]

IR is far from saturated. In fact, its the most in-demand field within radiology (hence the fact that the match rate into IR fellowship is approaching 50%). Yea, neuroIR turf is all but gone (probably why the neuroIR is complaining), and vascular volume has been taken, but they are still among the busiest services in many hospitals

To say that IR is dying sounds like the people claiming that radiology is 1 year from being replaced by an iphone app---this was actually claimed the other day. The ignorance about radiology on these forums is nothing short of astounding.

 

[tco]

IR is far from saturated. In fact, its the most in-demand field within radiology (hence the fact that the match rate into IR fellowship is approaching 50%). Yea, neuroIR turf is all but gone (probably why the neuroIR is complaining), and vascular volume has been taken, but they are still among the busiest services in many hospitals

To say that IR is dying sounds like the people claiming that radiology is 1 year from being replaced by an iphone app---this was actually claimed the other day. The ignorance about radiology on these forums is nothing short of astounding.

It's fine with me. I don't mind everyone remaining ignorant to IR until I match into fellowship.

 

[MilkIsGood]

It's hard for neuro IR docs to find work. That field is super-saturated.

Disclaimer: This is what I want to do, so I'm biased.

IMO, IR is not a dying field. I don't know how to provide objective evidence for this, it's just my feeling after hanging out in IR departments for the past few months. The departments I've been in are extremely busy, and one of them is actively trying to find more attendings.

As far as lifestyle, I'm sure you realize it's not the same as radiology since you've been interested in it for a while. Also, you have to consider that there's a shelf life for IR attendings, and yours might be shorter given the fact that you're starting later. One doesn't really see IR attendings practice in their late 50's, early 60's.

With that said, I feel it's the best field in medicine. If I were you, and were considering doing IR, I'd probably go the traditional route to have enough DR training to fall back on in a few years in case my prediction holds true. Don't forget that you could always do something like MSK and still do plenty of procedures.

Why are IR attendings shelf life shorter?

 

[tco]

Why are IR attendings shelf life shorter?

It has a little bit to do with lifestyle, and a lot to do with the 20 pounds of lead that you lug around on your shoulders (and hips) all day from case to case.

 

[D elegans]

IR is probably only going to grow as a field

 

[armybound]

I see more and more stuff that surgeons and non-surgeons used to do being sent to IR.

I can't imagine that specialty doing anything but being increasingly utilized in the future.

 

[Law2Doc]

Hey everyone, i could use some advice. i have been interested in interventional radiology for a few years and will be starting into my 3rd year clerkships next year. i got some doom and gloom advice for a neuro IR doc who told me i should look into something else because it is too hard for them to find work due to other fields taking their procedures. i'm an older student (38 with 5 kids), so my situation is unique. i want to do surgical procedures but love the fallback option on radiology if i get the shakes when i get older. i know a couple of IR docs and they love it, but i'd like to get some opinions maybe outside of utah about IR, its lifestyle, and future. thanks!

IR and neuro IR aren't really the same subspecialty, and don't face the same job market or encroachments.

 

[bquinnme]

Imaging is only going to get more advanced and accurate. Devices will continue to become better and less invasive. This will naturally lead to more IR procedures.

Radiologists in general are poised to be the first ones to utilize new imaging modalities and IR's will be able to exploit those imaging methods to intervene in the least invasive way possible.

I see the future as VERY bright for IR.

 

[MilkIsGood]

It has a little bit to do with lifestyle, and a lot to do with the 20 pounds of lead that you lug around on your shoulders (and hips) all day from case to case.

So do you think the same thing applies to intervential cardio as well?

 

[Trastuz]

Hey everyone, i could use some advice. i have been interested in interventional radiology for a few years and will be starting into my 3rd year clerkships next year. i got some doom and gloom advice for a neuro IR doc who told me i should look into something else because it is too hard for them to find work due to other fields taking their procedures. i'm an older student (38 with 5 kids), so my situation is unique. i want to do surgical procedures but love the fallback option on radiology if i get the shakes when i get older. i know a couple of IR docs and they love it, but i'd like to get some opinions maybe outside of utah about IR, its lifestyle, and future. thanks!

IR in Utah died like 3 years ago. Maybe that's why there's such doom and gloom there.

 

[Instatewaiter]

Hey everyone, i could use some advice. i have been interested in interventional radiology for a few years and will be starting into my 3rd year clerkships next year. i got some doom and gloom advice for a neuro IR doc who told me i should look into something else because it is too hard for them to find work due to other fields taking their procedures. i'm an older student (38 with 5 kids), so my situation is unique. i want to do surgical procedures but love the fallback option on radiology if i get the shakes when i get older. i know a couple of IR docs and they love it, but i'd like to get some opinions maybe outside of utah about IR, its lifestyle, and future. thanks!

There are a few problems with IR most importantly, they don't have their own patients like vascular and cardiology do. So as those specialties start to do more peripheral stuff, those IR procedures dry up. They still do lines that no one else wants to do and perc biopsies but the volumes are going down.

So as more specialties "encroach" on previous IR terrirotry, IR can't fight back. They don't have access to their own patients and require other docs to send them patients.

 

[tco]

There are a few problems with IR most importantly, they don't have their own patients like vascular and cardiology do. So as those specialties start to do more peripheral stuff, those IR procedures dry up. They still do lines that no one else wants to do and perc biopsies but the volumes are going down.

So as more specialties "encroach" on previous IR terrirotry, IR can't fight back. They don't have access to their own patients and require other docs to send them patients.

You act like fistulagrams are something awesome. Boy... I really hope those don't dry up.

I'll respond with less sarcasm when I'm on a computer... Currently watching a PE get fished out of a kid's main pulmonary arteries. Wonder why they didn't call cards or vascular surgery?

 

[badasshairday]

There are a few problems with IR most importantly, they don't have their own patients like vascular and cardiology do. So as those specialties start to do more peripheral stuff, those IR procedures dry up. They still do lines that no one else wants to do and perc biopsies but the volumes are going down.

So as more specialties "encroach" on previous IR terrirotry, IR can't fight back. They don't have access to their own patients and require other docs to send them patients.

Who are you? Aren't you the guy that said IR doesn't take care of patients and only works from 8am to 4pm? Cool story bro, tell the GI docs to call cardiology for the next 2 am GI bleeder.

 

[takeurmeds02]

I've actually heard the opposite, that IR is actually growing and their scope of duty is increasing much to the chagrin of other specialties that are having their procedures taken away lol

 

[evilbooyaa]

Maybe neuroIR is, but IR in general seems like it's only going to get more and more utilized in the coming years with the push for more endovascular stuff.

Will vascular surgeons and interventional cards and others hold onto some of their old procedures by converting it to endovascular? Yeah, probably, but IR is pretty damn valuable to most people in the hospital.

 

[Instatewaiter]

Who are you? Aren't you the guy that said IR doesn't take care of patients and only works from 8am to 4pm? Cool story bro, tell the GI docs to call cardiology for the next 2 am GI bleeder.

Sounds like one of us is a radiologist with a chip on his shoulder. Calm down Brah.

You know you responded to a dead thread and a post from 3 years ago. You really showed me. Did you search this thread just to try to start a fight? Good for you. Sounds like you're having a really crappy day.

 

[badasshairday]

.

Nope just calling you out when I was reading through threads in "similar thread" category that auto-populates brah. Crappy days are when we have to fix all the pseudoaneurysms caused by cardiology when they do femoral access.

 

[blastoise]

I was also wondering about this. IR doesn't own their patients and relies on referrals for their patients. As procedures become lucrative/efficient, the subspecialist who refers to IR can learn the related procedures. Interventional neurologists at my site have taken over a lot of the neuro IR work. Vascular already seems to have first say in what they want/not. I've heard of interventional nephrologists, urologists....and talk of possible OBs or oncologists taking over some interventional procedures. This in fact might even be better for patient care as they are the MRPs for each patient; why wouldn't they learn these procedures if it makes financial sense? I also don't assume it takes significant training time to just learn the imaging procedures relevant to their own field.

I'm worried that IR will be left with the procedures that nobody wants to do. I've even heard of some of my internal attendings calling it the 'garbage can' of the hospital, which is unsettling to hear. Thoughts?

 

[Mad Jack]

Why did this get bumped?

IR is consolidating, with the fellowships going away and being turned into 6 year integrated residencies. That should keep the market stable for some time to come, as it is going to likely decrease the overall number of IR graduates in the market.

 

[chronicidal]

Always interesting to see changes in attitudes over time. Three years ago, people were wondering whether IR is dying. This year, the first integrated IR programs are matching. Whenever I tell someone (attending, fellow student) I'm into radiology these days, the immediate follow-up is, do you want to do IR? The big places where IR services used to be split into body/chest/MSK divisions (eg, MGH) are now consolidating under the IR umbrella. There are dozens of IR symposia for medical students around the country each year. The set of positive trials for thrombectomy in stroke that came out a year ago is ratcheting up neuroIR volume dramatically. The bread and butter procedures like thora/para at my institution are increasingly done by a medicine procedure team; IR is not the 'garbage can' of the hospital, but the service you go to for intervention when nobody else can to do anything.