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Is it possible to practice IR without having a board certification in IR?
Started by Mo991
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Depends on the practice set up and what they want. Undesirable places often have DRs performing high end IR. I’ve heard of diagnostic radiologists who are to this day still performing EVARs. In desirable places, much less likely to swing working with IRs without the board cert. The job market is hot but not THAT hot.
How the hell does that even happen?
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It’s living proof that a lot of procedural medicine is overtrained. Do you really need 7 years of neurosurgery, or 5 years radiology+1yr neurorads, or god knows how many years on the neurology path to START to learn how to stent a carotid? Really?
EVARs in uncomplicated aortic anatomy, which many are, really aren’t complicated. Doesn’t take 6 years of high end medical training to know how to twist two plastic knobs and expand a big balloon.
Thanks for the replies. I am really interested in IR I will see how it goes after I am done with training. Worst case scenario I will stick with DR/light IR.
As for the procedure stuff, I totally agree. We learn so much in medicine only to practice in less than 20% than the stuff we studied.
As for the procedure stuff, I totally agree. We learn so much in medicine only to practice in less than 20% than the stuff we studied.
The 6 years of training is not the physical mechanics of a procedure. If it was you would have ER docs treating GI bleeds. But you don’t have ER doctors treating GI bleeds. You have interventional radiologist treating gi bleeds. Most ER doctors cannot even explain to the basic anatomy or even the meaning of a TIPS procedure. Most ER doctors don’t know much beyond the basic knowledge you learn in medical school about GI bleeds. You ask an ER doctor what artery is bleeding and they have no idea. All they know is some Radiologist or Radiology Resident called them and said there’s a Bleed somewhere and that supposedly interventional radiology knows how to stop it. The training length is about reps it’s about how to get through situations that are not straightforward, and many of which don’t come up very often. It’s about the pathophysiology of the disease process and learning how to manage it, clinical presentations etc. It’s not just the physical activity of doing a procedure. You could teach a monkey to pull the rip cord on a stent. That’s not what the training is about.
If you have finished two years of IR fellowship, you should be board eligible in IR. Somethings not adding up.
Regardless, I have never seen a DR that truly practices IR at a high-level and I’ve seen a lot of IR’s both in private practice and academics.
I am doing the alternate pathway. In order to become DR eligible you have to do 4 years of training. For IR it has to be 5 years. You can do 2/4 years of IR during this pathway but you that will only get you a DR. To be IR eligible, you have to do one additional year. So I will have completed a 2 year IR fellowship with a DR board. And now the question, should I invest one more year to get the IR/DR or it is not worth it.
It doesn’t take 3 months of mammo, 4 months of nucs, a year of worthless MS4 training, ID/nephrology/rheum/cardiac intern year rotations, months of msk mr and neuro mr rotations to understand the pathophys behind aorta expansion and knowing how to follow EVARs and manage their complications.
Can we be very honest: I’m happy I did six years and found a unique pathway where I get to use most all of my training from college after, but let’s be real for most people, 40% or more is worthless.
If there are DRs who continue to do PAD in remote community practices, it demonstrably does not need the dedicated training IC, VS, or IR gets.
There is not a specialty in Aortic disease management. There is not enough aortic aneurysms to go around. The 6 years is to be proficient in Diagnostic imaging, all modalities, interventional radiology procedures and patient care. And DR doing PAD is incredibly rare.
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Sure, but then we’re not talking about necessity of training, we’re talking about the infrastructural division of healthcare services. Which I guess is more or less my point.
Technically no. It's complicated though. If you want high end stuff in a larger center or academic place, you probably cannot work unless you are IR certified. In PP in a rural area, there are certainly old head DRs doing a lot of IR. But they were also trained in a more procedural manner than modern DR.
Agree...also the high end stuff (eg. well paying) will likely be snatched away at any large system by surgeon"X", but you may be the guy when it comes to 2 am 200 y/o GI bleed etc
This is the most frustrating thing with referral patterns for uro and vascular. During daytime, they are doing the ureteral stents, AVFs, etc that come in. But the call referral pattern is PCN first line and AVF thrombectomy to us. It's hard to say no though, otherwise you're shutting down your only pipeline. The hope is that you do good work and the referrers recognize it and call you first in the daytime.
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The only way to have a durable sustainable clinic is to have office hours and multiple days of clinic just like a surgeon. Surgeons have many days of clinic and that is why they have robust elective outpatient surgeries. Interventional physicians can if they invest in clinical infrastructure and more comprehensively manage clinical conditions similar to cardiology etc.
