Matched IR, Thinking About Switching to DR

[NecrotizingFasciitis]

My program is amazing, I'm just finding that I truly love DR & especially neurorads/emergency rads...

Without putting too much info out there, just wanted to hear from others that have switched from IR to DR (I matched categorical), what swayed you, how the process went & any other information that might help me figure out what to do with my life (lol.)

Long story short for me without giving too much detail is I love DR, I got excited about IR towards the end of medical school & ended up applying but honestly... after my surgery intern year like I don't care if I ever do a procedure again, but I love reading imaging. I don't wanna deal with patients or have clinic. I wanna show up, alas through studies & have a life outside of medicine. There is more to it than that, but that is the quick summary of it.

Any advice/feedback is greatly appreciated.. Trying to figure out if I got burnt out intern year & am over the moon to have a nice lifestyle, or if I truly should switch.

-NF

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[odyssey2]

I'm a DR resident, but can't you switch over to DR at your residency? If worst comes to worst you could just finish out your iR integrated and just do pure DR after, or apply for a DR fellowship in neuro or ER.

 

[NecrotizingFasciitis]

I'm a DR resident, but can't you switch over to DR at your residency? If worst comes to worst you could just finish out your iR integrated and just do pure DR after, or apply for a DR fellowship in neuro or ER.

I'm fairly confident the DR program would be supportive of trying to "make" me a spot in the class I would need to transfer into.. but before I mention it to anyone in the IR or DR program here I wanted to hear some feedback from other peeps to see if I should - like you said - just stay in the IR program, then go into PP & only do a little IR or maybe do a DR-related fellowship after IR residency or something.. that's a lot of time though I still have 4.5 years left & it would be another year for fellowship. Not opposed to it! I just was hoping to hear from others who have maybe been in this position at some point so I can figure out what's going on with me.

 

[guytakingboards]

If you truly don't see yourself wanting to do endovascular work and take IR call, I'd bail out for DR.

DR's can and do do plenty of procedures too. The DR lifestyle is way better IMHO.

 

[.Asterion]

In the past few years several people in my program have switched from IR categorical to DR.

 

[MouseChair]

Happens all the time

I would wait until you rotate through IR before doing anything. In fact you probably have until the end of your R2 year to officially take a call, although this is probably institution dependent

 

[NecrotizingFasciitis]

Happens all the time

I would wait until you rotate through IR before doing anything. In fact you probably have until the end of your R2 year to officially take a call, although this is probably institution dependent

See that's what I was wondering if I should do... like wait until next year when I have my first IR rotation functional as a full fledged IR resident...

I feel a little pressure to maybe make a decision earlier only because kinda the earlier I figure it out, the earlier I can start tackling all the obstacles involved with switching programs which.. idk how long that takes but I'd imaging there is a lot of logistical issues?

 

[NecrotizingFasciitis]

In the past few years several people in my program have switched from IR categorical to DR.

Do they typically switch into the DR at the same institution? & is the IR PD pretty supportive? (I know this could be variable per institution..)

 

[qxrt]

DR is a pretty nice lifestyle, aside from the weekend shift responsibilities. If you really could live without doing another procedure, then DR could be right for you. The vast majority of the IRs I know enjoy doing procedures including endovascular work and probably wouldn't be happy reading CT/MR/etc. all day every day (though many of us don't mind doing some DR). If you don't have that issue, then there's little reason you wouldn't be happy with DR. And even DRs frequently do procedures, just smaller ones like paras/thoras/LPs.

 

[guytakingboards]

Do they typically switch into the DR at the same institution? & is the IR PD pretty supportive? (I know this could be variable per institution..)

At my residency program, several people have switched from IR/DR to DR internally. I dunno if supportive is the right word but I think by rules the IR PD is an associate PD on the DR side as well as vice versa so there should be less trouble with a lateral transfer.

 

[Cognovi]

So many people make the switch from IR-DR integrated to regular DR in the same institution these days, it really undermines the purpose of having a separate match/track.

 

[NecrotizingFasciitis]

So many people make the switch from IR-DR integrated to regular DR in the same institution these days, it really undermines the purpose of having a separate match/track.

The more I explain to med students rotating through DR about the pathways the more I'm like... ESIR is literally the absolute best option to pursue IR. Not only does it give you more time to choose, but it also (potentially) allows seeing procedures from two different institutions by two different sets of attendings so you ~theoretically~ should get more exposure to different ways to do the same thing & potentially different scopes of practice too. ~Theoretically~ it would make you a better IR. But more importantly, it gives you more time to decide to commit.

Honestly I didn't understand why the Baylor - Houston program had a dedicated ESIR track you match into right our of medical school, but I kinda get it now. If you leave it's not a huge deal & there is a huge class of peeps in DR; likely at least one of them would likely take your spot.

 

[MouseChair]

See that's what I was wondering if I should do... like wait until next year when I have my first IR rotation functional as a full fledged IR resident...

I feel a little pressure to maybe make a decision earlier only because kinda the earlier I figure it out, the earlier I can start tackling all the obstacles involved with switching programs which.. idk how long that takes but I'd imaging there is a lot of logistical issues?

I don’t really know what logistical issues there would be. The curriculum is pretty much the same for DR and IR for the first two years. I’m sure there’s someone in your class who would be interested in your spot as well if you decide to switch

Surgery intern year is nothing like IR. I guess it varies by institution, but there is far less (most probably none) inpatient floor issues. IR call can be busy but surprising amount of stuff can wait until 7am. The majority of procedures are quick and IMO satisfying.

And if you do IR it’s not like you stop doing DR totally. Most jobs will still be mostly DR