Peripheral Interventions

[shouldigomd]

Curious as to how people approach peripheral if they want to have that skillset after interventional year. It is interesting given the struggle between IR vs Vascular vs IC. At my hospital peripheral is largely done by vascular so our exposure isn't optimal but we do have the opportunity. Even in other programs where interventional fellows get 100 or so cases of peripheral under their belt seems a bit underprepared compared to coronaries. Is this mostly learned on the job?

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[timpview]

Three options:

1. Get great training during your fellowship.. or Do additional training often in non accredited fellowships. Often with private guys for 3-6-12 months who offer a dual training and work exposure. Arteries plus veins. Often these guys focus more on peripherals than coronaries and go all in on the higher risk stuff. Can compete with anyone. Also some opportunities of full time office-based lab where you just quit cardiology/coronaries.

2. Do just enough in fellowship to get privileges and then try and grow on the job. Peripherals are relatively simple skill wise for basics and you can get a ton of industry support so it’s mostly how aggressive you are in building referral network and how much leeway you have with complications.. and how much time you have with your normal IC and Gen work. To me that’s the biggest limiting factor.

3. Develop basic skills and get enough numbers to get privileges but only “dabble” with it in the real world. Oftentimes 1-2 cases a month of the straightforward lesions or enough to deal with some of your femoral complications or just the stuff for your own patients.. Obviously comes to a point where it might not be worth it.. or to the point you might not keep your numbers high enough

But yes, if you’re really motivated than yes you can develop a peripheral skill set on the job as strong as anyone at your local hospital or regionally imo.

 

[shouldigomd]

Three options:

1. Get great training during your fellowship.. or Do additional training often in non accredited fellowships. Often with private guys for 3-6-12 months who offer a dual training and work exposure. Arteries plus veins. Often these guys focus more on peripherals than coronaries and go all in on the higher risk stuff. Can compete with anyone. Also some opportunities of full time office-based lab where you just quit cardiology/coronaries.

2. Do just enough in fellowship to get privileges and then try and grow on the job. Peripherals are relatively simple skill wise for basics and you can get a ton of industry support so it’s mostly how aggressive you are in building referral network and how much leeway you have with complications.. and how much time you have with your normal IC and Gen work. To me that’s the biggest limiting factor.

3. Develop basic skills and get enough numbers to get privileges but only “dabble” with it in the real world. Oftentimes 1-2 cases a month of the straightforward lesions or enough to deal with some of your femoral complications or just the stuff for your own patients.. Obviously comes to a point where it might not be worth it.. or to the point you might not keep your numbers high enough

But yes, if you’re really motivated than yes you can develop a peripheral skill set on the job as strong as anyone at your local hospital or regionally imo.

Thank you for the reply those options all make sense. Definitely don't want to limit my coronaries but just make myself marketable.

 

[timpview]

Oftentimes you’re more marketable if all you do are coronaries. It’s harder and harder to find non-structural IC do this job market is as wide open as I’ve seen it in years. In my area, most employers don’t want/care about peripherals…though I’m sure that could be different in other regions or the south. But I would have zero stresses about being marketable in todays world especially when the the major skill set that everyone wants/need is STEMI coverage. Good luck.