Question about Dual applying IR and DR

[NegzDO]

I was talking to a 4th year applying IR/DR who told me that if you dual apply, you will hurt your chances at some DR programs because they will be bias against you if you’r applying interventional. Has anyone in the trail has come across this issue? I’m on the fence about if I want IR so my plan was to do a few DR and IR aways. I was told that will not look good and to do all your aways in either DR or IR. Can anyone provide insight if this is true or not. Thank You.

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[SeisK]

According to people at my program, they investigate pretty thoroughly whether you’re dual applying if your app has suspicious features (IR research, lots of early 4th year IR electives, LORs, etc), and it hurts you badly if they determine you’re applying IR because statistically they know with almost certainty you’re using them as a backup.

Applying IR is a bit of a dangerous game. This is the opinion of one DR program. Caveat emptor.

 

[Hedge Trimmer]

According to people at my program, they investigate pretty thoroughly whether you’re dual applying if your app has suspicious features (IR research, lots of early 4th year IR electives, LORs, etc), and it hurts you badly if they determine you’re applying IR because statistically they know with almost certainty you’re using them as a backup.

Applying IR is a bit of a dangerous game. This is the opinion of one DR program. Caveat emptor.

Even if you're applying for all DR programs with intentions of doing ESIR?

 

[SeisK]

Even if you're applying for all DR programs with intentions of doing ESIR?

Then you had better demonstrate some reason why you really want or need DR in addition to IR. I’m having a hard time figuring out why you would want DR if you’re already set on IR, and even if you did, how you would demonstrate that.

 

[Hedge Trimmer]

Then you had better demonstrate some reason why you really want or need DR in addition to IR. I’m having a hard time figuring out why you would want DR if you’re already set on IR, and even if you did, how you would demonstrate that.

Right but I can't imagine there are many applicants going for IR who aren't also applying to DR programs, especially since integrated programs have such limited spots and the risk of not matching is very real. Charting outcomes for IR show only 2 people who applied with 1 specialty listed, whereas everyone else applying had at least 2 distinct specialties. For those set on IR, it seems (to me) kinda dumb to not try for the DR-ESIR pathway. I see what you're saying about it being risky, but it seems like it's a risk that everyone going for IR is taking when all is said and done

I'm still just an M3 though who doesn't know if I like IR yet or not. Hopefully future rotations will help determine that.

 

[CaptainSSO]

It’s fine for people to do at my program, we interviewed a lot of people applying both, and I know my program director is totally okay with it.

I don’t see how it’s a negative. Diagnostic and IR are closely associated, it’s not like you’re applying to surgery and psychiatry.

 

[TCOM12]

At my former institution, the DR and IR programs have a say on who gets ranked on both lists. The reason why DR has a say is that those same IR people are apart of the DR residency for 3 years.

I suppose if a program only has DR and no IR, then seeing that someone dual applied may be a red flag?

If someone only applies to any subspecialty that is that small and competitive and doesn't apply to a backup, I would wonder how crazy they are.

 

[Cognovi]

DR PDs can't let their program be overrun by IR-destined residents. You also have to produce body radiologists, neuroradiologists, breast imagers, etc.

 

[NDcienporciento100]

I was talking to a 4th year applying IR/DR who told me that if you dual apply, you will hurt your chances at some DR programs because they will be bias against you if you’r applying interventional. Has anyone in the trail has come across this issue? I’m on the fence about if I want IR so my plan was to do a few DR and IR aways. I was told that will not look good and to do all your aways in either DR or IR. Can anyone provide insight if this is true or not. Thank You.

I am going through this process now. I applied both IR and DR. I did away rotations in both IR and DR. I got plenty of interviews for both IR and DR. On my interview trail everyone but two people I met that was applying IR was also applying DR. As to the question of if doing IR and DR rotations will hurt you the answer is an emphatic no, it will help you actually and here is why. IR Residency is 5 years, 3 years meaning the majority of the time is spent doing DR so the fact that you have done DR rotations and have an idea of what DR is about will work in your favor because program faculty want to know that you won’t get in there program hate DR and want to switch to vascular surgery or something to that affect. Oh, and here is an obvious one, you have to be good at DR to be good at IR ask any good IR doc and they will tell you that. As far as discrimination applying to both programs, I only had one program that choose to only interview me for IR and not their DR program, so I am not going to say it won’t happen but the vast majority won’t give a ****. Listen, and this goes to whatever your applying to, your application has to tell a consistent story for example, you first became interested in rads during your preclinical years when you got some small exposer to imaging and explain what interested you about it, then during your third year one of your pts needed an IR procedure and you went and watched then you started shadowing IR, possibly research in IR, Possible SIR involvement, 4th year electives in both IR and DR from which you did so well you got great letters of rec, this is a consistent story and is what PDs look for in applications. Now what’s say you don’t think you have a chance at this X IR spot but you think for whatever reason you have a chance at X DR spot so you only apply to there DR program and not there IR program the PD will see all your IR interests in your app and will wonder why you did not apply to IR as well and it will be a red flag where is if you would have applied to both the DR PD would likely not seen this as a red flag and invited you for an interview because they have ESIR.

 

[NDcienporciento100]

Then you had better demonstrate some reason why you really want or need DR in addition to IR. I’m having a hard time figuring out why you would want DR if you’re already set on IR, and even if you did, how you would demonstrate that.

"Want or need DR", lol Everyone that does IR needs DR its part of the training and the vast majority of IR docs are not practicing 100% IR its a mix of IR and DR.

 

[NDcienporciento100]

DR PDs can't let their program be overrun by IR-destined residents. You also have to produce body radiologists, neuroradiologists, breast imagers, etc.

LOL, I agree with you in that IR is hot right now but the vast majority of applicants still have no plans on pursing IR. You make it sound as if every applicant is IR bound and that is simply not the case.

 

[NDcienporciento100]

At my former institution, the DR and IR programs have a say on who gets ranked on both lists. The reason why DR has a say is that those same IR people are apart of the DR residency for 3 years.

I suppose if a program only has DR and no IR, then seeing that someone dual applied may be a red flag?

If someone only applies to any subspecialty that is that small and competitive and doesn't apply to a backup, I would wonder how crazy they are.

If a program has only DR and no IR then the program has no way of knowing that your applying IR as well at other places.

 

[NegzDO]

I am going through this process now. I applied both IR and DR. I did away rotations in both IR and DR. I got plenty of interviews for both IR and DR. On my interview trail everyone but two people I met that was applying IR was also applying DR. As to the question of if doing IR and DR rotations will hurt you the answer is an emphatic no, it will help you actually and here is why. IR Residency is 5 years, 3 years meaning the majority of the time is spent doing DR so the fact that you have done DR rotations and have an idea of what DR is about will work in your favor because program faculty want to know that you won’t get in there program hate DR and want to switch to vascular surgery or something to that affect. Oh, and here is an obvious one, you have to be good at DR to be good at IR ask any good IR doc and they will tell you that. As far as discrimination applying to both programs, I only had one program that choose to only interview me for IR and not their DR program, so I am not going to say it won’t happen but the vast majority won’t give a ****. Listen, and this goes to whatever your applying to, your application has to tell a consistent story for example, you first became interested in rads during your preclinical years when you got some small exposer to imaging and explain what interested you about it, then during your third year one of your pts needed an IR procedure and you went and watched then you started shadowing IR, possibly research in IR, Possible SIR involvement, 4th year electives in both IR and DR from which you did so well you got great letters of rec, this is a consistent story and is what PDs look for in applications. Now what’s say you don’t think you have a chance at this X IR spot but you think for whatever reason you have a chance at X DR spot so you only apply to there DR program and not there IR program the PD will see all your IR interests in your app and will wonder why you did not apply to IR as well and it will be a red flag where is if you would have applied to both the DR PD would likely not seen this as a red flag and invited you for an interview because they have ESIR.

This was my initial thinking but some MS4s made me think otherwise. Thank you for the insight! I plan to dual apply IR/DR and do aways in both.

 

[Subsegmental]

N of 1 but I had more IR interviews then DR only interviews. Many programs that interviewed me for IR also did for DR, but I was surprised that I didn't get more DR only interviews. This is a sentiment I've heard repeated by some on the trail as well. Just recognize you *could* experience this but did it honestly change anything for me? no. Beyond Integrated IR/DR programs the only other DR residencies I applied to were ones that classically had IR fellowships. Also: I did meet many people on the trail only applying DR hoping for ESIR, or only applying IR at their home institution or places they did aways and otherwise they applied straight DR. Very few people only apply integrated IR/DR. You would have to be crazy, touched by the ghost of Dotter himself or just world-class. You can see in charting outcomes how rare that was last year. Just things to keep in mind for the future.

 

[piii]

N of 1 but I had more IR interviews then DR only interviews. Many programs that interviewed me for IR also did for DR, but I was surprised that I didn't get more DR only interviews. This is a sentiment I've heard repeated by some on the trail as well. Just recognize you *could* experience this but did it honestly change anything for me? no. Beyond Integrated IR/DR programs the only other DR residencies I applied to were ones that classically had IR fellowships. Also: I did meet many people on the trail only applying DR hoping for ESIR, or only applying IR at their home institution or places they did aways and otherwise they applied straight DR. Very few people only apply integrated IR/DR. You would have to be crazy, touched by the ghost of Dotter himself or just world-class. You can see in charting outcomes how rare that was last year. Just things to keep in mind for the future.

How many DR and IR programs did you apply to for you to experience this? I am planning to apply to about 30 DR (with ESIR) and 15-25 IR programs, many of which over lap.

 

[Subsegmental]

How many DR and IR programs did you apply to for you to experience this? I am planning to apply to about 30 DR (with ESIR) and 15-25 IR programs, many of which over lap.

I applied more broadly bc i didn't feel competitive. ~50 IR ~50 DR. Most DR with ESIR or meeting the qualifications above. of my IR interviews all but 2 were for both DR & IR. Certain places like USF & KPLAMC don't often cross interview.

 

[piii]

I am going through this process now. I applied both IR and DR. I did away rotations in both IR and DR. I got plenty of interviews for both IR and DR. On my interview trail everyone but two people I met that was applying IR was also applying DR. As to the question of if doing IR and DR rotations will hurt you the answer is an emphatic no, it will help you actually and here is why. IR Residency is 5 years, 3 years meaning the majority of the time is spent doing DR so the fact that you have done DR rotations and have an idea of what DR is about will work in your favor because program faculty want to know that you won’t get in there program hate DR and want to switch to vascular surgery or something to that affect. Oh, and here is an obvious one, you have to be good at DR to be good at IR ask any good IR doc and they will tell you that. As far as discrimination applying to both programs, I only had one program that choose to only interview me for IR and not their DR program, so I am not going to say it won’t happen but the vast majority won’t give a ****. Listen, and this goes to whatever your applying to, your application has to tell a consistent story for example, you first became interested in rads during your preclinical years when you got some small exposer to imaging and explain what interested you about it, then during your third year one of your pts needed an IR procedure and you went and watched then you started shadowing IR, possibly research in IR, Possible SIR involvement, 4th year electives in both IR and DR from which you did so well you got great letters of rec, this is a consistent story and is what PDs look for in applications. Now what’s say you don’t think you have a chance at this X IR spot but you think for whatever reason you have a chance at X DR spot so you only apply to there DR program and not there IR program the PD will see all your IR interests in your app and will wonder why you did not apply to IR as well and it will be a red flag where is if you would have applied to both the DR PD would likely not seen this as a red flag and invited you for an interview because they have ESIR.

I disagree that applying only DR (with ESIR) and not to the IR residency will be a negative, even if you have an IR focused app. Honestly, I was gungho about IR but as I've learned more about DR, I'm less certain that I should do IR. I was originally going to apply IR heavy but now I maybe send out mostly DR ESIR apps and a few IR apps. I feel like DR PDs will understand if I can explain that I want to experience R1 before deciding my path.

Thoughts?

 

[NDcienporciento100]

I disagree that applying only DR (with ESIR) and not to the IR residency will be a negative, even if you have an IR focused app. Honestly, I was gungho about IR but as I've learned more about DR, I'm less certain that I should do IR. I was originally going to apply IR heavy but now I maybe send out mostly DR ESIR apps and a few IR apps. I feel like DR PDs will understand if I can explain that I want to experience R1 before deciding my path.

Thoughts?

You are entitled to your opinion and whether your right or wrong may very in the eyes of the PD In question. Also when you say your app is IR heavy what do you mean by that, does it scream IR (mine does) or is there like one thing about it because that matters. I would love to hear multiple opinions on this including PD opinions on this, but here is mine I think PD's regardless of specialty want the people they rank high to be 100% sure they want to do the field they are applying to, it is a disaster for these programs when they have people quit for other specialtys both because of the loss of working residents and on the PD who ultimately chose these residents, right or wrong that's reality. So if you are saying yea I'm not sure if IR is for me or if I just want to do DR I need R1 time to figure it out (becouse it's not the same as saying I want to do DR and I'm stuck between body and MSK) it could and very liking will come off to some PDs as someone who is not sure about radiology if they don't know weather they want DR or IR and they may not know if they really want Radiology or another field. Lastly I think PDs look for Maturity and part of being mature is knowing what you want. Good luck to you and I would love to here others thoughts on this.

 

[piii]

You are entitled to your opinion and whether your right or wrong may very in the eyes of the PD In question. Also when you say your app is IR heavy what do you mean by that, does it scream IR (mine does) or is there like one thing about it because that matters. I would love to hear multiple opinions on this including PD opinions on this, but here is mine I think PD's regardless of specialty want the people they rank high to be 100% sure they want to do the field they are applying to, it is a disaster for these programs when they have people quit for other specialtys both because of the loss of working residents and on the PD who ultimately chose these residents, right or wrong that's reality. So if you are saying yea I'm not sure if IR is for me or if I just want to do DR I need R1 time to figure it out (becouse it's not the same as saying I want to do DR and I'm stuck between body and MSK) it could and very liking will come off to some PDs as someone who is not sure about radiology if they don't know weather they want DR or IR and they may not know if they really want Radiology or another field. Lastly I think PDs look for Maturity and part of being mature is knowing what you want. Good luck to you and I would love to here others thoughts on this.

That makes no sense though. Why would they have ESIR in the first place then? PDs want to train radiologists. They don't want you to commit to a sub asap unless you are sure. They are fully aware that there are subspecilaities including IR.

 

[NDcienporciento100]

That makes no sense though. Why would they have ESIR in the first place then? PDs want to train radiologists. They don't want you to commit to a sub asap unless you are sure. They are fully aware that there are subspecilaities including IR.

I think you just answered your own question, they don't want you to pick a sub super quick but they do want you to pick a specialty and IR is it's own specialty now. Part of being its own specialty is knowing how to read and interpret images and for a lot of practicing IR docs the reading aspect will still be a big part of what they do but IR is now it's own specialty and there are three ways of getting into it and ESIR happens to be one of those ways and is why they offer it and that is why they made these changes. And like I said before IR is a drastically different mode of practice from straight DR you will likely be following patients long term, have clinic time, have to manage complications things that DR's never has to think about. It's not like compareing body and chest where how you will practice is very simmilar.

 

[Subsegmental]

I think you just answered your own question, they don't want you to pick a sub super quick but they do want you to pick a specialty and IR is it's own specialty now. Part of being its own specialty is knowing how to read and interpret images and for a lot of practicing IR docs the reading aspect will still be a big part of what they do but IR is now it's own specialty and there are three ways of getting into it and ESIR happens to be one of those ways and is why they offer it and that is why they made these changes. And like I said before IR is a drastically different mode of practice from straight DR you will likely be following patients long term, have clinic time, have to manage complications things that DR's never has to think about. It's not like compareing body and chest where how you will practice is very simmilar.

The IR & DR split has been discussed ad nauseam on SDN & other places. & I agree with @NDcienporciento100 that now that the vision from SIR is more clinical than the stereotypical DR it *could* be a problem for applicants w/ strong IR ties applying DR.
But specific to your question @piii it's hard to say how successful applying straight DR at places with ESIR could be unless people who applied with that strategy chime in. That was not my strategy, so it is hard for me to do more than opine on what others are doing.