Question about IR and vascular surg

[texaspremed1]

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[Redpancreas]

Hi guys I am about to enter my 3rd year and realized I want to do IR or vascular after shadowing. My step score is 257 and i have research in ENT (couple of posters, possible pub, nothing special). I realize these integrated residencies are really tough to get into and I really do not want to do gen surg or DR. Wondering what I could do in the next year before applying to give me the best shot at matching. Thanks

First you should ask yourself what out of IM, General Surgery, and Radiology you enjoy the most. All have roads to vascular intervention. You can apply IM and probably end up at a place where Cards is very attainable. Also. Interventional Radiology integrated programs has a few enough programs so you could have your applications not overlap too much. Why not ENT?

 

[CaptainSSO]

If you don’t want to do DR. I would think long and hard about doing IR. Being strong at DR will help you be better at IR (usually). But more importantly, there are very few pure IR jobs and most places you’ll do a mix of DR and IR.

 

[VascularMan]

I just matched into Vascular, and know several others who matched after gaining late interest in the field. Your score definitely helps...research is a little weak, but you've done enough where I think you have a good chance given your step score. The biggest thing for you would be to get strong letters of recommendation and do 1 or 2 aways. I would bet on you matching into integrated vascular if you continued, especially given your board score and displaying some interest in research...

 

[texaspremed1]

First you should ask yourself what out of IM, General Surgery, and Radiology you enjoy the most. All have roads to vascular intervention. You can apply IM and probably end up at a place where Cards is very attainable. Also. Interventional Radiology integrated programs has a few enough programs so you could have your applications not overlap too much. Why not ENT?

I honestly just did the research to check off boxes in the resume. Never cared for ENT.

Basically, I really like the procedures in vascular and IR and cant tell much difference in the fields. So I wouldnt mind matching either. Which one would be easier to match?

 

[Oso]

vascular and IR and cant tell much difference in the fields. So I wouldnt mind matching either. Which one would be easier to match?

You need to do a formal rotation in each. One is surgery, one is not. Some overlap w/ endovascular stuff, but overall different fields. If you really end up feeling indifferent between the two (which I think is unlikely), I would go for IR b/c vascular lifestyle sucks.

 

[Redpancreas]

I honestly just did the research to check off boxes in the resume. Never cared for ENT.

Basically, I really like the procedures in vascular and IR and cant tell much difference in the fields. So I wouldnt mind matching either. Which one would be easier to match?

Vascular Surgery would be easier. IR is incredibly competitive and you mentioned you disliked Gen Rads so I don’t think you should do Diagnostic intending to do an integrated pathway down the road. I would definitely go with Vascular if you’ve ruled out IM -> Cards. I also loved my vascular rotation and they’re definitely in the endovascular world too working well with the other players. I really enjoyed the open bypass cases and the endarctectomies were awesome too. The field itself is not going anywhere despite some people who like to complain about the IC v IR v Vascular turf wars. When someone from the ED comes in with a cold extremity and non-dopplerable pulses or a high suspicion of compartment syndrome you consult vascular, period. Vascular Surgeons are some of the hardest working physicians of all. Best of luck!

 

[Gurby]

Vascular Surgeons are some of the hardest working physicians of all. Best of luck!

😕😢

 

[Lnsean]

😕😢

View attachment 235477

Wow...damn...is love gonna carry you for 30 years. That chart is sad.

 

[texaspremed1]

Damn didnt realize that about vascular. So what would i need to do in the next year to improve chances of matching IR?

 

[TypeADissection]

 

[VascularMan]

Damn didnt realize that about vascular. So what would i need to do in the next year to improve chances of matching IR?

I'm not sure where those numbers come from, but at my institution there is a mix of part-time and full-time vascular surgeons, and even the full-time vascular surgeons are happy and not over-worked. They love their jobs, and the only surgeons I've seen complain of "burn out" are chief surgeons who have administrative duties.

 

[IMreshopeful]

I honestly just did the research to check off boxes in the resume. Never cared for ENT.

Basically, I really like the procedures in vascular and IR and cant tell much difference in the fields. So I wouldnt mind matching either. Which one would be easier to match?

It sounds like you enjoy endovascular procedures. This can be done through IR, vascular, or interventional cards. The difference is that
- vascular surgeons have to do surgeries. You need to enjoy doing carotid surgeries, lower extremity bypass, etc in addition to endovascular stuff
- IR also does diagnostic radiology. You need to enjoy reading CT scans, MRIs, chest X-rays, etc as well as doing non-vascular IR procedures.
- IC are cardiologists. You need to also enjoy reading echos, nuclear studies, seeing patients in clinic and medical management of cardiac diseases.

keep this in mind

 

[You shall know the Truth]

It sounds like you enjoy endovascular procedures. This can be done through IR, vascular, or interventional cards. The difference is that
- vascular surgeons have to do surgeries. You need to enjoy doing carotid surgeries, lower extremity bypass, etc in addition to endovascular stuff
- IR also does diagnostic radiology. You need to enjoy reading CT scans, MRIs, chest X-rays, etc as well as doing non-vascular IR procedures.
- IC are cardiologists. You need to also enjoy reading echos, nuclear studies, seeing patients in clinic and medical management of cardiac diseases.

keep this in mind

Does this mean little to no clinic duties for vascular?

 

[NITRAS]

All of those have clinic duties.

 

[IMreshopeful]

Does this mean little to no clinic duties for vascular?

I didn’t say that. But vascular performs surgeries. The other two do not

 

[radsisrad]

If you really end up feeling indifferent between the two (which I think is unlikely), I would go for IR b/c vascular lifestyle sucks.

So does IR lifestyle.

 

[AsianPersuasion]

What's nice about VS is that if you can't do it endo style, YOU (not having to page anyone else) can do it open style. Obviously, you can't do that for the brain and heart. But overall, you have a larger freedom. Maybe I'm bias cause I'm pro vascular right now.

 

[TypeADissection]

* I am not going to discuss IC because it requires having to go through an IM residency and there's zero chance I personally would've been able to make it through that alive. *

I can only recommend to those who are truly on the fence between IR and VS to go rotate on each service for a month if able. It takes about 3 days to figure out the various day-to-day dynamics of each one. Ask yourself some questions while on each service:

- What kinds of consults are they getting? Is this something I'd enjoy?
- What kinds of procedures are they doing? Is this something I'd enjoy?
- What kinds of hours are they working? Is this something I'd enjoy?
- What do they do when not in OR? Are they reading vascular studies (VS) or CTs/MRs (IR when doing DR)? Is this something I'd enjoy?
- Do they seem happy?

If you're on IR, then ask to get placed on the call schedule. Come in when they do for traumatic pelvic/splenic angios or if they have to place a drain on an acutely septic patient that can't go to OR. With either field, there is a kind of pain that manifests when you're all done with cases for the day around 1630 and ready to head home and get a nice meal or go to the gym or go grab drinks with friends, when all of a sudden someone is calling for you to do a procedure that can't wait til tomorrow.

With turnover time and getting the patient into the theater by 1730 at the earliest, you now know if everything goes well you'll be done by 1830. Postop orders and tuck the patient in before going home and now you're looking at leaving the hospital by 1900. This is assuming everything goes well.

So here's the thing, you know already if you're inclined to live this lifestyle because you just have a hankering to see problems and fix them. It's just a matter of how you're going to go about fixing the various problems that'll come your way regardless of the field you're in. There's no wrong answer, just find your jam and go all in baby. Cheers.

 

[CherryRedDracul]

So does IR lifestyle.

Depends on the practice. At some places, pure IR jobs are 8 or 9-5 jobs with some call shifts. Others are more like 5 or 6 AM to 7 PM daily.

Definitely less of a lifestyle specialty compared to regular diagnostic radiology.