Radiation Oncology vs Interventional Radiology

[RJGOP]

I currently have interest in pursuing radiology or orthopedic surgery, albeit I have a while to decide what I want to do. As of this moment I'm leaning towards ortho but I could always have a change in heart and I'm keeping an open mind. However, I was wondering about the comparison of Rad Onc and IR. Those are the most attractive radiology sub specialties to me right now. I'm curious as to what the pros and cons are of each specialty. I'm heading into M1 this year and I know it is early, but ortho and rads are so competitive its advantageous to get a head start. Thank you guys in advance.

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[karayaa]

IR is a sub specialty of Rad, but I wouldn't call Rad Onc a subspecialty of Rad. It's a separate residency.

Rad Onc, you work with cancer patients, so it's mostly people who are middle-aged and older. It can be emotional. In private practice, you spend time in 1hr consults with new patients. Then you work on a computer to plan their treatment with a dosimetrist and medical physicist. You have 15min checkups with them during their 4-8 wk treatment to manage side effects.
It's a great specialty for introverts, because there's lots of computer time, and lots of intense face to face time where you're talking about serious, life changing diagnoses. Anatomy and physics are important. You spend a ton of time looking at MRIs and other scans and contouring the tumor area and determining the dosage.
Patients don't come to you until they have a diagnosis and someone else, their primary care doc or the surgeon or med onc doc who saw them before you, decides they're a good candidate for radiation therapy. You just focus on treatment. You can treat almost anything, and make a big difference in quality of life, but you can't cure everything. Rad Onc obviously focuses on the tumors that are viable targets of radiation. You usually don't order diagnostic tests.
You can also do brachytherapy if you want procedures.

IR is more about radiology-guided procedures and radiation medicine and tracers, from what I hear.

 

[RJGOP]

IR is a sub specialty of Rad, but I wouldn't call Rad Onc a subspecialty of Rad. It's a separate residency.

Rad Onc, you work with cancer patients, so it's mostly people who are middle-aged and older. It can be emotional. In private practice, you spend time in 1hr consults with new patients. Then you work on a computer to plan their treatment with a dosimetrist and medical physicist. You have 15min checkups with them during their 4-8 wk treatment to manage side effects.
It's a great specialty for introverts, because there's lots of computer time, and lots of intense face to face time where you're talking about serious, life changing diagnoses. Anatomy and physics are important. You spend a ton of time looking at MRIs and other scans and contouring the tumor area and determining the dosage.
Patients don't come to you until they have a diagnosis and someone else, their primary care doc or the surgeon or med onc doc who saw them before you, decides they're a good candidate for radiation therapy. You just focus on treatment. You can treat almost anything, and make a big difference in quality of life, but you can't cure everything. Rad Onc obviously focuses on the tumors that are viable targets of radiation. You usually don't order diagnostic tests.
You can also do brachytherapy if you want procedures.

IR is more about radiology-guided procedures and radiation medicine and tracers, from what I hear.

Thank you for the insight. I am hesitant in considering rad onc because of the emotional pain it can cause the patients. Also, I'm not introverted at all, not to say I'm an extrovert but I probably wouldn't like all the alone time and serious discussions. But as I said before, I'll keep an open mind. Thanks so much.

 

[Winged Scapula]

Thank you for the insight. I am hesitant in considering rad onc because of the emotional pain it can cause the patients. Also, I'm not introverted at all, not to say I'm an extrovert but I probably wouldn't like all the alone time and serious discussions. But as I said before, I'll keep an open mind. Thanks so much.

What you might not have considered is that an oncologic specialty can be very rewarding as patients typically want and will work to get better.

 

[shiftingmirage]

I did an IR rotation and it was basically procedures from the start of the day to the end of the day. AV fistula checks and declots, IVC filter placement and retrieval, biopsies, ports, chemoembolization, dialysis catheter placement. The fellows would take turns doing consults and helping with consents if there was a backlog, generally the PA did them. They really didn't spend much time with patients outside the OR.

I had a radiation oncologist preceptor that I observed 8-10 times. Like Karayaa said, new patient evals were generally 1 hr, follow ups were scheduled for 30 min. You would see a wide range of emotions from denial, fear, sadness, to strength and determination.

 

[RJGOP]

What you might not have considered is that an oncologic specialty can be very rewarding as patients typically want and will work to get better.

That is also true. It depends on the person though.

 

[RJGOP]

I did an IR rotation and it was basically procedures from the start of the day to the end of the day. AV fistula checks and declots, IVC filter placement and retrieval, biopsies, ports, chemoembolization, dialysis catheter placement. The fellows would take turns doing consults and helping with consents if there was a backlog, generally the PA did them. They really didn't spend much time with patients outside the OR.

I had a radiation oncologist preceptor that I observed 8-10 times. Like Karayaa said, new patient evals were generally 1 hr, follow ups were scheduled for 30 min. You would see a wide range of emotions from denial, fear, sadness, to strength and determination.

Thank you for the information.