Rads vs Vasc surgery
Started by triniman
Just a med student here. I loved my vascular surgery month, so I can see your conflict. More than half of the procedures we did were interventional which I really liked. On the other hand, your patients are very critical, **** can hit the proverbial fan very quickly intra and post-op, and the open procedures can last a long time. You will work ridiculous hours, but in the end will be paid very well. I personally wouldn't apply to radiology if you don't like diagnostics rads, since that is the majority of your residency training. Also, I would pick intergrated vascular over Direct IR since the job stability is there long-term (don't want to get in a big turf war discussion here). IR vs. Vascular procedures really depend on where you train. At our school Vascular does a lot of things that IR does at other places, so if doing direct IR you would have to be careful where you pick I would imagine (not well versed on this). Maybe an IR fellow can give you more insight. Like I said, if it was me I would pick vascular if only debating between direct IR and direct vascular.
doesn't seem like a tough decision, considering that there are so few integrated vascular programs out there it would be risky to apply to them exclusively.
Do vascular surgery integrated.
care to elaborate why?
thanks. i am considering traditional rads (i like diagnostic rads) and integrated vasc.
There are almost 20 integrated vascular programs now.
. . . and i would feel very uncomfortable applying to only those programs without applying to a backup specialty like gen surg or rads. How many spots in these integrated programs?
Disagree. IMHO the OP needs to decide which field he wants - vascular or IR - not which residency.
If it is vascular then you commit yourself to applying to the integrated programs + gen surg as your back-up
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I had a similar question when I was a student. I agree with SouthernIM in that you need to decide between General surgery / Integrated Vascular and DR/DirectIR. Once you pick surgery versus radiology, you can go for the more specialized options if you'd like.
While IR and vascular surgery share some of the same procedures (mostly being taken from IR), the time spent not doing minimally invasive peripheral arterial work is VERY different. That's great that you do have some interest in diagnostic radiology work, I think most med students could find themselves interested in this. The big difference is the open vascular surgeries that can be very grueling and something that only a few med students would be interested in.
You MUST do a vascular surgery rotation and decide how much you like doing AAA repairs, fem-pop bypasses, CEAs, etc.
I love vascular anatomy/pathology and ultimately ended up in DR residency and planning to do an IR fellowship - which I do not regret. Every now and then I do have some thoughts of what could have been, but the rare 10 hour vascular cases were not for me. I hope to also learn some NeuroIR procedures to get my vascular fix in the future.
Hope this helps.
While IR and vascular surgery share some of the same procedures (mostly being taken from IR), the time spent not doing minimally invasive peripheral arterial work is VERY different. That's great that you do have some interest in diagnostic radiology work, I think most med students could find themselves interested in this. The big difference is the open vascular surgeries that can be very grueling and something that only a few med students would be interested in.
You MUST do a vascular surgery rotation and decide how much you like doing AAA repairs, fem-pop bypasses, CEAs, etc.
I love vascular anatomy/pathology and ultimately ended up in DR residency and planning to do an IR fellowship - which I do not regret. Every now and then I do have some thoughts of what could have been, but the rare 10 hour vascular cases were not for me. I hope to also learn some NeuroIR procedures to get my vascular fix in the future.
Hope this helps.
The beauty of IR is the variety. I can go from fixing a thoracic aortic dissection to stenting a renal artery to doing a carotid stent,to ablating a lung tumor and then a vertebroplasty for a compression fracture. The versatility and variablity is what I truly enjoy.
It would be easy to argue that vascular surgery has equal or possibly more variety. Of course, the argument would be biased.
I think that surgery and radiology are so fundamentally different that the OP should focus on that decision first. Lots of people go into both surgery and radiology with plans for a vascular fellowship, then change their minds during the five years of training with exposure to other subspecialties.
As someone who matched into radiology with the intention of doing IR and is now in the process of switching into GS, though not to do vascular here is my perspective. Both fields are terrific, the variety you see in IR far outpaces what you would see in vascular, though not in GS. As many procedures as there are in VS, you are still ultimately dealing with one specific disease process, vs. IR where you could be running around doing UAE, then do a couple of AAA stents, then do a clot removal, then do a TACE for HCC and all the CT/MRI guided procedures there are.
As everyone else has posted you must figure out where you interests lie regarding the basis for each sub-specialty: DR vs. GS. and as someone who did DR residency and has spoken with GS residents who switched into radiology, DR residency is not a cake walk. You may be in the hospital less, but you are doing a significantly larger amount of reading relative to GS; I would argue that DR resident read more then any other field, with the exception of maybe pathology. There just isn't enough volume in residency to be able to see and learn what you need to. Furthermore while GS call is variable with the amount of sleep you get, pretty much count on NO sleep when you are on call in DR, you are the only one in the whole hospital, so imagine the amount of imaging ordered overnight while you are doing your ER, IM, GS rotations as a med student and then imagine one person having to deal with all that.
To qualify, here is why I am switching: I miss taking care of patients, and while IR does do that, it is not the focus of the training, though it seems to be heading in that direction, and some programs do a phenomenal job of it, particularly Miami Vascular. IRwarrior is a shining example of what an interventionalist should be. But as all paradigm shifts go, it will take some time before his/her mode of practice is the IR standard. And it is about 4 years before you can do IR, and I miss it too much. You absolutely get pt contact in rads residency,(Mammo, US, peds, IR rotations) and anyone who says differently is simply unaware or a jack@$$, but I found that it is not enough for me. I did a year of IM, and that was too much pt care for me. So GS seems to be the perfect mix. So to sum up, do what you are passionate about, if you don't think you can stand 5 years of GS, vascular won't make up for it, and same goes for DR/IR. Basically don't do a residency just because you like the fellowship.
As everyone else has posted you must figure out where you interests lie regarding the basis for each sub-specialty: DR vs. GS. and as someone who did DR residency and has spoken with GS residents who switched into radiology, DR residency is not a cake walk. You may be in the hospital less, but you are doing a significantly larger amount of reading relative to GS; I would argue that DR resident read more then any other field, with the exception of maybe pathology. There just isn't enough volume in residency to be able to see and learn what you need to. Furthermore while GS call is variable with the amount of sleep you get, pretty much count on NO sleep when you are on call in DR, you are the only one in the whole hospital, so imagine the amount of imaging ordered overnight while you are doing your ER, IM, GS rotations as a med student and then imagine one person having to deal with all that.
To qualify, here is why I am switching: I miss taking care of patients, and while IR does do that, it is not the focus of the training, though it seems to be heading in that direction, and some programs do a phenomenal job of it, particularly Miami Vascular. IRwarrior is a shining example of what an interventionalist should be. But as all paradigm shifts go, it will take some time before his/her mode of practice is the IR standard. And it is about 4 years before you can do IR, and I miss it too much. You absolutely get pt contact in rads residency,(Mammo, US, peds, IR rotations) and anyone who says differently is simply unaware or a jack@$$, but I found that it is not enough for me. I did a year of IM, and that was too much pt care for me. So GS seems to be the perfect mix. So to sum up, do what you are passionate about, if you don't think you can stand 5 years of GS, vascular won't make up for it, and same goes for DR/IR. Basically don't do a residency just because you like the fellowship.
