Too late for IR? Not sure if its the right choice? M3

[sipping_cipro]

Sorry in advance for another thread from a confused med student.

A reddit post called IR the "wild west" of medicine that sometimes flies close to the sun. I love that. They described needing to find creative solutions to procedural problems that few (if any) have ever described in the literature. It seems like this kind of IR work only occurs at "top name" academic centers, which I know I'm not competitive for, and know the odds of landing a future job at a "top name" academic center is a slim shot as I don't have the pedigree. The thought of training in IR only to be relegated to a dumping ground for ports / lines / drains is not appealing.

Other things I've read online is that the training at these top name places is super variable. Residents don't get a ton of practical experience doing procedures, as attendings don't let them do operate. I've heard this is true at my own institution (a top 20 medical school, w/e that means). I've even read it here on this forum, where people say the "see one do one teach one" model is dead and residents end up just watching cases. And then of course, the possibility of not being trained in certain things at all because of turf battles is scary as well.

Are these concerns overblown? Would I find good training by doing DR into ESIR? I fear even ESIR is getting crazy competitive now. I like DR, but don't feel like I could do it for 100% of my time. Briefly, stats are mid 240's step 1, half H half HP for 3rd year, tons of research (first authors + some more, but none of it is DR/IR), and I attend a top 20 med school. My home IR department apparently sucks, as their ESIR spots always go unfilled, so I'm looking here for advice. Thanks in advance.

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[Clean7795]

Sorry in advance for another thread from a confused med student.

I always thought I was going to do IM, but recently have been leaning away from it. I like the cerebral aspects, but find rounds merely tolerable, hate the social work aspect, and 80% of the time it feels like the service is not advancing patient care. I did an anesthesiology rotation and enjoyed intubating and placing lines, now I'm doing my surgical rotation and like the OR so much that I'm thinking about it when I'm not in it. I did a radiology rotation which I enjoyed a ton as well. This all has me considering IR now, but I fear I'm too late to be competitive and a lot of what I read online about the field scares me.

A reddit post called IR the "wild west" of medicine that sometimes flies close to the sun. I love that. They described needing to find creative solutions to procedural problems that few (if any) have ever described in the literature. It seems like this kind of IR work only occurs at "top name" academic centers, which I know I'm not competitive for, and know the odds of landing a future job at a "top name" academic center is a slim shot as I don't have the pedigree. The thought of training in IR only to be relegated to a dumping ground for ports / lines / drains is not appealing.

Other things I've read online is that the training at these top name places is super variable. Residents don't get a ton of practical experience doing procedures, as attendings don't let them do operate. I've heard this is true at my own institution (a top 20 medical school, w/e that means). I've even read it here on this forum, where people say the "see one do one teach one" model is dead and residents end up just watching cases. And then of course, the possibility of not being trained in certain things at all because of turf battles is scary as well.

Are these concerns overblown? Would I find good training by doing DR into ESIR? I fear even ESIR is getting crazy competitive now. I like DR, but don't feel like I could do it for 100% of my time. Briefly, stats are mid 240's step 1, half H half HP for 3rd year, tons of research (first authors + some more, but none of it is DR/IR), and I attend a top 20 med school. My home IR department apparently sucks, as their ESIR spots always go unfilled, so I'm looking here for advice. Thanks in advance.

While yes a lot of academics are doing borderline crazy procedures, lines/ports/drains/tubes/biopsies are the bulk of an IR practice everywhere. Although there is not much glory in them (except for knowing are providing an important life altering intervention), when you are established in your IR practice you will appreciate these sort of straightforward easy cases. If you despise doing them though I would reconsider careers.