Fellowships

[davidjones]

I know there is a thread on AM every year about fellowship reviews. But I think we should start one here, just for consolidation purposes, there is no "IR group" on AM (befuddling in its own way).

I'm not sure if anyone on here is applying this year (I'm not) but perhaps they can post their impressions here. Also people who are at residencies with great programs should feel free to post.

Even though I started this thread, I have no insider knowledge of any IR fellowships, as I am at a program with no fellowship, but I will post places that are consistently ranked as top places, and people from those places can feel free to elaborate on why they rock.

UVA
BCVI (Miami)
U of I (Peoria)
Northwestern
MCW
Stanford
Kasier LA (heard from a co-resident that it's awesome, great clinical time, lots of cases)
MUSC
U of Minnesota
Mayo (Florida and Minnesota)
Emory
Vanderbilt
Duke
U of Colorado
UPenn
U of Arkansas

---

Members don't see this ad.

 

[badasshairday]

Does Kaiser LA have an IR fellowship? I know they do awesome IR out there, one of the attending's from there frequents this forum and from his posts it seems like they do just about all of it.

 

[omarsaleh66]

all of the above are solid programs, some much better than others. I would add Mt Sinai, GW, VCU, pretty much any place that does alot of PAD.

Brown is excellent as well.

Of the above, the best ones are BCVI, Peoria, UVA, MCW from the places I interviewed and discussed with other IR. Obviously these places do alot of PAD.

If cancer is your thing, there are alot of places that are oncology heavy. Just my humble opinion as a resident. Gluck on the interview trail. IR is awesome field. Diagnostic is fun, but nothing like playing with all these new toys they keep coming out with.

 

[Interchange]

Agree with adding Mt. Sinai; of the places I interviewed, it was the strongest in every way except one, which is that it has no clinic. Otherwise fabulous program with lots of vascular, lots of onc, plenty of TIPS, and fellow autonomy (some might say a tad too much). This program is a must to apply to if you're even sniffing around the NYC region.

I would also add Yale to the mix, albeit reluctantly. I say it that way because while they do plenty of vascular work in addition to the usual complement of onc and other cases, and while they also have a dedicated clinic, the vibe there was so uncomfortable when I interviewed that I ended up dropping it to just about the bottom of my ROL. Many, many others I spoke to on the interview trail, either applicants or fellows, said the same thing. But those who were there swore up and down it was spectacular training, so I think if you're interested in PAD work then you should at least take a look. There were certainly a couple folks on AM who felt that Yale was being underrated. But I ranked it far lower than the program I ended up at, which btw has zero PAD training, if that tells you anything. Otherwise I'm thrilled with my placement, which brings me to the following:

You can have your claudicants. I say that with tongue in cheek, because I'm glad there's excitement among current and future IRs about staying competitive in PAD diagnosis, treatment, and followup. But I have to tell you, it's really ok if you... um... don't really find it all that interesting. I know some folks in cards and VS make it out to be the only thing worth doing in the world of intervention, and much of the discussion among prospective IRs the last couple years has been centered around the pursuit of PAD exposure during fellowship training. But the truth is, extremity vascular work barely scratches the surface of what you can do in IR, and if you never do a single case of it in practice--who cares? As I mentioned in another thread, there is no field in medicine nearly so versatile as IR. And this idea that IRs "don't do any vascular work" is pure fallacy, unless you consider TIPS, BORTO, mesocaval and other portosystemic shunts, declots and other fistula cases, venous access, filters, EVLA, SIRT, TACE, UFE, varicocele embos, spleno-embos, GI bleeders, PAVMs, bronchials, etc etc etc, nonvascular. See what I mean? And that's STILL not even close to rounding out the ridiculous complement of skills you acquire as an IR. So if you have a special passion for treating claudication, by all means go for it and gun for a spot at BCVI where you'll do runoffs until you can't stand it anymore. But if you don't really care, then don't get hung up on it, because you'll just forge a great career in other areas of expertise.

 

[badasshairday]

I hear great things about MCW and UVA in particular. Great mix of cases from onc to msk to venous to arterial. BCVI is always talked about because they are so clinical and have so much arterial work.

 

[Dotterer]

I just went through the match this past year and so I'll throw in my 2 cents.

Rather than dividing programs into those that are heavily involved in PAD and those that are not, I found it more useful to divide programs into those that have a very strong clinical model and those that do not. There are a handful of programs out there that will train you so well both technically and clinically that you can compete on even ground with cardiologists, vascular surgeons and other subspecialists. You can get good procedural training at many programs, however the difference between an average IR and a great IR lies in their clinical acumen and decision making. Anyone can learn to do a procedure, the trick is knowing when to do a procedure, when to do one technique over another, when to opt for conservative medical management (and actually manage it yourself), how to handle your own complications, and follow your patients longitudinally.

It just so happens that many of the clinically modeled fellowship programs are also the ones that still do a large volume of PAD and aortic work. I would argue that the reason they still do these cases while other programs have lost them is directly related to their clinical expertise and the indispensable role they play within their institutions.

The top 4 clinically oriented programs (in no particular order) that I had the pleasure of interviewing at are:
BCVI, Brown, MCW, UVA

Northwestern was also extraordinary and probably the best and most clinical of the other well known but less clinically oriented programs.

Peoria is a great clinical program with an excellent out-pt clinic and strong PAD and general IR work. The faculty there are amazing and very good at bestowing their knowledge and skills on their fellows. The only downside is a paucity of oncology work. The medical oncology group in Peoria is very dominant and prefer to do trial after trial of experimental chemo regimens rather than refer their pts for interventional onc therapies.

GW is another exceptional program that only takes 1 fellow (sometimes with a 2nd fellow from the military) which does not participate in the match process. It is a unique, almost apprentice like fellowship year under the tutelage of the great Anthony Venbrux and other excellent faculty from UVA and Hopkins.

I did not apply to any programs west of Chicago/Milwaukee, or in the NYC area. Programs I have heard good things about and cannot discount since I have no first hand experience include University of Colorado, Oregon (Dotter), University of Washington, Stanford, Mt. Sinai and UCLA.

Several high-powered institutions with historically excellent names in the medical field overall have lost a lot of ground in IR and offer somewhat diluted experiences with minimal clinical training. Things change rapidly in academics and these programs may improve significantly in a short period of time. It's worth checking them out and deciding for yourself if interested.

The entire interview trail was an excellent experience and I found it both exciting and invigorating getting to see the practice and scope of IR at various institutions. There are some amazing things happening in our profession. I would encourage everyone to apply and interview broadly.

 

[ironmaidenrules]

Update on the Peoria program. They just hired a new IR attending that trained at MCW and the oncology work is ramping up. Great new addition to an already excellent program. Probabably one of the best in the midwest.

 

[RedMorning]

Can anyone speak to the quality of the MD anderson program. Heavily onc oriented Im sure, but is their training well rounded?

 

[badasshairday]

Update on the Peoria program. They just hired a new IR attending that trained at MCW and the oncology work is ramping up. Great new addition to an already excellent program. Probabably one of the best in the midwest.

I would agree. Arguably top 5 in VIR training. That is the thing with VIR fellowships, a lot of the good ones tend to be less "name brand" programs.

The new interventionalist from MCW is a great addition, I know him personally. MCW gives plenty of exposure to arterial interventions and oncologic interventions. Great addtion to Peoria, which as you said, is already a great program.

 

[Radiologyreviews2015]

Any thoughts on Michigan IR or their Clinical Residency pathway?

Young faculty, one from UVAs Direct pathway and a Penn IR faculty member

 

[mcridog3]

Michigan IR is great

 

[rufaterd]

Michigan IR is great

Michigan seems to be really popular based on fellowship ROLs this year.