Interventional Neuroradiology Fellowship and recent changes in IR pathways

[plasmodium]

Considering that the IR Fellowships are expected to be phased out come 2020, will the INR pathways be affected in any way? Will INR still be an option for those entering IR through the DR/ESIR, independent, or integrated pathways?

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[IRorBustguy]

considering interventional neuroradiology fellowships are obtained via DR --> Neuroradiology fellowship --> NIR, i presume this would be no different. you still need to get a neuroradiology fellowship (which VIR would allow you to persue since you are still dual certified)

 

[Naijaba]

I agree with IRorBustguy, in an ideal world completing the DR/IR residency would teach you some of the basic skills used in neuro interventional. There is significant overlap in terms of gaining access, manipulating catheters, deploying coils, etc. Unfortunately, there is no overlap in interventional training, so you'd have to do 6 years of DR/IR + 1 year neurorads + 2 years interventional neuro.

As a side-note, I think it's strange that the integrated program is not shorter than doing DR + IR fellowship. In all of the integrated surgical disciplines they were able to shave off a year by adding focused study during the intern year. For example, in vascular surgery you typically do 6 months of general surgery and six months of vascular during your intern year. I think it makes a lot of sense to do six months of gen surg and six months of IR during intern year. This would be more valuable than a whole year of prelim surg. The problem is IRs don't "own" the preim surg training spots, and typically only a handful of floor patients are managed by IR. Once IR starts having more patients that require floor management, then I think having dedicated interns on the team makes sense. Then maybe they can reduce the duration of training.

 

[irwarrior]

You should strive to get a solid experience doing cerebral angiography, carotid stenting and stroke therapy during your IR residency. In fact I would look to identify residency programs where you are able to get that experience during the integrated/ESIR training . If you want to expand and do cerebral AVMs and aneurysm coiling you should do a Neuro IR fellowship. Certain programs such as Brown university offer their IR fellows a significant amount of experience in neuro-interventional training.

Some surgical preliminary programs are starting to offer IR months for those who are designated as IR pathway residents. I also agree that as the IR programs expand their clinical role (more admissions, more formal consults , rounding etc) that it would make more and more sense to have some more IR rotations during internship.

 

[maxxor]

I agree with IRorBustguy, in an ideal world completing the DR/IR residency would teach you some of the basic skills used in neuro interventional. There is significant overlap in terms of gaining access, manipulating catheters, deploying coils, etc. Unfortunately, there is no overlap in interventional training, so you'd have to do 6 years of DR/IR + 1 year neurorads + 2 years interventional neuro.

As a side-note, I think it's strange that the integrated program is not shorter than doing DR + IR fellowship.

It is shorter. The powers that be simultaneously decided that training was not LONG ENOUGH so they decided to take on an additional year of IR training.

Old model
1 year internship + 4 years DR + 1 year IR

New Model
1 year internship + 3 years DR + 2 years IR

Yes the (net) time is the same, but fundamentally, they cut DR training by a year and doubled IR training. If they'd not done that decision, then they'd have "shaved a year".