Status of IR Training

[Sheldor]

I read in a SDN thread from a few years ago that a decision had been made by the higher ups to create a stand alone, 5 year IR residency similar to ENT and Urology. However, from the research I've been doing I see that the most common path to IR is still to do a diagnostics residency followed by an IR fellowship.

I am just curious what the current status of this push is. I know there are some DIRECT pathways cropping up, is that the wave of the future? Is that what these older forum posts were referring to?

Thanks!

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[badasshairday]

Traditional pathway still seems to be the way to go in the time being.

 

[IRneuroIR]

There was an idea to have a primary certificate in IR (akin to the straight 5 year vascular surgery pathway) but this was ultimately not supported by radiology groups/societies outside of IR.

The DIRECT pathway is a more clinical model for training by which you do two years of clinical training and more IR training but ultimately are responsible for all of the diagnostic training in a shorter time span. There are a few of these slots in diagnostic radiology residency programs across the country and the first wave of graduates will be finishing soon.

The most recent proposal which has passed through the ACR (American College of Radiology) is for a 6 year program at the end of which you are dual certified in diagnostic and interventional radiology (similar to a med/peds model). The difference between this and the current/most common model (5 years diagnostic radiology then 1 year IR) and the DIRECT model is that your certification in IR would be a primary certification rather than a CAQ (certificate of added qualifications -- a secondary certification). Therefore you would be double/dual board certified in DR and IR versus a primary certification in DR and a CAQ in IR. It may seem like semantics but this is an important step to elevate the status and importance of IR.

Right now, this proposed model is before the ABR (American Board of Radiology) who will determine whether this will be supported and implementable.

 

[IRneuroIR]

Here is the release from SIR regarding the dual certification pathway...

 

[DeadCactus]

How competitive are the direct pathway spots? About the same as DR?

 

[cowme]

How competitive are the direct pathway spots? About the same as DR?

DIRECT=2 years of surgery=way easier

 

[Radonkulous]

There was an idea to have a primary certificate in IR (akin to the straight 5 year vascular surgery pathway) but this was ultimately not supported by radiology groups/societies outside of IR.

The DIRECT pathway is a more clinical model for training by which you do two years of clinical training and more IR training but ultimately are responsible for all of the diagnostic training in a shorter time span. There are a few of these slots in diagnostic radiology residency programs across the country and the first wave of graduates will be finishing soon.

The most recent proposal which has passed through the ACR (American College of Radiology) is for a 6 year program at the end of which you are dual certified in diagnostic and interventional radiology (similar to a med/peds model). The difference between this and the current/most common model (5 years diagnostic radiology then 1 year IR) and the DIRECT model is that your certification in IR would be a primary certification rather than a CAQ (certificate of added qualifications -- a secondary certification). Therefore you would be double/dual board certified in DR and IR versus a primary certification in DR and a CAQ in IR. It may seem like semantics but this is an important step to elevate the status and importance of IR.

Right now, this proposed model is before the ABR (American Board of Radiology) who will determine whether this will be supported and implementable.

I don't see how IR can survive long term without a stand alone primary certificate. You just don't get enough clinical training during DR period. Perusing the AM forums, I get the feeling that unless you go to places like BCVI, UVA, Brown, Yale, MCW, Northwestern, Penn and several others you won't receive adequate training. If that's the case, then it might be only worth it to apply to these dual certificate programs. I can't rationalize why you might apply Hopkins DR/IR if the IR portion isn't up to snuff with the rest of the big boys as an example (I'm talking about having a well-balanced program).

 

[IRGuru]

I don't see how IR can survive long term without a stand alone primary certificate. You just don't get enough clinical training during DR period. Perusing the AM forums, I get the feeling that unless you go to places like BCVI, UVA, Brown, Yale, MCW, Northwestern, Penn and several others you won't receive adequate training. If that's the case, then it might be only worth it to apply to these dual certificate programs. I can't rationalize why you might apply Hopkins DR/IR if the IR portion isn't up to snuff with the rest of the big boys as an example (I'm talking about having a well-balanced program).

That's the point. That's why programs across the country are turning more and more clinical, b/c that's where IR is inevitably heading and that's what applicants are demanding. Other strong programs include VCU, Mt. Siani, UI-peoria, UCLA, Georgetown, George Washington etc... I myself won't apply to clinically weak programs for fellowship. That's also why you see a lot of threads on this site and aunt minnie with residents who want to do IR the right way searching out opportunities to gain more clinical experience. Perfect example is IR resident clinic. I'm sure the thought of that would've blown minds just a few years ago but they're reality now.

 

[Radonkulous]

That's the point. That's why programs across the country are turning more and more clinical, b/c that's where IR is inevitably heading and that's what applicants are demanding. Other strong programs include VCU, Mt. Siani, UI-peoria, UCLA, Georgetown, George Washington etc... I myself won't apply to clinically weak programs for fellowship. That's also why you see a lot of threads on this site and aunt minnie with residents who want to do IR the right way searching out opportunities to gain more clinical experience. Perfect example is IR resident clinic. I'm sure the thought of that would've blown minds just a few years ago but they're reality now.

But there is hardly a standard "curriculum" with these programs (i.e. BCVI heavy on arterial work whereas NW heavy on IO). Maybe that's the issue you face with such a "new" specialty. Do ever see there being a standardization of what is taught at each program? I know there are issues with that since you might have to compete against cards and vs for PAD.