Why did you decide to choose DR over IR / IR over DR? Excluding reasons of patient contact/AI

[Tiger100]

Historically, the VIR graduate did primarily DR in their training, but this is changing with the advent of the integrated training . Of their 6 year program well over 50 percent is clinical/procedural which often includes a busy surgical internship. Also, if you include the number of surgical and clinical rotations they do 4th year this amounts to closer to 4 of the 7 years being mostly clinical/procedural. The IR graduate is also going to more and more dedicated IR meetings(SIR/WCIO/GEST/LEARN/Synergy/ISET/AIR/AIIMs etc) as opposed to DR meetings (RSNA/ARRS). This is much different than when their 4 th year of medical school was more DR rotations and the internship was often a prelim IM or even a TY and they only did about a year of traditional procedural IR fellowship. So just around 2 of the 7 years was clinical/procedural in nature. Those deciding that they want to go the integrated IR route are far more willing to sacrifice the historic ROAD lifestyle to pursue a higher end IR practice.

The IR graduate may also feel more comfortable in the angio suites and the clinic as opposed to the reading room.

So though the current trend still favors mixed practices and that will likely be the majority for some time. There is a transition to more and more pure outpatient IR jobs and even more and more independent IR practitioners and independent IR groups. This trend is likely to increase as the needs of the IR clinician include a clinic to see and counsel patients, which most DR groups in the current structure are unable to easily provide.

This seems like a good setup to spend 4 out of 7 years in IR/clinic and have their main focus on interventional radiology. But this setup also implies that unlike the traditional pathway, the new generation of IR docs won't be good diagnostic radiologists and probably they won't be able to cover an ER shift as good as diagnostic radiologists or even traditional IR docs (everything is a tradeoff, isn't it?).

This setup is great if all of them can find a 100% IR job once they are done (I personally don't think there is enough IR business out there for all of them to do 100% IR). However, According to some posters here, most IR jobs are 100% IR (which I disagree). If that's the case, then the new training system is great. And IR is in a unique position in a way that many other proceduralists and surgeons don't have this opportunity. For example, In the community most interventional cardiologists have to do a lot of general cardiology on the side. Or many surgeons have 2 days of OR and spend the rest of their time doing non-OR tasks.

But if they want to do some DR days, I don't know how it will work giving their not-so-great-DR training in the first place and more importantly how it will work giving the fact that the hospital will have two seperate DR and IR groups.

Good Luck!

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[NDcienporciento100]

This seems like a good setup to spend 4 out of 7 years in IR/clinic and have their main focus on interventional radiology. But this setup also implies that unlike the traditional pathway, the new generation of IR docs won't be good diagnostic radiologists and probably they won't be able to cover an ER shift as good as diagnostic radiologists or even traditional IR docs (everything is a tradeoff, isn't it?).

This setup is great if all of them can find a 100% IR job once they are done (I personally don't think there is enough IR business out there for all of them to do 100% IR). However, According to some posters here, most IR jobs are 100% IR (which I disagree). If that's the case, then the new training system is great. And IR is in a unique position in a way that many other proceduralists and surgeons don't have this opportunity. For example, In the community most interventional cardiologists have to do a lot of general cardiology on the side. Or many surgeons have 2 days of OR and spend the rest of their time doing non-OR tasks.

But if they want to do some DR days, I don't know how it will work giving their not-so-great-DR training in the first place and more importantly how it will work giving the fact that the hospital will have two seperate DR and IR groups.

Good Luck!

What post says that most IR jobs are 100%?

 

[Tiger100]

What post says that most IR jobs are 100%?

Look at recent posts bt UChicagoIR who claims to be an academic IR and knows a lot about IR job market. Also he believes that DRs should not give any comment about IR.

Below is his post on recent thread:

[There's certainly a large number of 50/50 IR/DR practices, but this is changing and will continue to change. My personal outlook is that within 10 years any radiology practice in a mid-to-large city will have full-time interventionalists. It's simply more efficient to have your DRs stick to churning out films and your IRs sticking to procedures. Jumping from one to the other during a workday is not efficient. The hybrid practice will still exist in smaller locales. I've trained roughly 25 fellows and I'd say 80-90% of them have joined 100% IR practices.]


So he claims that out of 25 fellows 80-90% of them join 100% IR practices.
I totally belive in freedom of speech but people should be l responsible for what they say.

A few other posters also have similar beliefs.

Comment: Although I disagree with them, I believe that they are entitled to their opinion. I just asked whether all these 100% job will be available for them or not since according to the last poster their DR training will be suboptimal at the expense of better clinical training.

 

[NDcienporciento100]

Look at recent posts bt UChicagoIR who claims to be an academic IR and knows a lot about IR job market. Also he believes that DRs should not give any comment about IR.

Below is his post on recent thread:

[There's certainly a large number of 50/50 IR/DR practices, but this is changing and will continue to change. My personal outlook is that within 10 years any radiology practice in a mid-to-large city will have full-time interventionalists. It's simply more efficient to have your DRs stick to churning out films and your IRs sticking to procedures. Jumping from one to the other during a workday is not efficient. The hybrid practice will still exist in smaller locales. I've trained roughly 25 fellows and I'd say 80-90% of them have joined 100% IR practices.]


So he claims that out of 25 fellows 80-90% of them join 100% IR practices.
I totally belive in freedom of speech but people should be l responsible for what they say.

A few other posters also have similar beliefs.

Comment: Although I disagree with them, I believe that they are entitled to their opinion. I just asked whether all these 100% job will be available for them or not since according to the last poster their DR training will be suboptimal at the expense of better clinical training.

My guess is you can probably remember when radiation oncology was a subspecies of Radiology. Now rads onc is it’s own field, and I don’t think they are sad about it. My prediction is that Interventional rads will take the same course.

 

[JoshSt]

My guess is you can probably remember when radiation oncology was a subspecies of Radiology. Now rads onc is it’s own field, and I don’t think they are sad about it. My prediction is that Interventional rads will take the same course.

I don’t know if IR can naturally separate from radiology departments like rad onc did from a logistics standpoint, but if they did it would make sense if there were a sufficient number of 100% IR jobs. For those that end up practicing 100% IR and are really really sure they never want to take on DR responsibilities later in their career, an IR and no DR residency might make sense.

 

[UChicagoIR]

Yes, that is correct. 80-90% of my fellows have joined 100% IR practices. We provide a list of all graduates over the last 10 years and the practices they have joined to candidates on our interview day.

@Tiger100 Unfortunately this is the last year of the IR fellowship system. But if you're interested in a career in IR, you can consider applying to our IR/DR integrated program: IR/DR Integrated Residency Program | Department of Radiology | The University of Chicago

On a tangential note: if there is enough interest on this forum, I'm happy to start an "IR Faculty - Answering Questions" thread much like @RadiologyPD did. I've communicated with SDN staff @Neuronix who are supportive of this idea. The goal would be to help clear up some of the misconceptions and, of course, answer questions that come up from interested medical students and residents. Let me know your thoughts here or feel free to PM me.

Look at recent posts bt UChicagoIR who claims to be an academic IR and knows a lot about IR job market. Also he believes that DRs should not give any comment about IR.

Below is his post on recent thread:

[There's certainly a large number of 50/50 IR/DR practices, but this is changing and will continue to change. My personal outlook is that within 10 years any radiology practice in a mid-to-large city will have full-time interventionalists. It's simply more efficient to have your DRs stick to churning out films and your IRs sticking to procedures. Jumping from one to the other during a workday is not efficient. The hybrid practice will still exist in smaller locales. I've trained roughly 25 fellows and I'd say 80-90% of them have joined 100% IR practices.]


So he claims that out of 25 fellows 80-90% of them join 100% IR practices.
I totally belive in freedom of speech but people should be l responsible for what they say.

A few other posters also have similar beliefs.

Comment: Although I disagree with them, I believe that they are entitled to their opinion. I just asked whether all these 100% job will be available for them or not since according to the last poster their DR training will be suboptimal at the expense of better clinical training.

 

[Tiger100]

Yes, that is correct. 80-90% of my fellows have joined 100% IR practices. We provide a list of all graduates over the last 10 years and the practices they have joined to candidates on our interview day.

@Tiger100 Unfortunately this is the last year of the IR fellowship system. But if you're interested in a career in IR, you can consider applying to our IR/DR integrated program: IR/DR Integrated Residency Program | Department of Radiology | The University of Chicago

On a tangential note: if there is enough interest on this forum, I'm happy to start an "IR Faculty - Answering Questions" thread much like @RadiologyPD did. I've communicated with SDN staff @Neuronix who are supportive of this idea. The goal would be to help clear up some of the misconceptions and, of course, answer questions that come up from interested medical students and residents. Let me know your thoughts here or feel free to PM me.

Thank you very much for your suggestion.

I finished fellowship many many years ago (probably before you entered med school) and don't have any interest in doing another fellowship. The IR guys whom I know are trying to get out of IR at my age. Anyway, thank you.

It is great that you try to help med students and answer their questions.

My recommendation to med students: everybody lives in his/her own world and their opinion will not refect 100% reality. It is necessary for you to be open to and listen to different opinions including academic and private practice physicians in different fields. Don't dismiss opinions easily and listen to people's opinions carefully.
For example to my experience most IR jobs are a mix of IR/DR. But the above poster's experience has been different. Rather than attacking one person or dismissing his opinion talk to other radiologists. Look at job boards. See how many jobs are advertised. Talk to other doctors. And you will find out yourself.

Also consider people's biases. For example academic people are usually more biased towards what they do (similar to academic primary care attendings who try to convince med students to go to primary care fields) and generally speaking academic environment tend to attract people with higher egos ( I will change the world mentality). On the other hand, private practice guys also has their own biases which is usually centered around business side of things.

Anyway keep your eyes and ears open and good luck.