Figure 1: Interventional radiology Training pathway in the UK4
with the overall quality of training they receive as well as their quality of life. There remain issues of competition from other specialties and concerns around reciprocity of training, particularly for endovascular aortic and peripheral arterial work.3,4
This review showed that
concerns around endovascular training are most acute in the United States and less frequent in Europe. In the UK, trainees reported a greater satisfaction with their exposure to vascular training. Heretofore, this has not been an issue for Irish trainees.
Training in Ireland Radiology training in Ireland (overseen by the Faculty of Radiologists, Royal College of Surgeons in Ireland) is a 5-year residency consisting of 4 core years followed by a final year in the resident’s subspecialty of choice. Entrance to the training programme remains intensely competitive. All entrants will have completed a minimum of two years of clinical practice prior to commencing Radiology; however, most will have spent 3–4 years in Medical or Surgical practice before starting, resulting in a strong, clinical base. All radiology residents rotate through IR as part of their core 4 years, IR teaching and training (including vascular simulator- based training) being core components of the educational program which follows a common centrally-prescribed curriculum and incorporating central and local institutional-delivered components. At the end of fourth year, residents must pass a general Radiology exit examination (FFRRCSI— equivalent to the North American Board examinations).
Those interested in pursuing IR will choose IR as their fifth year, following
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which they will complete an additional IR Fellowship in a non-Irish center, most commonly North America, the United Kingdom or the Antipodes. Those pursuing IR take the European Board of Interventional Radiology examination (CIRSE) at the end of their dedicated IR fifth year or first year of fellowship (adopted by the Faculty as the recognized exit exam in IR). Many Irish radiologists undergo two years of fellowship training to enhance their competitiveness in the job market. Scholarly pursuits leading to publications are expected and thus most will assume positions as attendings in major academic teaching hospitals.
A large proportion ultimately return to Ireland for most of their attending careers where the majority work in public academic teaching hospitals, some of whom also provide IR services to affiliated private hospitals. A minority of IRs work in sole private
practice hospital settings; however, prohibitively high malpractice insurance is a disincentive.
IR is well regarded by other subspecialists and collaboration, rather than competition is the norm, albeit some turf battles are ongoing with vascular surgeons for PAD and aneurysm work in particular.
The Irish IR community is currently engaged in a lengthy process with the Medical Council to achieve subspecialty recognition, which is anticipated in the near future. Despite the current lack of such recognition, most Irish IRs have a clinical practice model, seeing patients referred from Family Practitioners and other Hospital-based attendings in clinic pre-and post-procedure or as in-house consults. Most IRs have day bed rights and a significant proportion have admitting rights; the latter usually reflecting individual IR’s motivation,
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