In short, institutions that offer multiple pathways into IR are high yield for application season, seeing as they provide availability and flexibility to maximize the applicant’s resources.
Location, location, location Location is becoming less of a potential barrier to practice in the field of IR. Students used to emphasize the location of a residency thinking it would impact the scope of their future practice. However, the current training structure de-emphasizes the local/regional mindset of trainees being stuck in the area where they trained. Due to the increased consistency of training and the emphasis on a structured curriculum for each of the training pathways, practices and programs are becoming more familiar with the level of preparation a resident receives from another institution across the country. Future IRs are going to become more mobile, especially with the wide-reaching network of IRs across the country.
With this in mind, do residency programs take into consideration where a student is coming from when considering them for a position? How does a student demonstrate a meaningful connection to every place they apply? While the obvious ties still carry weight (family connections, places you have previously studied, etc.), students can find authentic ways to demonstrate a potential link to a program. Are you passionate about training in a place that works with the underserved? Is there a faculty mentor involved in a research topic that you find fascinating? While the process of applying for residency can make students hypersensitive about potential rejection, keep in mind that programs likely feel the same way. Students have better chances of being favorably ranked by a residency that believes the student would likely come to their program.
“I regularly tell medical students, when applying to residency, to already have job considerations in mind,” said David Tabriz, MD, RPVI. “Do you want to settle down in a competitive geographic market? Then, I would recommend ranking programs in those areas highly. Do you want to pursue a research-driven academic job? Then ranking research-heavy programs would take precedent.”
Location is becoming less of a potential barrier to practice in the field of IR. Students used to emphasize the location of a residency thinking it would impact the scope of their future practice. However, the current training structure de-emphasizes the local/ regional mindset of trainees being stuck in the area where they trained.
Interventional radiology as a clinical specialty Interventional radiologists have been performing life and limb-saving procedures for many decades. But while public awareness has grown over the years, according to a 2023 study only 39.8% of participants recognized IR as a medical specialty.
One of the reasons for this, as Isabell Newton, MD, PhD, the cocreator of Without a Scalpel puts it, is because interventionalists have traditionally been doing “good work in dark places.” The tools and techniques of our field are exceptional, but other providers can learn them. In order for our specialty to survive and thrive, and for our patients and the healthcare system to gain the full benefits of our unique discipline, we must strive to become visible, equal partners in patient care along with our medical and surgical colleagues.
As IRs of the future, we must be equipped to educate our patients about their disease processes, counsel them on alternative therapies and provide comprehensive longitudinal care both in and out of the hospital. Hence, when evaluating integrated residency programs, it is important to inquire about the extent of meaningful clinical training offered.
We asked our faculty and residents what to look for in order to make an educated assessment of IR residency programs’ culture and quality of clinical training.
1 Look for a vertical integration
Vertical integration in IR programs is defined as the level of clinical training offered throughout the full length of residency. While some programs offer no clinical rotations during the PGY-2–4 years, others allow residents to rotate through several surgical subspecialties. Currently, integrated IR programs have a minimum requirement to provide 1 month of ICU training during the entire length of integrated residency; but as stated previously, there is a wide disparity of exposure to the quantity and timing of non-IR clinical rotations offered at different institutions. When evaluating a program, it’s important to inquire about how many clinical rotations they offer and how much of that clinical training is offered during the first 4 years of the program. As the curriculum for the residency programs become more standardized, the variability in both the number and variety of these rotations may decrease, but it will still be beneficial for students to consider the different clinical opportunities that will be available to them outside of the IR suite.
2 Look for a robust IR outpatient clinic
The practice of IR has changed dramatically in the past several decades. Interventional radiologists are transitioning from being the option of last resort to becoming the first choice over surgical therapy. Many primary care providers routinely send patients to surgical colleagues instead of IRs because they don’t know about us. Building a robust outpatient practice is a key step to attracting patients and generating referrals from primary care providers. As future IR physicians, we must become comfortable with the outpatient management of our patients. Therefore, applicants should ask about the extent of faculty and resident involvement in the IR outpatient clinic. All integrated IR programs are required to have an outpatient IR clinic, but there
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