use and practice. But while it’s easy to ask a program how many ICU rotations they off er, it’s diffi cult to gauge the culture of an institution and their commitment to clinical patient care during the course of an interview.
are no rigid requirements about the extent and quality of time that residents spend in clinic. Currently, residents in some programs have assigned clinic days throughout the PGY-2–6 years, but others only participate in the clinic in the PGY-5–6 years of training.
Tip from an expert: When evaluating the quality of the IR clinic, ask about the clinic volume, what percentage of clinic visits are new consults or follow- ups, what percentage of new consults result in procedures, and inquire about the average length of follow-up for patients. A strong clinic is one where there are more follow-up visits than new consults, and not all consults lead to procedures. In a true clinical consultation, the physician utilizes their best clinical judgment to identify the most appropriate treatment modality for the patient’s specifi c concern. It is the clinical decision-making piece that distinguishes a consultation from preoperative assessment, where a patient is being worked up for a treatment modality that a consulting provider determined to be the most appropriate course of action. In addition, the length of follow-up (post-op visit vs. lifelong) is also very telling of the attitudes that providers have towards clinical practice and demonstrates if a provider takes ownership of their patients.
3 Role of IR in patient management and
relationships with other providers The call for IR to become clinically oriented is nothing new. It was Dr. Charles Dotter, the father of our specialty, who famously said that if interventional radiologists are unwilling or unable to take full clinical responsibility for their patients, then they will become “high-priced plumbers.” However, it is important to recognize that there are many practicing interventionalists that have not adopted this style of practice. So when evaluating IR residencies, it is critical to assess the culture of IR when it comes to patient care at that institution. It’s not difficult to imagine that training at an institution where IR has admitting privileges, acts as the primary team managing the patient’s hospital course, and follows patients long-term in an outpatient clinic is a superior educational experience compared to training in an environment where IR serves primarily as a consult service, performing procedures and utilizing physician extenders to manage patients. As Dr. Vatakencherry said, “it’s not hard to manage a patient’s blood glucose or blood pressure, but if you haven’t done it in a long time, it can be challenging.”
After going through the grueling surgical intern year recommended by many IR residency program directors, none of us want to forget the basics of inpatient management due to lack of
38 IRQ | WINTER 2026
So what is the best way to fi nd out? David Maldow, MD, a former radiology resident at the University of Rochester and a previous RFS Governing Council member, recommends asking attendings and residents about their daily routine. Find out if the IR attendings see consults, round on patients, participate in inter-departmental meetings and where they interface with other specialties. All of this can provide meaningful information about how engaged the IR service is in patient care and their relationship with other providers at their institution. Both Dr. Vatakencherry and Dr. Rochon also made a point to emphasize the importance of collaborative medicine to the future of IR, advising students to inquire about multidisciplinary conferences, clinics and whether or not the practice performs hybrid procedures with other specialties.
Tip from an expert: Residents are expected to keep an accurate log of their procedures during core training. When interviewing and rotating at an institution, ask to see the current resident procedure logs!
As students begin to narrow down their list of residency programs, it may be helpful to keep in mind some of the tips above to fi nd distinguishing features between residencies. In a fi eld where excellent training is the norm, many of the details that set programs apart from each other will be what helps students to fi nd their best fi t. While the integrated IR residencies are appealing for applicants committed to IR, the ESIR and traditional pathways off er students the ability to further explore the specialty and diversify their training locations, which are all things for students to consider.
Acknowledgement: Special thanks to Paul J. Rochon, MD, FSIR; Geogy Vatakencherry, MD, FSIR; David Maldow, MD; and David Tabriz, MD, RPVI, for contributing to this article.
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