by Paul D. Rotolo, MD, MS, PGY-5
As the chair of the SIR RFS Government Advocacy Committee, I think it is important that we all be involved in advocating for Vascular and Interventional Radiology. In general, the hard work, sacrifice, and rules governing a person’s transition from medical student to attending physician are poorly understood. The value of your work as an attending is affected by others who also have a biased or limited perspective of your therapies.
These problems with our system will become apparent once the Dual Certificate residency is in full swing. Securing funding for Dual Certificate residents while not taking away from Diagnostic Radiology programs will be a tall task. It is for this reason, and many others, that we as residents, fellows, and students must educate and influence the people making important decisions about our future.
One way to inform our representatives is through site visits. This past October, through Project Medical Education, a number of policymakers and government representatives came to Maine Medical Center to learn about life as a medical student and resident. They learned about the hard work that goes into graduating from medical school and the harsh reality of paying for a United States medical school education. As part of the day, they spent an afternoon with residents from the various specialties at Maine Medical Center. I was able to spend the day with Portland, Maine State Representative Dick Farnsworth, and had the opportunity to teach him about the field of Interventional Radiology.
Our visit started with a luncheon where Representative Farnsworth was surprised to learn about Interventional Radiology as it was not a specialty that he was familiar with. We discussed the many therapies that we offer patients and I gave the example of a pulmonary emboli thrombolysis case that I was recently involved in. One of our other visitors was surprised to hear about thrombolysis as his father had passed away from a severe pulmonary embolus and did not recall his father being offered such a therapy. After describing the minimally invasive foundation of our therapies, everyone at our table was quite interested. They were impressed at the complex and elegant procedures we perform through such small incisions.
Representative Farnsworth and I then moved downstairs to the Interventional Radiology Department. He observed as I completed procedures. My attending, Dr. Thomas Dykes, and I discussed our cases for the day with him. He was thoroughly impressed by the deep vein thrombosis cases that we were treating that week. He even assisted me in discharging my patient who underwent DVT thrombolysis and watched as I arranged the patient’s follow up with hematology. More than once, he expressed his surprise as to how patient-centered Interventional Radiology is at Maine Medical Center.
During our time together, we discussed the challenges of graduate medical education, including the formation of the new residency dedicated to training Interventional Radiology clinicians. We discussed the problems with the current model of Graduate Medical Education funding, specifically the difficulties of creating a spot at our hospital for a Dual Certificate DR/IR resident. This currently necessitates taking a residency spot away from our Diagnostic colleagues or potentially from a separate specialty altogether, including a primary care specialty, unless we could identify alternative funding from an outside source. Representative Farnsworth was concerned about and disappointed in the complex rules and regulations that govern Graduate Medical Education. He agreed that changes need to be made to make the system more flexible.
While our visit and conversations regarding Interventional Radiology and Graduate Medical Education funding were excellent, perhaps the most rewarding part of the day occurred when I returned Representative Farnsworth to the project coordinators. While waiting for the rest of the group, several other participants in the day’s activities, as well as high-level Maine Medical Center administrators joined us in conversation. When they found out that Representative Farnsworth spent his afternoon in Radiology, they expressed dismay that he was unable to interact with patients. He immediately corrected them, describing the therapies, the patients we met, and the family members we talked with, including the patient that we discharged. He complemented our department for our patient-centered care and ability to quickly form relationships and bonds with our patients, despite the lack of an extended stay. He specifically stated how impressed he was by the gratitude our patients and their families expressed for the care and treatment that we offered.
As residents, we need to be more involved in projects and opportunities that bring exposure to our field. We need to be arranging site visits that showcase our therapies and our clinical care. It is up to us to make Interventional Radiology a more visible and understood specialty. I encourage everyone to approach their department and try to arrange visits with the policymakers and government officials who will dictate the future of our field. Get involved with the RFS, help SIR with the current push to redistribute funded but historically unfilled Residency spots across the country, so that Dual Certificate Programs can be opened. Please feel free to contact me with any questions, comments, tips, or advice.
Photograph by Charlie Allen, Maine Medical Center