by Victor N. Becerra, MS3, FIU Herbert Wertheim College of Medicine
Interventional radiology continues to attract attention from many specialties as well as many inquisitive residents and medical students. One of the best ways to learn about the specialty (besides diving right into the interventional suite) is learning about the advances in the field by attending conferences. One such conference that took place recently was the New Cardiovascular Horizons (NCVH) Miami Florida conference held on December 5th, 2015. The conference offered a medical student program to introduce and update prospective interventional radiologists on what makes the specialty unique, rewarding, and innovative, solidifying its place in the future of medicine. Several conference programs paired small groups of medical students with an interventional radiologist, rotating through vendors to familiarize students with the concepts behind the tools used by interventional radiologists in their day-to-day work life. Students were able to practice setting up catheter guided interventions and learn about the different tools that are available in the interventionalist’s toolkit.
Another great workshop was the Tibiopedal Access workshop led by interventional cardiologist Dr. Arthur Lee of Gainesville and co-chairman of the NCVH meeting in Orlando, FL. Using lower extremity cadaveric specimens, Dr. Lee instructed students on the clinical significance of obtaining tibiopedal access as well as instructing the proper technique required to perform the procedure correctly including proper ultrasound technique and catheter placement with either a long-access or short-access approach. Many students, donned in surgical gowns and gloves, were able to participate and appreciate this essential technique.
Perhaps one of the most fruitful aspects of the meeting was learning about how interventional radiology can be useful in many clinical situations and how to enter the field. There were case presentations that covered several interesting cases including treatment and management of lower limb DVT, pulmonary embolism, acute limb ischemia, and prostatic enlargement. Those in attendance were encouraged to ask questions and explore the decisions regarding clinical treatment and interventions performed.
Furthermore, because of the recent addition of IR as a stand-alone residency recognized by the ACGME, the current interventional radiology fellowship training will be phased out by July 1st 2020 and the changing paths of entering the field of IR was explained. There are now three options to enter the field which include:
1) 5 year Integrated IR Residency + 1 ACGME-accredited clinical year [6 years]
2) Early Specialization in IR (ESIR) during DR training may receive credit for the first year of the two-year independent IR program [6 years]
3) Independent IR Residency DR residency + 2 years of additional IR training [7 years]
The pros and cons of each route were explained in depth by a panel of residents, fellows, and attendings with active audience participation. While the prospect of entering an interventional radiology residency sounds like a great way to save a year and enter the specialty, many students found themselves worrying about the few spots that are currently available and the amount of competition for those spots brings. Students and residents were assured that entering the field is still very possible through ESIR or entering an independent IR residency, although the latter would add an extra year of training. The panelists addressed a popular question regarding how to enter any of these routes. It was explained that the integrated IR residency and independent IR residency options both participate in the NRMP match process while ESIR is a process that happens at the institution where the resident is currently working on their diagnostic radiology residency.
Throughout the conference day, it was strikingly apparent how friendly and conversational the attendings, fellows, and residents were to the inquiries of conference attendees. Interventional radiology is a field that drives innovation through nurturing and encouraging inventive and hardworking students to consider what interventional radiology has to offer. “The ‘Standard of Care’ is not always set in stone; in a way this is why IR can be seen as future proof,” says Dr. Beau Bosko Toskich of University of Florida’s Department of Radiology. “It’s always about innovating and defying what we know about medicine by finding new and better approaches to treatment all the while keeping the patient’s best interest at heart.” This seemed to be the shared mindset among many of the doctors in attendance. It was stressed many times that what sets IR apart from other specialties was this drive for innovation ever since Dr. Dotter’s humble beginnings as the world’s first IR physician. “Interventional Radiologists are true clinicians,” added Dr. Reginald Baker, Vascular IR attending at the University of Miami. “Before the procedure even begins all the way to follow-up, interventional radiologists seek to take care of patients as a whole; this is one way how as a profession we are able keep our patient population.” Indeed, scope of practice is a hot topic in IR and related fields, but many share Dr. Baker’s and Dr. Toskich sentiments which will undoubtedly propel IR into the growing specialty of the future.
If you are interested in attending future NCVH conferences, please visit www.NCVH.org.
Upcoming NCVH conferences
- Orlando, FL – March 5th
- Hattiesburg, MS – March 12th
- Mid-Atlantic, Washington, D.C. – April 2nd
Pictured: Interventional Cardiologist Dr. Arthur Lee of Gainesville instructs medical students on proper tibiopedal access techniques on lower extremity cadaveric specimens.