IR Residency FAQs

The information below is current as of June 11th, 2017. Please be aware that the current IR training structure is in flux. On or before July 1, 2020, the ‘old’ IR training pathways will no longer be available, and all future IR trainees will have to go through the IR Residency, of which three separate pathways will exist.

The table below summarizes the probable pathway(s) for medical students planning on pursuing a career as an IR.


Click here for currently accredited integrated programs.

Click here for programs currently offering the Early Specialization in Interventional Radiology (ESIR) designation.

Why Interventional Radiology (IR) is becoming a separate primary medical specialty?

Interventional radiology (IR) began to evolve into a more specialized field since the accreditation of IR fellowships by the ACGME in the 1990s. Although there is a large overlap between IR and Diagnostic Radiology (DR) training, specifically the competence in image interpretation and understanding of the underlying disease processes, IR requires a more comprehensive grasp of complex image-guided procedures and longitudinal patient care. Thus, a need for a different IR training model became increasingly apparent.

Recent advents:

  • 2012, the American Board of Medical Specialties (ABMS) approved interventional radiology as a primary specialty in medicine.
  • 2013, the Accreditation Council for Graduate Medical Education (ACGME) approved the formation of a new residency training program in interventional radiology.

Tell me more about the IR Independent Residency?

In addition to the Integrated IR Residency, the Independent IR Residency allows residents to enter IR after the completion of the traditional five-year DR training (1 internship + 4DR). Instead of the traditional one-year IR fellowship, the Independent IR Residency will be a two-year program during PGY-6 and 7. The two years will include components of PGY-5 and 6 of the Integrated IR Residency such as procedural and patient care experience such as ICU, inpatient service, consult service and outpatient clinic. This will serve as the new 2-year ‘IR fellowship option’ for those that do not train under a ESIR program (see below). All independent program applications will be reviewed beginning in 2017, and will have an accreditation effective date of July 1, 2020.

Tell me more about Early Specialization in IR (ESIR)?

Early specialization in IR (ESIR) may be offered at various DR programs, preparing residents with sufficient IR training to qualify for advanced entry into a one-year Independent IR residency. ESIR will allow residents to complete 12 interventional radiology or interventional radiology-related rotations and at least 500 image-guided procedures within the domain of interventional radiology during their 5-year DR residency. The resident could then directly enter the second year of Independent IR Residency, only requiring one additional year of IR training. The ESIR is essentially a ‘mini-fellowship’ in IR during a DR residency.

What makes a competitive applicant?

Please consider reading our article titled “Becoming a Competitive IR Applicant”

If I do not get accepted into the Integrated IR Residency directly from medical school and get accepted into a DR program instead, how can I still pursue IR? What are my options?

The transition into the new ACGME approved IR Residency will be a gradual process and vary from institution to institution. During this monumental shift in the training paradigm, applicants will have several options which will include entering a non-ACGME accredited Clinical Pathway that will eventually become an accredited IR Residency, transfer into an Integrated IR Residency during their DR residency, or apply to an Independent IR Residency after completion of their DR residency.

Whom (e.g. program director, coordinator, chair, etc.) at the institution of interest should I reach out to regarding their intentions for the new IR Integrated Residency / Independent Residency / ESIR?

The head of IR (chief of staff or program director) is likely going to be the most informative individual when it comes to their program’s intentions in regards to the new IR Residency. If that individual is unable to help you, they may be able to direct you to the right person. Another possible point-of-contact in a department is the program coordinator. These individuals are usually easy to get in touch with and can be very knowledgeable about the status of residency.

Whom in RFS can I reach out to to obtain more information regarding the new IR Residency?

You can reach out to Dr. Mamdouh Khayat (, the current chair of IR Training Pathway, or any of the other active members for more information.

Where can I find the most up to date information regarding the new IR Pathway?

This webpage by SIR is devoted to providing the most up-to-date information about the IR/DR certificate.

Will my DR training be negatively affected if I enter the new IR Residency?

The short answer is: no, your DR training will not be adversely affected. The training that DR residents and IR residents is essentially the same until the end of PGY-4. At that point, both DR and IR residents will take the same radiology board exam at the end of the PGY-4 year. Thereafter, DR residents continue onto PGY-5 in whatever diagnostic (or ESIR) rotations they want. IR residents, on the other hand, continue on to their IR training in PGY-5 and PGY-6 years. In other words, at the end of PGY-4, DR and IR residents would have received more or less the same training in diagnostic imaging. This allows both set of residents (DR and IR) to sit for the radiology board exam. They are both equally adept in core DR at the end of PGY-4, and both sit for the CORE exam offered by the ABR.

Could I still practice DR after graduating from the new IR Residency?

Yes. A graduate of the IR residency will be dual certified in both IR and DR. Thus, an IR resident can practice both IR and DR.

1. Kaufman JA, Laberge J, The IR/DR certificate and New IR Residency. IR Quarterly. Winter 2014; 28-30.

2. Training Pathways in IR. Society of Interventional Radiology Resident and Fellows Section Website [Internet]. [cited 2014 Oct 20]. Available from: 2014.

3. DIRECT Pathway. Society of Interventional Radiology Website [Internet]. [cited 2014 Oct 20]. Available from:

4. DIRECT PATHWAY. American Board of Radiology Website [Internet]. [cited 2014 Oct 20]. Available from:

5. IR Pathway Options: Clinical Pathway. Society of Interventional Radiology Website [Internet]. [cited 2014 Oct 20]. Available from:

6. ACGME Program requirements for Graduate Medical Education in Interventional Radiology. Accreditation Council for Graduate Medical Education Website [Internet]. [cited 2014 Oct 20]. Available from:

7. IR/DR Certificate and New IR Residency: Future Direction of the Specialty: Frequently Asked Questions. Society of Interventional Radiology Website [Internet]. [cited 2014 Oct 20]. Available from:

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