Training Pathways in IR

The information below is current as of August 1, 2015. The current IR training structure is undergoing a shift towards the IR Residency. On or before July 1, 2020, the ‘old’ IR training pathways (Direct Pathway, Clinical Pathway, Traditional Pathway) 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.

For the traditional fourth year medical student applying for the 2016 radiology match, few (if any) Integrated IR Residency programs will be available.  You will most likely have transition to an Integrated IR Residency at your radiology program internally or apply for an Independent IR Residency program during your radiology residency to begin during your PGY-6 year (2021). 

Please visit our dedicated ‘IR Residency and Training Pathway FAQ’ page for further details.

Currently there are several VIR training pathways, each of which qualifies the trainee for the diagnostic radiology boards. The traditional pathway involves a one year internship, four years of radiology residency, and a one year VIR fellowship. A recent change in the format of the diagnostic radiology boards examinations allows greater flexibility in radiology residency curricula, and as a result, many residency programs have developed IR tracks that allow opportunities for earlier subspecialization in VIR. The Clinical and DIRECT pathways are designed to offer participants a substantial amount of time on the interventional radiology service and key clinical rotations.

Recently, the American Board of Medical Specialties approved a new IR/DR Certificate in interventional radiology and diagnostic radiology and new IR residency programs are being established to ultimately phase out the old pathways. While the dust hasn’t quite settled from this momentous change, the IR residency is likely to resemble the IR clinical pathway, already available at several institutions.

The SIR is currently recommending the IR Clinical Pathway to medical students who know they want to go into interventional radiology. This pathway and the new IR residency are meant to place a greater emphasis on clinical experience by giving trainees more time in related clinical services such as surgery, internal medicine, and intensive care. Ideally, the new IR residencies are meant to provide sufficient training in imaging, procedural care, and longitudinal patient care. Below we have highlighted four of the IR Clinical Pathway programs leading the transition to the IR/DR dual certificate. For more information regarding the new IR residency, be sure to visit our ‘FAQ page’.

University of Colorado*
University of Michigan
University of Virginia
Ohio State University
Kaiser (Los Angeles)
Number of Positions 1 2 2 1-2 1-3
PGY1 Surgery Internship (2 mo ICU) Surgery (2 mo ICU) Medicine or Surgery Internship Medicine (1 ICU, 1 CCU)
PGY2 10 DR / 2 IR 10 DR / 2 IR / 1 Clin 9.5 DR / 1.5 IR / 1 ICU 11 DR / 1 IR 11DR / 2IR
PGY3 10 DR / 2 IR 10 DR / 1 IR / 2 Clin 7.5 DR / 1.5 IR / 2 VS / Clin / 1 Research 10 DR / 1 IR / 1 Clin 11DR / 2IR
PGY4 10 DR / 2 IR 12 DR / 1 Clin 11 DR / 1 IR 10 DR / 1 IR / 1 Clin 10DR / 2IR / 1 AIRP Review
PGY5 IR Focus + DR / Clin 4 DR / 6 IR / 3 Clin 3 DR / 6 IR / 2 Clin / 1 Research 2 DR / 9 IR (mini-fellowship) / 1 ICU 3DR / 8IR / 1 VS / 1 Misc. Clin (Podiatry, Wound Clinic, Dialysis)
PGY6 IR Fellowship IR Fellowship IR Fellowship IR Fellowship (not categorical) IR Fellowship (not categorical)

Table I. Timelines for post-graduate education at the indicated institutions.
VS=Vascular Surgery; Clin=Clinical rotation (including IR clinic, hepatology, GYN clinic, inpatient cardiology, etc.)
*Not offered for 2015 application cycle

Read more about University of Michigan Vascular & Interventional Radiology Clinical Pathway

Read more about University of Virginia Vascular & Interventional Radiology Clinical Pathway

Read more about Kaiser Permanente Southern California (Los Angeles) Vascular & Interventional Radiology Clinical Pathway

  • Traditional Pathway

    In addition to the other non-traditional pathways (DIRECT, Clinical and the new IR/DR Certificate), many Diagnostic Radiology residencies offer IR track and mini-fellowship curriculums, which allow for tailoring of residency towards IR.

    The ABR currently allows diagnostic radiology residents to spend up to 16 months in any one subspecialty. With the new board structure of exams being taken during the third year of residency, many programs are developing mini-fellowships. The following is a list of radiology residencies offering these IR tracks/mini-fellowships. At a minimum, these programs offer nine months in IR and/or clinical rotations during the PGY 2-5 years.

  • IR Residency

    The IR Residency is a pathway only recently approved by the American Board of Medical Specialties. This pathway is designed to provide a direct, and clinically based pathway for training of Interventional Radiologists.

    Please proceed to the following link for more detailed information about the new IR Residency:

    IR Training FAQ

  • DIRECT Pathway

    The Diagnostic and Interventional Radiology Enhanced Clinical Training (DIRECT) Pathway allows up to two years of clinical training to count toward the Diagnostic Radiology certificate and subspecialty VIR certificate. Never before has the ABR permitted more than one year of credit for non-radiology clinical years. This effectively decreases a barrier of “lost time” for those residents who become interested in the IR specialty, but have already completed clinical time in another specialty. Some DIRECT pathway programs accept residents who have already completed one or more years of post-graduate clinical residency training, while others are available to medical student applicants who desire a more robust clinical experience than that afforded by traditional diagnostic radiology residencies. Click here for a description of the DIRECT pathway, and a list of ABR-approved DIRECT pathway programs.

    Christina Care
    Number of Positions 1
    PGY1 Medicine Internship (2 ICU)
    PGY2 10 Surgery (1 ICU) / 2 DR
    PGY3 10 DR / 2 IR
    PGY4 9 DR / 3 IR
    PGY5 8 DR / 4 IR
    PGY6 IR Fellowship

    Table I. Timeline for featured DIRECT pathway

  • Clinical Training Pathway

    The primary intent of the Clinical Pathway is to provide a broader and more in-depth experience in the clinical diagnosis and care of patients with diseases commonly treated by interventional radiologists. The secondary intent of the pathway is to allow the trainee an opportunity to participate in research to advance the field of interventional radiology. Unlike the DIRECT pathway, the Clinical pathway fits within the curriculum requirements of a traditional radiology residency, and can therefore be developed in any residency program, without the need for special ABR approval.

    Read more in our Guide to the IR Clinical Pathway


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