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Interventional Radiology In Canada

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IR has just become its own royal college specialty in Canada.  To be eligible you must have completed a radiology residency.  Therefore competitiveness is related to DI residency competitiveness, which fluctuates year to year.  Earnings depend on your location and radiology group.  Generally, IR's are partners in a radiology group and incomes are similar BTW the two.  Call and lifestyle is generally not as good as diagnostic radiology, but then again, I would argue radiology is no longer a lifestyle specialty anyway.  IR is headed towards more comprehensive clinical care of its patients in the future.  This will mean clinics and rounding, etc.

 

To be a good candidate:  spend some time shadowing and first decide if you'd like to do it.  Then get into a radiology residency, and choose one that lets you get your hands dirty and build experience.  You will have ample opportunity at some centres to get IR experience, for example, as a resident at my centre I was able to independently do tunnelled central lines, fistulograms/plasties, CT/US guided procedures, drainages, tubes, and got to be the primary operator with supervision for IVC filters, arterial procedures including TACE, etc.  I scrubbed and was co-operator on a stroke case earlier today.  Although I cannot speak from first hand experience, at many other "fellow-centric" centres residents apparently don't get to participate to the same degree in major procedures.

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IR has just become its own royal college specialty in Canada.  To be eligible you must have completed a radiology residency.  Therefore competitiveness is related to DI residency competitiveness, which fluctuates year to year.  Earnings depend on your location and radiology group.  Generally, IR's are partners in a radiology group and incomes are similar BTW the two.  Call and lifestyle is generally not as good as diagnostic radiology, but then again, I would argue radiology is no longer a lifestyle specialty anyway.  IR is headed towards more comprehensive clinical care of its patients in the future.  This will mean clinics and rounding, etc.

 

To be a good candidate:  spend some time shadowing and first decide if you'd like to do it.  Then get into a radiology residency, and choose one that lets you get your hands dirty and build experience.  You will have ample opportunity at some centres to get IR experience, for example, as a resident at my centre I was able to independently do tunnelled central lines, fistulograms/plasties, CT/US guided procedures, drainages, tubes, and got to be the primary operator with supervision for IVC filters, arterial procedures including TACE, etc.  I scrubbed and was co-operator on a stroke case earlier today.  Although I cannot speak from first hand experience, at many other "fellow-centric" centres residents apparently don't get to participate to the same degree in major procedures.

What exactly does the bolded mean? The Royal College site says it's a "new subspecialty of diagnostic radiology" 

 

It seems in the US, there are solid plans in place to make IR a direct residency program in the US, but I'm not sure what the plan is in Canada. Thoughts? 

@W0lfgang @W0lfgang @Lactic Folly @Lactic Folly

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What exactly does the bolded mean? The Royal College site says it's a "new subspecialty of diagnostic radiology" 

 

It seems in the US, there are solid plans in place to make IR a direct residency program in the US, but I'm not sure what the plan is in Canada. Thoughts? 

@W0lfgang @W0lfgang @Lactic Folly @Lactic Folly

 

it is not a direct entry specialty in Canada  at the current moment in time. Eventually there are thoughts it might be and overtime that will probably make sense as the fields diverge more and IR ends up doing more and more things. 

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it is not a direct entry specialty in Canada  at the current moment in time. Eventually there are thoughts it might be and overtime that will probably make sense as the fields diverge more and IR ends up doing more and more things. 

One issue with it becoming it's own specialty would be that IR doesn't really "own" many diseases so I'm not sure how they would have a clinic. Right now they fill their non procedure time with normal radiology reading. If they were branched off from rads I'm not sure what they would do with the remaining 3-4 days a week. Most procedure based specialties do clinic during non operating time.

 

The plus side would be IR having to run it's own wards.

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One issue with it becoming it's own specialty would be that IR doesn't really "own" many diseases so I'm not sure how they would have a clinic. Right now they fill their non procedure time with normal radiology reading. If they were branched off from rads I'm not sure what they would do with the remaining 3-4 days a week. Most procedure based specialties do clinic during non operating time.

 

The plus side would be IR having to run it's own wards.

 

I guess this is handled using the US model at some centres - they just have IR docs going most of week doing procedures (3-4 days), coupled with vascular run off studies in the "down time". There simply isn't a lot of procedural down time when they have the ability to directly accept patients. They run those docs pretty hard - they are a real money maker actually (unlike Canada).

 

one question is where neuro IR would belong - have to throw that one into the mix as well. I mean imagine a non Canadian model where a IR doc team takes over BOTH angio and neuro IR procedures and thus also covers call for both at the same time (right now both are separate fellowships - but if you create from scratch from the ground up a direct entry IR field then they wouldn't have to be - after all neuro IR has a lot more in common with angio IR than other fields in radiology).  You can see how people can end up have not much down time at all actually.

 

Anyway point is this has a lot to do with how we actually structure things - which is often quite arbitrary or just based on historical reasons. There is no particular reason that IR needs to belong in radiology at all as opposed to some off shoot of a surgical specialty or even a medicine one for that matter (case in point interventional cardiology). That been said for now it does ha, and if you have your heart set on IR you first have to dig your way through radiology.

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