Interventional/diagnostic combined residency?

[DBJ]

---

Members do not see this ad.

Anyone got the scoop on the IR/DR combined programs? I know they're called DIRECT pathway and clinical pathway, 6 years, offered at about 16 hospitals, but I don't know much about competitiveness, etc.

I've been discouraged by a few DR residents about these programs because you get less overall DR training and it's more difficult to learn that side of it and pass the DR boards. It also doesn't save any time, and makes for a harder overall residency. On the flip side, you don't have to play the fellowship game, and you get to a lot more IR during a combined residency than you would during a residency + fellowship.

Does anyone know people who have matched in these programs out of med school? Any info would be great.

Thanks!

Dave

 

[hans19]

You hit the nail on the head. We've taken our first batch of Direct guys and we are still trying to iron out the kinks. What you said is about right. They have less time to learn DR. Some more time to do IR. But still I think if you want to do IR, the best option is to do a clinical internship, maybe surgery (then nothing should phaze you, and you won't be afraid to work hard) then do DR and then interview for fellowship. There are so many flavors of IR fellowship, Onc heavy, Vascular heavy, well-rounded, some do nothing but low end work. But I think it behooves you to figure out what kind of training you want and then have your pick of fellowship that offers that kind of training, rather than be stuck to any particular fellowship because its tied to your residency. Its hard to figure out what kind of IR fellowship you want right out of medical school.

One other thing. DIRECT is not a back door into radiology. If you aren't competitive as part of the general applicant pool you won't be a candidate for DIRECT. The clinical pathway is a way that surigical residents can get into IR, usually after 1 or 2 years of some surgical subspecialty.

-Hans

 

[DBJ]

Thanks for the reply, Hans. That's an interesting point about programs having different subfield strengths within IR... I hadn't thought of that. Definitely something to consider.

Are your DIRECT residents matched out of med school or do they come from your DR program? Do they have a set curriculum for the first two years (gen surg?) or do they choose?

Also, do you know anything about the competitiveness in terms of number of applicants, unfilled spots, etc? I'm planning my 4th year schedule and I'm trying to figure out if it's really worth it to do an IR-heavy 4th year if the chances of matching into a DIRECT program are vanishingly small.

Thanks again!

Dave

 

[OHMAN0125]

Thanks for the reply, Hans. That's an interesting point about programs having different subfield strengths within IR... I hadn't thought of that. Definitely something to consider.

Are your DIRECT residents matched out of med school or do they come from your DR program? Do they have a set curriculum for the first two years (gen surg?) or do they choose?

Also, do you know anything about the competitiveness in terms of number of applicants, unfilled spots, etc? I'm planning my 4th year schedule and I'm trying to figure out if it's really worth it to do an IR-heavy 4th year if the chances of matching into a DIRECT program are vanishingly small.

Thanks again!

Dave

I believe in his post Hans already said you have to be competitive, same as if you were going for DR.
My feelings on DIRECT is that you definetly should not do it. IR is not that hard of a fellowship to match into right now. So u wont have to worry about not getting a spot.
For me I like IR but then again, what if I find out i like neuro or musculoskeletal? Rads residency is long, many of ur interests may change i think.

 

[LurkerOnHigh]

From the SIR website -

The following are the critical features of the pathway.

1. Residents entering the pathway will need one year of clinical training in addition to the year currently required. Two years of clinical training are considered essential. Residents may enter the new pathway from medical school or after two or more years of clinical training in other disciplines.
2. The core diagnostic imaging training is 27 months.
3. VIR residency (nonfellowship) training includes nine months, as described in the table below.
4. The sequence of scheduling the fellowship year and the final year of the core program is reversed.


PGY 1 & 2 24 months Approved Clinical Training*
PGY 3 12 months 10 Diagnostic Imaging + 2 IR
PGY 4 12 months 9 Diagnostic Imaging + 3 IR
PGY 5 12 months 12 Accredited IR Fellowship
PYG 6 12 months 8 Diagnostic Imaging + 4 IR Primary certification exam in Diagnostic Radiology
12 months 12 Clinical Practice Subcertification exam in IR
* Clinical training in an ACGME-approved program. Clinical training might include a transitional year plus another year in internal medicine, surgery, etc., or possibly in an integrated clinical year in Diagnostic Radiology. Most likely, 2 years of clinical training will be in another clinical discipline with entry directly into this provisional pilot.

5. The primary certificate and subspecialty certificates (CAQ) will not change, but the sequence of timing of training and administration of the examination for the certificates will change for this pathway.

 

[Mad Jack]

From the SIR website -

The following are the critical features of the pathway.

1. Residents entering the pathway will need one year of clinical training in addition to the year currently required. Two years of clinical training are considered essential. Residents may enter the new pathway from medical school or after two or more years of clinical training in other disciplines.
2. The core diagnostic imaging training is 27 months.
3. VIR residency (nonfellowship) training includes nine months, as described in the table below.
4. The sequence of scheduling the fellowship year and the final year of the core program is reversed.


PGY 1 & 2 24 months Approved Clinical Training*
PGY 3 12 months 10 Diagnostic Imaging + 2 IR
PGY 4 12 months 9 Diagnostic Imaging + 3 IR
PGY 5 12 months 12 Accredited IR Fellowship
PYG 6 12 months 8 Diagnostic Imaging + 4 IR Primary certification exam in Diagnostic Radiology
12 months 12 Clinical Practice Subcertification exam in IR
* Clinical training in an ACGME-approved program. Clinical training might include a transitional year plus another year in internal medicine, surgery, etc., or possibly in an integrated clinical year in Diagnostic Radiology. Most likely, 2 years of clinical training will be in another clinical discipline with entry directly into this provisional pilot.

5. The primary certificate and subspecialty certificates (CAQ) will not change, but the sequence of timing of training and administration of the examination for the certificates will change for this pathway.

This is a very old thread, and the integrated IR pathways and requirements have changed much in structure over the last two years (roughly six years after this thread was created).

 

[Fundamentals]

Could someone explain the outcome of this track a bit better. To me it seems like the companies that want DR's will only take people who have done the DR residency as there is more diagnostics exposure. Conversely, noone will want an IR from a DR residency as the combined residency has people to offer that have had more training in the IR field. Does this not effectively diverge the two.

 

[DrBowtie]

Could someone explain the outcome of this track a bit better. To me it seems like the companies that want DR's will only take people who have done the DR residency as there is more diagnostics exposure. Conversely, noone will want an IR from a DR residency as the combined residency has people to offer that have had more training in the IR field. Does this not effectively diverge the two.

Doing the two year residency aka fellowship more than prepares you for the vast vast majority of IR jobs. People have been doing them with only one year of training as of now.