Interventional Radiology Residency Program

IR ProcedureThe Rochester General Hospital IR/DR residency is a new five year training program built from the ground up to train residents in all aspects of the increasingly clinical world of Interventional Radiology. The Integrated Interventional Residency is fully accredited program by the ACGME, and includes 3 years training in Diagnostic Radiology followed by 2 years immersed in the clinical world of IR in our health system. The complementary Diagnostic Radiology residency at Rochester General Hospital has been certified and training radiology residents for decades, including sending many residents over the years to prestigious interventional radiology fellowships.

The field of IR has evolved greatly over the past decade or so. It has gone from simply a field of physicians technically performing cases “ordered” by medical doctors and surgeons, to being its own true clinical specialty that is unique in every sense. IR procedures have replaced many invasive, time-consuming and risky surgeries with ingenious and elegant minimally invasive solutions, yet still many providers still believe IR procedures require an “order” akin to a chest x-ray. Only as of a few years ago, many IR docs barely spoke to patients prior to major procedures. Patient workup was negligible; there was no bond formed between doctor and patient. Much of the public had never even heard of an interventional radiologist.

The new paradigm is for IR to be a clinical service. All other procedural or surgical fields realized long ago that you need to provide periprocedural services to adequately treat patients, treating the disease itself completely rather than technically performing a procedure that someone else decided needed to be done. Therefore, those other services dedicated time and resources to outpatient clinic and inpatient services. Thus, we have rethought IR by building a clinical model where we actively recruit and get patients referred with complex issues, work them up de novo in IR clinic or see them as true inpatient consults in the hospital, create a plan, perform their procedure (or develop an alternative plan), then follow them up as inpatients by rounding daily on them, and finally follow them longitudinally in IR clinic.

IR Procedure 2The shift in thinking has been so eye-opening that many realized the training between diagnostic radiology and IR had to change, for the better. The classic pathway of four years of Diagnostic Radiology followed by only 12 months of IR (oftentimes at a different institution with different attendings, equipment, and staff) was not sufficient for training nor was it optimal to create clinically oriented, patient-centered interventional radiologists.

Many thought that the two needed to be split completely into two separate specialties. However, others realized that interventional radiologists are so adept to do their work only because of the intensive training in analyzing and interpreting diagnostic imaging. Therefore, the plan was to create a new track for trainees interested in pursuing interventional radiology. The new track would be a dual certificate in IR and DR to complement both but to have the IR training be more clinical and global. Thus, in September 2012, the American Board of Medical Specialties (ABMS) -- which allows for all board certification -- approved a new dual primary certificate in IR and DR. Interventional Radiology thus officially became the 37th medical specialty in medicine in 2012. As such, by 2020 it will officially cease being a subspecialty fellowship as it now becomes its own primary residency. We are proud to have one of these new accredited programs, and one of the first in the nation to have one without previously having an IR fellowship.

EmbolizationCTAWhy is this important? Again, the entire IR/DR residency program here at Rochester General Hospital was built from the ground up (with input from many including numerous former residents) with the trainees’ best possible training environment the foremost and sometimes only agenda. The first three years will involve mastering diagnostic radiology in a busy diagnostic imaging department, during which time you learn to interpret all imaging modalities with confidence. The final two years in PGY-5 and PGY-6 are spent immersed in a robust clinical interventional radiology division with five interventional radiologists and aided by 3 physician assistants, which is thriving and growing every year. That is why we are looking for passionate, hard-working physician trainees to join our program and lead the next generation of clinically oriented Interventional Radiology.