A lucent specialty - Interventional Radiology

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What is Interventional Radiology again?


December 28th, 2017 - the day I decided to pursue a medical career. Attending a triple bypass surgery was something so mind-boggling to me that I fell in love with this field immediately. Entering med school to become a surgeon is quite a cliché, I am not gonna lie, but it was what fascinated me at that time. Having finished the first year of my studies, I have acquired a better understanding of some specialties. Until recently, I still believed that surgery was the specialty I could imagine myself doing in the future. So what changed? 

On a not so busy day in May, I was scrolling through some TEDx talks, and I came across one called “Saving mothers through a pinhole” by Dr. Gregory Makris. As the title was very strange (but definitely eye-catching), I clicked on it without a second thought. On that day the secret world of interventional specialties unraveled in front of me. So let me enlighten you on what it is about.

Charles Theodore Dotter is considered to be the “Father of Interventional Radiology” as he utilized the body’s vascular network to reach every possible target (organ or tissue) with a wire. This notion has developed to minimally invasive image-guided (with X-Rays, ultrasound, CT, and MRI scans) surgeries that are highly accurate. It is needless to say that interventional radiologists are involved in all kinds of specialties and this is a particularly important asset for those who easily get bored with a daily routine.


What can be treated using these techniques? Sites of internal bleeding can be accessed and stopped, blocked arteries can be unblocked, venous problems can be resolved and even stroke or cancer can be treated! It is also noteworthy that oftentimes no general anesthesia is required and the operation can proceed with only local anesthesia.  As the operation is minimally invasive, complications are fewer and the duration of the patient’s stay in the hospital is very short, many patients are discharged on the same day. 


To those of you who think that this sounds interesting, a question may arise: how do I become an Interventional Radiologist (IR)? Well, it depends on the country. For those of you who are interested in pursuing a medical career in the U.S., you need to sit some exams called “USMLE” to grant you entry to local medical residency programs. One option in the States is to start with a 5-year residency in diagnostic radiology followed by a 1 to 2-year fellowship in interventional radiology. Another (more recent) option is to start immediately with the interventional radiology residency program. In the U.K. the pathway looks a bit different. After medical school you have to complete a 2-year foundation program, which is an introduction to “real-life clinical medicine”, you continue with a 3-year diagnostic radiology training and eventually you proceed with an extra 3-year interventional radiology program (recognized as sub-specialty). In the Netherlands the specialization to radiologist takes 5 years, this is followed by a 2-year sub-specialization to Interventional Radiology. In Europe, most of the IR specialists are employed by public hospitals, but these services can also be offered in the private sector (in a small percentage, affiliated with a public hospital). An exception to this rule can be found just over the Atlantic, as quite some private practices offer IR services in the U.S.


Above you can see how the IR operating theater looks like.


Above, the treated varicose veins with the use of IR can be visualized.


How can I get involved during my studies in this field? IR society is rather welcoming and many associations from different entities have been created. One of the most well known is the Cardiovascular and Interventional Radiological Society of Europe (https://www.cirse.org/). There you can find various activities, conferences, webinars, and other programs to familiarize yourself with IR and find out whether it is something for you. Another initiative would be to create an activity yourself. Profile Education is a very attractive opportunity for second-year medical students to try out Interventional Radiology just by reaching out to IR specialists in other hospitals or within the UMCG and organizing internships or clinical shadowing opportunities during a 56-hours course.


All in all Interventional Radiology is still in its infancy, but it seems very promising for complex medical problems like cancer or cardiovascular disease. Lately, it has become increasingly popular and many IR-residency positions are occupied as the need for IR specialists is hitting the roof in many countries like the U.K. and the U.S.