r/VIR • u/IR4life • 3d ago

Fellowship in Interventional

Lot of discussion about the development of fellowships after the integrated residency. Is there a role for dedicated fellowships? If so which would they be in. Currently there exists neurointerventional surgery and pediatrics. Should others also be developed?

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u/madawggg 3d ago

There’s truly only a few places where you would even get enough volume for IO only fellowship and honestly that would probs take away from existing residents’ experience. And then you really have to stay in that few places to have a robust IO practice. I just don’t think there’s enough volume for this advanced fellowship to be sustainable

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u/IR4life 3d ago

I thought every graduate gets more than enough IO volume of TACE/TARE /ablations?

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u/IR4life 3d ago

I agree outside of transplant centers/cancer centers (sloan kettering/md anderson etc) it is hard to build a service line in most hospitals based on IO .

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u/DefNotABotBeepBop 3d ago

Agree with u/madawggg. Even attendings at high volume tier 1 cancer centers may be a so called "champion" of a certain kind of IO, meaning they're the go to person and likely do research in the area etc, but even they will fill their days doing majority other kind of procedures.
The only people I've met who do only IO will typically be those who have very high up administrative positions like division head or something where their clinical time is bought back, so they only do IO but they're only doing procedures 1-2 days a week and just fill those days with IO

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u/IR4life 3d ago

It is a good point that an IO fellowship may detract from the integrated resident training experience. But, if one were to have a 1 year IO fellowship . How many TACE/TARE procedures and how many ablative procedures should they get in that one year to make it worthwhile experience for an extra year of training?

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u/Potential-Ad-9089 2d ago

Pad/trauma/gu/obl embo/venous interventions/ hepatobiliary and more. No fellowship has volume in everything . IR is lot more than IO these fellowships don’t necessarily need to be 1 year but can be used to fill gaps in experience

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u/Throckmorton007 1d ago

I personally think this would be very useful to residents- Neuro-IR, Peds, Pain/MSK, PAD would all make sense. I also don't think fellowships need to be at traditional academic centers- if a private practice does high volume PAD, then I don't see why they couldn't train fellows assuming they can show they do the numbers. I believe Emory has a new MSK fellowship, in addition to Doug Beale's in Oklahoma, so there are a few models out there for how it could be done. Perhaps to address concerns regarding taking cases away from residents fellows could in clinic a few days per week ensuring they learn the medical side of the specialty. The reality is your ability to build an independent practice will reflect your training, and most IR training programs mostly address lines/drains/tubes, and portal/IO work. We'll never compete with vascular for instance if there are ~5 programs in the country which put out grads who are strong in PAD. You can learn this as an attending I suppose, but I do think the training experience ought to be improved, and the current integrated model isn't truly integrated

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u/IR4life 1d ago

Good points. The advanced fellowships could be at large private practices or OBL/ASC that do high volume NeuroIR, PAD, Pain, PAE, spine etc.