Curriculum

Training Timeline
Our six-year program is comprised of a surgical internship year (PGY-1), three years of diagnostic radiology (PGY-2, PGY-3, and PGY-4), and two years of interventional radiology training (PGY-5 and PGY-6). PGY-1 includes one month in the ICU; PGY-6 includes one month devoted to mammography.

Periprocedural Expertise
The volume of procedures in our division provides each interventional radiology resident with an abundance of opportunities to develop and enhance their procedural skills. Our residents graduate with an enviable proficiency in image-guided procedures and the confidence to bring these abilities to the next step in their careers. We also emphasize the importance of understanding and gaining proficiency in the entire episode of care surrounding an IR procedure. Success in this field is achieved when as much attention is paid to the patient before and after the procedure, as is paid to the patient during the procedure.

Hospital-Based Experience
There is typically one PGY-5 (junior resident), one PGY-6 (chief resident), and one diagnostic radiology resident on the service at all times. In an effort to fairly distribute the clinical responsibilities and procedural volume between the junior resident and chief resident, two roles are assigned on a daily basis: procedure resident and clinical resident. The "procedure resident" chooses the procedures he or she performs that day and manages the entire episode of care surrounding each patient's procedure, including morning rounds presentations, pre-procedure consultations, post-procedure orders (including admission orders if applicable), and rounding on patients who will undergo procedures that day. In coordination with other members of the IR team, including junior residents, medical students, and nurse practitioners, the "clinical resident" is primarily responsible for managing the IR clinical service, including rounding on patients previously seen by IR and evaluating requests for consultations. Clinical residents also participate in procedures when their other responsibilities have been completed for the day.

Office-Based Experience
An important component of the experience gained during this residency is the time spent in our outpatient office. At this clinic, PGY-5 and PGY-6 residents spend one day per week evaluating new patients prior to therapeutic procedures, seeing patients in follow-up, and performing office-based procedures. During this rotation, each resident has the opportunity to spend consistent time with one attending in their office, as each attending has a slightly different focus. Residents also have opportunities for observation in the IR office during their PGY-2 through PGY-4 years.

Procedural Training & Responsibilities
Our interventional radiology residents are required to show proficiency in a wide spectrum of vascular and nonvascular procedures, and we provide trainees with in-depth exposure to the multitude of procedures performed by our interventional radiologists. Gradually increased responsibility during procedures is given to each resident during the final two years (PGY-5 and PGY-6) of the residency (the "IR" years). At the beginning of PGY-5, procedures are performed under direct supervision, with an attending physician in the room. Residents are expected to understand the role of the assistant during procedures and must be proficient in that role before becoming the primary operator. Residents must also demonstrate the ability to anticipate the next steps in a procedure before they occur. The goal is for residents to perform most procedures independently by the mid- to end of PGY-5. Throughout, residents are expected to demonstrate an understanding of limiting both radiation exposure and contrast administration with patient safety in mind.

On-Call Responsibilities
The junior resident and chief resident take call approximately one to two weeknights per week, and no more than one in three weekends. In a given year, the chief resident takes slightly less call than the junior resident; the diagnostic radiology resident rotating on IR also takes call one weeknight per week and one weekend per month. The resident on call is responsible for taking the initial calls for any procedure or patient care issues that arise during off-hours; all procedure requests and urgent issues regarding patients on the IR service are discussed with the on-call attending. Depending on the situation, staff may need to be called in while the patient is being evaluated in order to expedite the procedure; for less urgent cases, the resident will evaluate a patient prior to calling in other staff. The on-call responsibilities for IR residents almost never require staying in-house over night, but on-call rooms are provided if that becomes necessary.

Teaching Responsibilities
Our IR residents are expected to participate in teaching diagnostic radiology residents and medical students rotating on the IR service. IR residents help manage the role that the diagnostic radiology resident has while rotating on IR, and give medical students insight into the procedural and periprocedural care provided by interventional radiologists. The chief IR resident is also responsible for organizing a quarterly morbidity and mortality conference and journal club.