established the program requirements for the new IR Residency.
IR Residency update I
n 2012, interventional radiology was recognized as a primary medical specialty by the American Board of Medical Specialties (ABMS). Two years later, the Accreditation Council for Graduate Medical Education (ACGME)
Most of the IR community is already aware of the fundamental IR education changes that are taking place as a result. These changes were designed to increase exposure to the growing number of complex image-guided procedures and, more importantly, to incorporate improved longitudinal and periprocedural clinical training. Since the release of the ACGME requirements, training institutions have been working to develop their residency programs to accommodate the required increased number of IR rotations, ICU training and clinical electives.
Models for success The IR Residency is structured to allow entry points directly from medical school (integrated model) and after completion of a diagnostic radiology residency (Independent model).
The integrated model includes one year of internship and five years of residency, three of which concentrate on diagnostic radiology and the final two of which concentrate on the imaging, procedural and clinical aspects of interventional radiology. Graduates are eligible to be certified in diagnostic and interventional radiology by the American Board of Radiology (ABR).
The independent model consists of two years of interventional radiology after completion of an internship and a diagnostic radiology residency. Graduates are eligible to be certified in diagnostic and interventional radiology by the ABR.
This flexibility of entry point is similar to the options provided by integrated and independent residencies in plastic surgery, cardiothoracic surgery and vascular surgery.
Integrated model status All prospective IR residency training programs will complete an online application to the ACGME. The application is reviewed by the radiology Residency Review Committee (RRC), an IR advisory group to the RRC and an ACGME site visitor. Once the reports from these reviews are complete, the program is reviewed at a scheduled RRC meeting. Final determination of accreditation is made by the RRC on behalf of the ACGME.
As of March 2016, 20 institutions have completed this process and received ACGME accreditation of their integrated IR residency programs. Seven received accreditation in time
16 IR QUARTERLY | SPRING 2016
to participate in the 2016 NRMP Match. There were 15 open positions, all of which filled!
The rest of the approved programs will interview IR residency applicants (senior medical students) this fall. It is anticipated that more integrated IR residency programs will be accredited by ACGME in time to recruit applicants for the 2017 NRMP Main Match. A total of sixty three applications for integrated IR residency accreditation have been received by ACGME.
Independent model and ESIR The application process for the independent model of IR residency training has not yet started. The plan is for independent residencies to launch on July 1, 2020—right after the sunset date of the fellowship training model on June 30, 2020.
Most institutions have indicated that they intend to implement both the integrated and independent residencies. The independent model of training will total seven years—one more year than the integrated model.
However, residents who complete an Early Specialization in IR (ESIR) curriculum during diagnostic radiology residency can complete both a DR and IR residency in six years. The ESIR curriculum includes a minimum of 11 IR or IR-related rotations and an ICU rotation during DR residency. An ESIR resident must complete a minimum of 500 procedures during DR residency. A DR residency must apply to ACGME for approval of an ESIR curriculum. Of the 30 applications that have been received, 10 have been approved. DR residents who complete an ESIR curriculum and match into an independent IR residency are eligible to matriculate into that residency at an advanced placement level and graduate in one year instead of two years.
What does this mean for me? Current third-year medical students will be the next medical school class with the option of applying directly for an integrated IR residency and have the following training options:
• Option 1 (6 years): Match directly into an ACGME-accredited integrated IR residency: 1 clinical intern year + 5-year integrated IR residency
• Option 2 (6 years): Match directly into a DR program that is developing an integrated IR residency and transfer into the program’s integrated IR residency internally after it receives ACGME accreditation. As with option 1, this path includes an internship prior to residency.
• Option 3: Match directly into a DR residency with or without an ESIR program.
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