In terms of competitiveness, how bad do you think it will be for the next year's match? Do you think it will be as competitive as dermatology or plastic surgery? Given ~120 total residency spots for IR/DR residency this year, how many more spots will be available for the next year's match? Appreciate your inputs.
Competitiveness of IR residency next year
- Thread starter leahy
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it's going to only get more competitive
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I think it's going to be more competitive than derm or plastics this year.
My guess (and it's just a guess) is that next year it will be a little less competitive. I say this for 2 reasons:
1) Next year there will be more positions than there are this year.
2) The large number of applicants this year will make it look like IR/DR is outrageously competitive (% unmatched). Once the numbers get published, next year some people may have second thoughts about applying because of how competitive it is, and so there will be fewer applicants.
My guess (and it's just a guess) is that next year it will be a little less competitive. I say this for 2 reasons:
1) Next year there will be more positions than there are this year.
2) The large number of applicants this year will make it look like IR/DR is outrageously competitive (% unmatched). Once the numbers get published, next year some people may have second thoughts about applying because of how competitive it is, and so there will be fewer applicants.
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% unmatched won't actually be that high because of all of the applicants that will match into DR programs
% unmatched will be very high, because it is based off of "preferred specialty". If you rank IR as #1, but match DR as backup, then that counts as unmatched for IR.
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I agree with Fab5 but would add a stipulation. This year will likely be the most competitive #applicants/#spot wise, but after this year there will be more candidate self selection based on how this year's match goes. The candidates next year will likely be more qualified on average, and there will probably be less of them.
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self selection argument doesn't make sense in this example. in other fields the interviews are separate and not related. like if you are applying plastics vs gen surg, you don't interview gen surg then do the plastics interview in the afternoon, vs rads where it is like that.
there's no penalty to applying to IR besides the 20 bucks per place or whatever. you're going to be there anyway for the DR interview likely. not to mention if you apply gen surg at the same institutions as the integrated institutions, they tend to look down on that and make it seem like you aren't sure of yourself.
there's no penalty to applying to IR besides the 20 bucks per place or whatever. you're going to be there anyway for the DR interview likely. not to mention if you apply gen surg at the same institutions as the integrated institutions, they tend to look down on that and make it seem like you aren't sure of yourself.
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So you don't think any of the 578 that applied this year would avoid applying if this was next year and the match data was available showing that about 120 matched into IR out of 200-500 that put it first on their ROL?
Especially if those 120 are very competitive, I can see it discouraging some applicants from pursuing Integrated IR. Some people will choose other fields; presumably the same fields that the greater number of applicants were poached from. It's true you can just add IR to the places you apply DR, but less competitive applicants might not want to apply to IR at the same institutions if it might make the DR PD wonder if they are going to rank DR highly.
I think everyone that wants to do IR should apply and give it a try, see what happens. I think it's the best specialty there is, and if more people apply next year that would be a great indication of interest in the specialty.
I was only saying that I agree with Fab5 that some people might have second thoughts and drive down the application #s a bit.
Especially if those 120 are very competitive, I can see it discouraging some applicants from pursuing Integrated IR. Some people will choose other fields; presumably the same fields that the greater number of applicants were poached from. It's true you can just add IR to the places you apply DR, but less competitive applicants might not want to apply to IR at the same institutions if it might make the DR PD wonder if they are going to rank DR highly.
I think everyone that wants to do IR should apply and give it a try, see what happens. I think it's the best specialty there is, and if more people apply next year that would be a great indication of interest in the specialty.
I was only saying that I agree with Fab5 that some people might have second thoughts and drive down the application #s a bit.
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why would they? again what is the downside? It's 20 bucks a program. In surgery and other competitive fields like derm, there are much greater penalties for applying to multiple different fields and accompanying logistical concerns. With IR and DR there isn't aren't the same penalties.
The whole wondering about ranking highly is a bunch of crap and makes no sense. Match system works best when you just rank in terms of preference, for both sides. I really don't think they are going to rank the IR people lower. The only thing that would prevent this ideal outcome from occurring is a PD's ego about matching at X position on their rank list.
The whole wondering about ranking highly is a bunch of crap and makes no sense. Match system works best when you just rank in terms of preference, for both sides. I really don't think they are going to rank the IR people lower. The only thing that would prevent this ideal outcome from occurring is a PD's ego about matching at X position on their rank list.
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It's not just choosing between IR and DR. It's also IR and other surgical specialties, or IR and medicine, or IR and anything else. It's also not just about penalties. Some applicants would rather not try for something they aren't likely to obtain.
It's true the match algorithm was designed to have everyone rank their candidates in the order of their own preference. Some programs do that. Other programs take into account who they are likely to match when they make their rank list. It's the same reason a mid level program doesn't interview only the top 10% of people that apply to their program. They want to interview the right people, not necessarily the best people. When programs rank based only on who they want without regards to if the applicant would want to match there, they have to go deeper on their rank list. Going deeper on your rank list increases your chance of not filling. Some PDs also like to not go deep on their rank list for its own sake. Why do you think interviewers try so hard to gauge your interest in the program to which you're applying? DR interviewers at DR only institutions also want to know if you're applying to IR even though it's against the rules to ask if you applied to IR as well.
It's true the match algorithm was designed to have everyone rank their candidates in the order of their own preference. Some programs do that. Other programs take into account who they are likely to match when they make their rank list. It's the same reason a mid level program doesn't interview only the top 10% of people that apply to their program. They want to interview the right people, not necessarily the best people. When programs rank based only on who they want without regards to if the applicant would want to match there, they have to go deeper on their rank list. Going deeper on your rank list increases your chance of not filling. Some PDs also like to not go deep on their rank list for its own sake. Why do you think interviewers try so hard to gauge your interest in the program to which you're applying? DR interviewers at DR only institutions also want to know if you're applying to IR even though it's against the rules to ask if you applied to IR as well.
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I think it's going to be incredibly competitive next year. Why? Med students know it exists now. IR has flown under the radar for the longest time. SIR has done a tremendous job in raising awareness at the med student level. Many schools now offer IR rotations or even sub-internships. IR provides what many med students want out of medicine:
1. Ability to work with specific populations. Women's health (UFEs / uterine artery bleeds / breast cancer mets to the liver ablation). Pediatrics (vascular/lymphatic anomalies, congenital biliary problems). Alcoholic / Hep C / NAFLD (TIPS). Diabetic population (dialysis fistulas). It's possible to make 50% of your work dedicated to one of these populations, at least at academic places. Or, you could do it all.
2. Innovation. More and more medical students have engineering backgrounds. Computer science in particular has surpassed biology as the most popular undergraduate major at many schools. IR docs invented angioplasty (Charles Dotter) and vascular plugs (Amplatzer). Recent developments include improvements in microwave ablation (NeuWave Medical - Fred Lee, Jr.), hydrophobic catheters (Cook Medical - William Cook was an IR srub tech) and laser-removal for IVC filters (Will Kuo). One reason why IR is so innovative is that the physicians frequently try new things intra-op to solve the problem at hand. This might include repurposing a neuro catheter for abdominal work or using an AngioJet for debridement (okay this one is a kinda expensive off-label use).
3. It is surgery, without the hubris. Think about the things that turn med students off to surgery: Getting yelled at by the scrub tech for improper sterile technique, having to stand up for 12-hours straight, endless retracting, poor visibility, waking up at 4:00 am, dressing up for Grand Rounds. The atmosphere of the IR suite is much more relaxed than the operating room. There's a collegial relationship between the nurses, scrub techs, fellows, and attendings. Albeit, the hours on IR can run longer than surgery and this might be a turn off to med students.
4. Compensation. It's no joke that 4 years of undergrad, 4 years of med and 6 years of residency is a long time, and that's if you go straight through. IR docs are in the top 5 specialities for compensation. They make essential the same as an interventional cardiologist. This is another fact that flies under the radar. Online lists of "well paid" specialties group IR with diagnostic radiologists, but IR docs earn substantially more (we're talking $50-$100K higher). You can reasonably expect to make $450,000 in the middle of your career
1. Ability to work with specific populations. Women's health (UFEs / uterine artery bleeds / breast cancer mets to the liver ablation). Pediatrics (vascular/lymphatic anomalies, congenital biliary problems). Alcoholic / Hep C / NAFLD (TIPS). Diabetic population (dialysis fistulas). It's possible to make 50% of your work dedicated to one of these populations, at least at academic places. Or, you could do it all.
2. Innovation. More and more medical students have engineering backgrounds. Computer science in particular has surpassed biology as the most popular undergraduate major at many schools. IR docs invented angioplasty (Charles Dotter) and vascular plugs (Amplatzer). Recent developments include improvements in microwave ablation (NeuWave Medical - Fred Lee, Jr.), hydrophobic catheters (Cook Medical - William Cook was an IR srub tech) and laser-removal for IVC filters (Will Kuo). One reason why IR is so innovative is that the physicians frequently try new things intra-op to solve the problem at hand. This might include repurposing a neuro catheter for abdominal work or using an AngioJet for debridement (okay this one is a kinda expensive off-label use).
3. It is surgery, without the hubris. Think about the things that turn med students off to surgery: Getting yelled at by the scrub tech for improper sterile technique, having to stand up for 12-hours straight, endless retracting, poor visibility, waking up at 4:00 am, dressing up for Grand Rounds. The atmosphere of the IR suite is much more relaxed than the operating room. There's a collegial relationship between the nurses, scrub techs, fellows, and attendings. Albeit, the hours on IR can run longer than surgery and this might be a turn off to med students.
4. Compensation. It's no joke that 4 years of undergrad, 4 years of med and 6 years of residency is a long time, and that's if you go straight through. IR docs are in the top 5 specialities for compensation. They make essential the same as an interventional cardiologist. This is another fact that flies under the radar. Online lists of "well paid" specialties group IR with diagnostic radiologists, but IR docs earn substantially more (we're talking $50-$100K higher). You can reasonably expect to make $450,000 in the middle of your career
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I would not be posting salary numbers on a public forum....
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Writing "so and so is making 600k in his/her next job" has a huge cognitive effect on people, or lay public who may read this post, thinking IRs are making it big and make us targets of reimbursement cuts. It set up disappointment in trainees when they find out the realistic job pays half as much job starting.
Plus, people's specific salaries are NOT public information. Compensation of IR is highly regional as well.
Plus, people's specific salaries are NOT public information. Compensation of IR is highly regional as well.
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x1000... we don't need this to be public info. Also, this naijaba guy needs to stop pontificating on things he knows nothing about. Get back to us when you finish residency.
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I find Naijaba's posts really helpfull, actually.
Isn't one point of forums such as SDN to help each other get some insight like this?
Seems to me that what Naijaba has to share must have some basis in truth, otherwise he/she wouldn't be eliciting such a response from yourself and others.
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Yes, basis in truth such as a abled 600k+ midwest job actually only involves lines and drains and are 80% DR (confirmed with local IR who is one of our alum recently regarding a specific job which I will not name). Such a job is a career suicide for IRs wanting to do high end procedures.
All jobs that sound too good to be true are too good to be true usually.
When premeds and med students see those ads, they develop an unrealistic sentiment of what this field is and may pursuit it for the wrong reasons.
All jobs that sound too good to be true are too good to be true usually.
When premeds and med students see those ads, they develop an unrealistic sentiment of what this field is and may pursuit it for the wrong reasons.
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Very true. I would offer, directly complementing your input, that is precisely why we should continue to discuss openly. Knowledge is power, right?
Let's put the knowledge out there.
Let's put the knowledge out there.
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Knowledge is power, but half truth lead to ignorance.
This is why I do not ever condone discussing salary on a public forum. Until you have the contract in hand, all you have are half truth.
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So ultimately, the decision is yours or mine. What we read here should only serve as a component of helpful information in making any decision. Only a fool is going to act literally based on what is posted in an anonymous forum.
I think we are all wise enough to recognize that if you are relying on SDN threads to form the basis of lifelong decisions, there are other issues at play that no amount of knowledge is going to help anyways!
I also wanted to add, that the point I'm trying to make isn't about agreeing or disagreeing with you or anyone else. It isn't about being right or wrong. What does matter is the fact that you are comfortable expressing your opinion, and that's something I'm going to fight for you on no matter what.
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The $450K figure I quoted was based on public data from the University of California (see here). It's the only transparent source of salary information I've seen, especially regarding clinical salaries. For example, Washington State publishes base salaries but excludes clinical salaries. I posted UCLA salaries on this thread. I didn't mention the specific subspecialties, but all of the IR docs made between $350K and $500K. As I mentioned, an academic position in sunny Southern California is a good lower-bound on your expected income.
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I believe in that very post someone mentioned UCLA pay more than typical academic setting. I go to a midwest program and our IR faculties DO NOT get paid that much.
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Interesting, thanks for the insight.
So ultimately, the decision is yours or mine. What we read here should only serve as a component of helpful information in making any decision. Only a fool is going to act literally based on what is posted in an anonymous forum.
I think we are all wise enough to recognize that if you are relying on SDN threads to form the basis of lifelong decisions, there are other issues at play that no amount of knowledge is going to help anyways!
I also wanted to add, that the point I'm trying to make isn't about agreeing or disagreeing with you or anyone else. It isn't about being right or wrong. What does matter is the fact that you are comfortable expressing your opinion, and that's something I'm going to fight for you on no matter what.
Agreed. Compensation related posts are rarely all encompassing or give a full picture. Of course, that leaves them open to misinterpretation by impressionable people, but that's not even close to reason enough not to discuss the subject at all.
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Problem with job and salary posts is that it's a telephone game
Fellow gets a contract offering 300k and 16 week of vacation, 26 IF made partner in a rural small town. Meanwhile he turned down a 600k job in Oklahoma with only 20 percent IR which would be career suicide. Fellow did not take the average 285k job an hour from the coast. He shares his experience with his resident.
Resident tells his colleague about the job with sweet 26 weeks of vacation, then he mentioned something about being near the coast. Also something something 600k.
Med student walks in and overhears the reaident. Goes home and tell his/her spouse about the cool job with 26 weeks of vacation at partnership and appearently one can make 600k if one takes another job.
The spouse tells his/her mom that if the med student do IR they can expect a job one hour from the coast, pays 600k and have 26 weeks of vacation.
This is why discussing such matter, even based on public data, is a bad idea.
Take UCLA for example. It's one of the most competitive fellowship, and I am sure fellows walk on water before they become a faculty there. Those folks have been living and breathing IR since they were early on in training. It's NOT the baseline.
The baseline is more like a 250k job in an undesirable area because someone has geographical tie to that area and the local academic center cannot afford a big salary. Or a 300k job in generic rural area that have you sit in a 50 bed hospital and do 20% IR.
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^I applaud your fictional story of telephone, truly.
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Do you know the stats for successful IR applicants?
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Dude, if you google "IR Salary" you get this blurb, above the actual search results:
Survey results showed that the median compensation level in 2013 for non-interventional radiologists increased by 5 percent over the previous year, from$453,216 to $476,013. Interventional radiologists received a smaller—yet still healthy—increase of 2.7 percent, from $504,772 to $518,164
Survey results showed that the median compensation level in 2013 for non-interventional radiologists increased by 5 percent over the previous year, from$453,216 to $476,013. Interventional radiologists received a smaller—yet still healthy—increase of 2.7 percent, from $504,772 to $518,164
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sorry for the misunderstanding, I was talking about the stats of a successful IR residency applicant, are you of that?
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I was addressing the "oh noez don't post salary info publicly" argument.
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That's not an accurate number. Real salary is about 200-300k smaller before tax.
I'm not sure I would call IR surgery, nor would vast majority of surgeons and non-surgeons, although I think its a gray zone. That said surgeons should be only called so for those who went through surgical training. I would never call people who do large amounts of procedures: IR, IC, cardiac EP, GI as surgeons.
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Neurosurgeons have renamed interventional neuroradiology to endovascular neurosurgery and it's printed on their fleece jackets.
I second this; surgery is highly resistant to change and its tradition has been to increase the duration of training rather than split into separate specialities. Surgeons now learn floor management, open surgeries, laparoscopic surgeries, sub-speciality surgery, and then (optionally) robotic surgery.
Regarding laparoscopy, there are many, many surgeries that are just better when done under laparoscopy, yet all surgeons are classically trained on how to perform open operations. What necessitates converting to an open procedure? The short answer is visibility. I find this a bit paradoxical, since insufflation is designed to maximize abdominal visibility. The hybrid-OR presents an interesting option - if laparoscopic tools could be made MRI-safe, you could acquire an MRI after insufflation to see where adhesions are located. I can envision a different historical trajectory whereby laparoscopy was a separate speciality under radiology (they are using cameras, after all) instead of surgery. We'd probably still call it surgery.
Regarding interventional, if endovascular imaging was embraced by surgeons years ago, they would probably have tacked on "endovascular surgery" as another 1-2 years of training. This is exactly what neurosurgery has done. I think it's near impossible to be a great open surgeon, a great laparoscopic surgeon, a great interventionalist and great at floor-management. It may start another flame war, but I think cardiologists should be doing interventional cardiology, and neurologists should be doing interventional neurosurgery. Who better to manage a post-intervention MI patient than a cardiologist, and who better to manage a post-intervention stroke patient than a neurologist. I know the studies have shown that neurologists have the worst outcomes compared to radiologists and neurosurgeons, but I think this just comes to the need for additional training.
I don't think neurosurgeons have any business doing endovascular. Their training is too long, the procedures are too different than open, there's a critical shortage of open neurosurgeons, and, most importantly, they don't manage ischemic stroke patients in traditional training. Historically, patients with ischemic strokes would be given tPA and handed off to the neurologists; the neurosurgery team wouldn't follow these patients. The three items that are in favor of neurosurgeons doing interventions are: a. the hours, b. the anatomy, and c. the money. Neurologists/radiologists aren't used to a neurosurgeon's call schedule, and stroke call is brutal. Financial considerations are driving a lot of it as coiling has replaced clipping in certain cases.
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Food for thought, some neurosurgeons prefer to not do stroke work because of the lifestyle. Faculty at my program (IR) refuse to do stroke even when they were presented with the opportunity and the money, and they were endovascular stroke trained also.
Lifestyle is important and stroke work is a young person's game.
DrFluffy, Naijaba, you guys bring up excellent points. The field of medicine is evolving quickly and there are more and more overlaps being made. That said, I think there are many components that distinguishes how we identify ourselves. The type of training we go through in addition to the services our specialty offers. I can only speak on behalf of the field of GI where (like IR) we are offering more services for things that was previously only offered by surgeons. For example, esophageal/large bowel perfs can now be contained endoscopically by stents and over-the-scope clips. Sleeve gastrectomies are being routinely done by some advanced practices. That said even though we spend 3 years of GI fellowship (and for those in advanced GI 4 years) building our procedural skills, our training relied on our foundation in internal medicine for both the evaluation and management of the issues we see and treat. I would never call myself a surgeon (eventhough I am called that by patients so frequently I have stopped correcting them). Now I think of it though, IR is definitely much hard to define. Technically you would still be radiologists who do procedures, correct?
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Why did light at the end of the tunnel and Fab5 get banned?
For making love on the internet!..and not letting Tiger100 join in.....the internet is a dangerous thing.
