At noon on March 18, as medical students across the country tore open their National Resident Matching Program letters to learn where they would be pursuing their residency, one fourth-year medical student at Johns Hopkins School of Medicine, Liwei Jiang, learned that he would spend the next six years at BWH as the hospital’s first interventional radiology (IR) resident.
BWH’s new Interventional Radiology/Diagnostic Radiology (IR/DR) Residency Program was established this year and is one of the first IR residency programs in the country. Prior to this change, residents planning to specialize in IR would complete a DR residency and then go on to pursue an IR fellowship—one of the most competitive fellowships among residents. With the new residency program, traditional IR fellowships will no longer be needed and will be phased out at BWH and other academic medical centers over the next few years.
While DR focuses on the expert reading of various imaging modalities for disease diagnosis, IR involves minimally invasive image-guided diagnosis, as well as treatment of diseases in every organ system. BWH’s IR/DR residents will receive specialized training that balances medical image reading and diagnosis with patient care.
“This change is good for the specialty and gives us the ability to improve residents’ clinical education,” said Tim Killoran, MD, director of the new residency program. “More exposure to clinical medicine will better prepare our residents to take care of patients before, during and after image-guided procedures. They will also have exposure to critical care, and depending on their interests, be exposed to a full range of oncologic clinical care so that they can participate in treating cancer patients with more insight into the role of cancer treatment.”
The new residency track is the result of 10 years of planning by the Accreditation Council for Graduate Medical Education (ACGME), the American Board of Medical Specialties and leaders in radiology and medicine at BWH and across the country to make IR its own medical specialty—instead of it continuing as a subspecialty of diagnostic radiology (DR).
“The decision to create a new Brigham residency was made in concert with the decision to create a new specialty,” said Killoran. “Prior to the approval of IR as its own specialty, we were making changes to the curriculum to give our residents and fellows more clinical exposure.”
Going forward, BWH will match two new IR/DR residents per year, beginning next year. Though only seven institutions matched IR/DR residents this year, many academic medical centers are expected to participate in the IR/DR Match next year.
“New specialties are not born very often,” said Richard Baum, MD, chief of the Division of Angiography and Interventional Radiology. “Specialties are created when the ACGME believes that care has evolved in a subgroup beyond its parent; the specialty evolves and outgrows its roots. With IR, we’ve started doing more and more complex procedures, and direct patient care has become much more critical to the specialty.”
The preliminary, or first year, of the new program will be focused on general surgery at BWH, which will help familiarize residents with the Brigham and give them a strong foundation in surgical care. As with the traditional DR residency, IR/DR residents’ second, third and fourth years will consist of training in diagnostic radiology. During years five and six, IR/DR residents will focus on specialized clinical care in IR and related electives, such as oncology. Residents will leave BWH’s new program board-certified in both IR and DR.
“The Brigham has 50 years of excellence in this specialty; our long and rich history in IR dates back to Herbert Abrams, MD, former chief of Radiology,” said Baum. “We are thrilled that the Brigham will be home to this new program.”