In 2012, the American Board of Medical Specialties established interventional radiology (IR) as a unique specialty in medicine. In September 2014, the Accreditation Council for Graduate Medical Education (ACGME) approved a dedicated IR residency. These changes were made to provide increased exposure to the growing specialty of IR and to incorporate training in the clinical management of patients being cared for by IR. The training pathways in IR have been set up to allow entry into the specialty either directly from medical school (Integrated IR Residency) or after the completion of a residency in Diagnostic Radiology (Independent IR Residency).
Integrated IR Residency
The integrated IR residency is entered directly from medical school and can essentially be thought of as a 1-3-2 program. This means that the PGY-1 year consists of an internship in medicine or surgery (it is preferred that the training be in surgery). The PGY 2-4 years consist of the full complement of diagnostic radiology rotations in preparation for the Core Examination of the American Board Radiology at the end of the PGY-4 year. The final 2 years are essentially spent in dedicated IR training, which includes procedural rotations, an ICU rotation, and clinical care experience. At the end of residency, and upon successfully passing the ABR certifying and subspecialty exams, the resident will receive a dual certificate in interventional and diagnostic radiology. An IR/DR certifying examination will be administered three months after completion of the IR residency. This examination will consist of both a computer-based portion and an oral examination. More information on the IR/DR board certification can be found here.
Independent IR Residency
The independent IR residency can be thought of as a direct replacement for the IR fellowship. Instead of a one-year program though, the independent residency is a two-year program. It is entered after completion of a four-year residency in Diagnostic Radiology. The independent IR residency requires the same procedural and clinical rotations as the last 2 years of the integrated residency. The first independent IR residency will begin in July 2020.
ESIR Pathway
The ESIR (Early Specialization in IR) pathway enables residents in certain programs to receive 12 months of dedicated IR training during their diagnostic radiology residency. This translates to at least 8 procedural IR rotations, one ICU rotation, and up to three IR-related rotations during the diagnostic radiology residency. In addition, there are procedural requirements (500 procedures) that are a mandated part of this program. This pathway subsequently enables residents to directly enter the second year of an independent IR residency and complete one additional year of IR training. In order to enter an ESIR pathway, you have to match into a diagnostic radiology with an ACGME-approved ESIR pathway, and then apply for that pathway within the context of the DR program. Then, you would apply to an independent IR residency for your final year of training.