Interventional radiologist and medical director for The Royal College of Radiologists, Raman Uberoi (The John Radcliffe Hospital, Oxford, UK), gave this year’s Andreas Gruentzig Lecture at the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2023 annual meeting (9–13 September, Copenhagen, Denmark). Central to his lecture was the designation of speciality status in interventional radiology (IR), and the liberty this may provide clinicians to affect innovation in the field, as well as furthering its “vital” evolution for the next generation of interventional radiologists.
In a presentation titled ‘Interventional radiology: The next generation’, Uberoi began by making no uncertain parallel between the “futuristic and technologically-driven” evolution of Star Trek’s computer-generated imagery (CGI)—a passion of his—and the evolution of IR, which is “reshaping and changing, with new horizons, challenges and frontiers”, he told the CIRSE 2023 delegates. Before looking ahead however Uberoi explained that “it is important to look back”, giving a brief overview of the evolution or, “the roots”, of IR to date, spanning from the first angiography conducted in 1923, to the development of stents and contemporary tools used today.
“We are involved with just about every aspect of clinical practice, we have roles in patient safety, service improvement and patient outcomes—we would be forgiven for thinking ‘we are really in a nice position, we are doing exceptionally well’, but there is a problem.” Uberoi then introduced the challenges presented by the technician versus clinician dichotomy that faces interventional radiologists today, and has ultimately influenced “who is clinically responsible for the patient”, he posited. “The best outcomes for patients come when we are clinical interventional radiologists”, said Uberoi, which, he stated, begs the question: “Are we preparing the next generation for the needs of modern IR?”
What is needed to produce the next generation of modern interventional radiologists, Uberoi then flagged, is multifactorial. This includes increased touchpoints with patients throughout the treatment process, access to the latest technologies, and a revision of “unrealistic expectations” which assert that interventional radiologists must be “experts in imaging”, creating an environment in which burnout can thrive, he stated.
“We must gain control of our working lives, our practices, and our future” said Uberoi. Signalling a central theme of his lecture, he introduced the potential ways in which IR becoming a speciality could provide “solutions” to many of the field’s prevalent challenges. Among these challenges are the few UK trusts which have resource to provide 24/7 IR services—48%, Uberoi revealed, alongside the growing prevalence of burnout which has reduced the retirement age of interventional radiologists today to 44.
This “shocking” statistic reaffirms the importance of giving the new generation of interventional radiologists “control of their working future and working lives” which, he stated, means “rationalising the workload” and placing more focus on “core IR activities”. In order to make these changes, the speaker conveyed that evidence is needed to prove that IR is “improving and saving lives”, displaying several research titles that have been published in the space in recent years which have bolstered efforts of interventional radiologists worldwide, helping to distinguish IR as a speciality.
Leaving no stone unturned, Uberoi conveyed that the “strongest message” he can impart is that, with speciality status, interventional radiologists will be able to “control [their] destiny and future”, and this will enable clinicians to “gain control” over training and patient safety. He believes that speciality status could also help create a more defined career path for interventional radiologists, while “widening the pool” of potential takers who are considering the speciality.
“[Speciality status] will strengthen the voice of interventional radiologists—being a speciality gives you a strong voice at the table”, Uberoi asserted to delegates. With a touch of realism, he bookended this statement by noting that, if speciality status is universally granted, “nothing will change overnight”, but he underlined that “we cannot stand around waiting for somebody to deliver speciality status to us, we must start developing it ourselves”.
Imparting his final thoughts to the CIRSE 2023 audience, Uberoi highlighted that there are “hugely powerful drivers for change”, reiterating that evolution and speciality status are “vital” to the future survival of IR. “It is about improving training, the visibility of IR, improving workforce planning, and ultimately, high-quality patient-focused care”, Uberoi said, concluding that these crucial developments will only be achieved by fundamentally “improving the lives of interventional radiologists”.
