A window into IR training in the USA

Left to right: Oluwatoyin Dada, Ariana Mills

Oluwatoyin (Toyin) Dada is a current fifth-year postgraduate trainee (resident) in interventional radiology (IR) and diagnostic radiology (DR), and Ariana Mills, a first-year resident. Both are based at the Icahn School of Medicine at Mount Sinai (New York City, USA) and have answered some questions for Interventional News about their journeys into IR from their US perspective.

IN: What led you into medicine? What has since led you to pursue IR?

OD: Some of my greatest influences growing up were my mom, who was a health aide for a short time, and my older sister, who pursued medicine. Naturally, I wanted to be like them, so medicine was always something I had at the back of my mind. I also had the opportunity to work with a child who had autism and volunteered at our community hospital during high school. Being in those environments gave me a deep appreciation for medicine. In medical school, I knew I wanted to go into a field that had a lot of variety and allowed me to do procedures, as I already loved hands-on activities. I went to a Latino Medical Student Association conference as a second-year student and met an IR attending who chatted with me about the variety of cases in IR, their complexity, and what they were able to offer patients. After that interaction, I made it my mission to learn more about the field of IR, and the rest is history!

AM: I wanted to become a doctor after taking a human biology class in sixth grade. I loved science and admired the tremendous commitment to helping patients inherent in medicine. After seriously exploring that childhood dream through shadowing, I was certain I wanted to begin the path to applying to medical school by the time I started college. I learned about IR from an attending physician on a panel during my first semester of medical school. After shadowing that physician, I was drawn to the specialty. I liked the field’s procedural nature, the ability to treat various pathologies, the countless opportunities for research, the supportive professional community, and the novelty of devices and interventions. After leading a research project on fertility after transcatheter arterial embolization for obstetric haemorrhage, I was certain I wanted to train in IR because the field constantly identifies safe and innovative alternatives for patients.

IN: What did you do to prepare for your application to IR? What was the greatest challenge?

OD: I did a two-week IR rotation at the beginning of my clinical years and did a quality improvement project with the IR faculty at my institution. I also tried to attend conferences and symposia geared toward medical students, which provided a window into other IR departments across the country. I would say the biggest challenge when applying was the number of people telling me not to pursue IR/ DR for fear of poor work-life balance, artificial intelligence taking over, turf wars, radiation exposure, etc. I decided to apply anyway and have been extremely happy with my choice thus far.

AM: I prepared for my application by exploring my interest in IR. Specifically, I shadowed during preclinical years, participated in multiple clinical rotations, completed two visiting student electives, attended and presented at academic conferences and symposia, and volunteered with the Society of Interventional Radiology (SIR) Medical Student Council. Not only was this process helpful for building my application, but it gave me a multifaceted view of IR that informed my decision to apply to the specialty. I wanted to remain open-minded about other specialties during medical school too, so my greatest challenge was maintaining a strong involvement with IR while also exploring other fields.

IN: Toyin, what has been the highlight of your residency so far? The biggest challenges? Ariana, what are you most looking forward to, and what do you think the greatest challenge will be?

OD: The biggest highlight of residency was finding that I was staying at my current institution for IR training! It felt like all the hard work finally paid off. Because IR/DR is a rapidly evolving field and there is not much exposure as medical students, I found that the learning curve was incredibly steep. Thankfully, with repetition and experience, I am finding it much easier now to grasp concepts. Additionally, there are multiple amazing resources (SIR Learning Center, the Backtable podcast, etc.) that are available to trainees to make learning IR concepts much easier.

AM: I am most looking forward to being even more involved in patient care as a resident physician. I am also excited to spend more of my time learning experientially, working towards a collective goal as a part of a team, and contributing to a rapidly growing specialty. Given that residents are learning at such a fast pace and being pushed to their full potential, I think the greatest challenge for me will be to keep in mind how much progress I have made without harping on how much I still cannot do and how much I still do not know.

IN: I can see from Twitter etc. that you are involved in IR outreach)—what made you want to be involved in this?

OD: Many people invested time in me as a medical student and resident, and it has paid off greatly. I feel that it is my duty to pay it forward to those coming up behind me. Additionally, while I have had (and still have!) amazing mentors, I find that not many people in IR look like myself—a black woman. I feel it is important to be visible and show others like me that we are here, and that there is plenty of room for them at the table too.

AM: Dr Daryl Goldman started an elective called ‘Introduction to IR and Minimally Invasive Procedures’ that was offered to students at our institution. During the pandemic, she recognised that the widespread adoption of virtual education could enable the department to expand the elective to any student worldwide interested in IR. She kindly reached out to me to see if I would like to help her facilitate this iteration of the course, and I was subsequently co-course director for two years. It was very impactful to witness that the course fostered excitement in students, and I look forward to working on similar initiatives in residency.

IN: What words of advice would you give to current medical students trying to decide what specialty to go into?

OD: The best advice I received as a medical student is to stay open to all possibilities and treat each rotation as if that is the specialty you are going into. I took that advice very seriously and I am in a completely different field than the one I first thought I would pursue. I am very happy with my choice and would gladly choose IR all over again.

AM: Deciding on a specialty involves a lot of reflection. It is helpful to be extremely honest with yourself about who you are, including your proclivities, strengths, areas for growth, limitations, and professional and personal aspirations. As you learn about different fields, consider what is required in the training and especially what is required as an attending. Through this process, you can evaluate whether you see yourself being successful professionally in this field, whether you are excited about what the field can add to your life, and what you believe you can offer to the field.

IN: How well is IR introduced to med students in the USA? What, if anything, do you think med schools in the USA could do to better inform students of opportunities in IR, or what a career in IR entails?

OD: Depending on the institution, IR is not readily offered as an elective or is often limited to a small number of students. A strategy that I have seen work really well, especially at Mount Sinai, is that it is offered as a subspecialty elective within the required surgery rotation. Speaking from my own experience, I learned about IR at a non-IR conference, and that was pivotal in my career path. Symposia and conferences geared towards medical students are fantastic ways to reach potential recruits early on.

AM: It is well established that students do not have much exposure to IR in medical school, and in my experience it is not for lack of enthusiasm from the IR community. I hope the general medical education teams can do more to reduce barriers to exposing students to IR. For example, schools could invite interventional radiologists to be involved in preclinical education, such as around IR procedures like uterine fibroid or prostate artery embolization during relevant lectures, and schools could allow rotations in IR to meet acting internship requirements.


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