Indrajeet Mandal, a second-year radiology registrar at Oxford University Hospitals NHS Foundation Trust (Oxford, UK), speaks to Interventional News about the interventional radiology (IR) awareness initiative that he co-founded in 2019—IR Juniors.
Mandal along with Niall Burke (NHS Lothian, Edinburgh, UK), Sachin Modi (Royal Free London NHS Foundation Trust, London, UK) and Navin Nagesh (Oxford University Hospitals NHS Foundation Trust) under the guidance of Gregory Makris (Guy’s and St Thomas’ NHS Foundation Trust, London, UK) and further support by Jim Zhong (Leeds Teaching Hospitals NHS Trust, Leeds, UK), launched the website to further awareness of the specialty. IR Juniors is now partnered with the British Society of Interventional Radiology (BSIR). The group aims to educate those at the start of their medical career about how they can pursue IR, become involved in the initiative’s affiliated research collaborative (UNITE) and embark on an elective in IR abroad—and much more besides.
Q: How did you end up as a radiology trainee with a passion for IR?
A: Just one day of a vascular surgery placement I did as a medical student was in IR, and that day changed my life. The consultants there probably do not know that they inspired me this much, but I am going to namedrop them anyway—Nick Woodward and Neil Davies at the Royal Free Hospital in London. I just had a fantastic experience—they let me scrub and explained exactly what IR was. Before, I had thought that it was just cardiologists who did stents, and this showed me a whole other world. Independently of that, I then did a placement in radiology towards the end of medical school and my supervisor happened to be an interventional radiologist. I really got inspired by the concept of ‘minimally invasive procedures under image guidance’—there is no other specialty like it.
Q: Why do you think that there tends not to be much awareness of IR among medical students? What specifically led you to set IR Juniors up?
A: In my opinion, the medical school curriculum is already very congested, and IR does not really fall among the priorities, which was fair enough a few decades ago. However, it has now become such a vital cog of healthcare. Even with some medical school teaching, it is hard to get a full grasp of what radiologists do, and this was partly the ‘why?’ for IR Juniors. It was also personal—before my IR elective I was searching for a basic website or book to help me prepare and I felt like there was a gap. We hope IR Juniors, as a solution to this, is accessible and not too advanced.
Q: UNITE—National IR Trainee REsearch Collaborative—is IR Juniors’ affiliated research group, which you also set up. Why was encouraging research involvement among students and trainees a priority?
A: Education is important, but research is too—IR has been one of the most innovative specialities. There are not that many avenues in the UK to explore IR research, and while not everyone is going to be an investigator or a researcher, it is still key to show that a career in research in IR is possible.
Q: You have carried out COVID-19-related projects through UNITE, among others—what has come from this research so far?
A: Our first project was on the impact COVID-19 had on IR training and services. As a trainee-led research collaborative, it was important to start with this. We found that, while a lot of surgical services had to stop because of the anaesthetic risk during the pandemic, a lot of IR services carried on, which highlights the importance of IR in the patient pathway. The next project was a multicentre study on the outcomes of cholecystostomy and over 30 centres collaborated—that work was presented at the BSIR meeting in 2021. It was great proof that we could mobilise trainees across the country, which had been done in other specialties, but never until then in IR. The papers from this study have now been accepted for publication.
Q: The Global IR section of IR Juniors shows your commitment to widening access to all that IR has to offer, for clinicians and patients alike—what does this look like in practice?
A: As a specialty, IR has always been collaborative—among different specialties but also countries—and we wanted to show that as an IR, you are part of a huge network around the world. There are two parts to the Global IR section, the first being highlighting opportunities for training in countries such as Canada and Australia. You can learn new techniques during these fellowships, while sharing how things are done in the UK too. Secondly, IRs can help set up training programmes and infrastructure in less developed countries. Road2IR is a great initiative as part of which trainees from the UK and USA go to Uganda to set up an IR training programme. This teaches participants that the specialty is not just about fancy, expensive equipment.