Last year, the American Board of Medical Specialties (ABMS) approved the Dual Primary Certificate in Interventional Radiology and Diagnostic Radiology. Although its precise mechanics are yet to be determined, there can be little doubt that its implementation will change the face of medical education in interventional radiology. That kind of change isn’t unprecedented, however— interventional radiology education has evolved steadily over the decades.
Some changes in education are closely tied to how IR practice is evolving. According to Daniel Siragusa, MD, FSIR, SIR Graduate Education Division councilor, one of the biggest such changes is the increased emphasis on clinical care of patients. “Over the years,” he says, “the IR community has realized that it must be involved in the full spectrum of patient care to provide the best outcomes. Training has correspondingly expanded from performing procedures to providing longitudinal are in outpatient clinics and admitting patients to our own in-patient services.”
Gary P. Siskin, MD, FSIR, SIR 2013 Annual Scientific Meeting chair, has noticed the increased attention paid to clinical practice as well. “We expect our fellows today to not only master the wide variety of procedures we perform,” he explains, “but also to understand the issues patients face before and after these procedures and how to assume responsibility for managing these issues.” (See how SIR is helping on page 37).
That’s not the only way education has shifted to reflect current practice. Dr. Siskin adds that “The decreased volume in PAD that many practices are experiencing has meant fewer PAD training opportunities for our fellows. This can be a challenge to those entering the field because they may feel unprepared to handle these cases if called on to do them.” (See the back-cover ad for information on how SIR’s LEARN meeting can help you stay current in a competitive PAD environment).
Daniel B. Brown, MD, FSIR, SIR 2014 Annual Scientific Meeting chair, notes one area that may necessitate additional training: “A number of IR programs don’t cover coding and billing in any depth—which could be a problem since the trainees will be responsible for it when they enter practice. Given the complexities in billing and coding, this gap can pose quite a challenge.”
Some changes in medical education stem from changes in society, itself—such as the increasing role of emerging technology, says Brian Funaki, MD, FSIR, SIR Postgraduate Medical Education Division councilor: “Certainly, medicine evolves as technology evolves. By the time my kids are in college, campus bookstores may sell only computers.”
Growth of communication technologies means that learners have new ways to access educational opportunities—and, by extension, that the days of scheduled lectures may be passing. According to Dr. Siskin, “These lectures are still necessary,
but will likely more often be filmed and made available online for later viewing. Because that approach is more practical and efficient, it actually increases the amount of teaching we can offer to our trainees.”
It seems intuitive that trainees should first learn procedural technique with a simulator before learning on a patient. With today’s—and tomorrow’s—technology, that practice is becoming a reality and will ultimately better serve our patients.
Gary P. Siskin, MD, FSIR
But trainees aren’t the only beneficiaries, Dr. Brown says: “We have only scratched the surface of what we can do with advanced technologies: The ability to store Webinars and allow later acquisition of CME is a tremendous help for those in busy practices. The success and popularity of SIR’s VIRtual SIR 2013 meeting portal is particularly telling, I think.” (See page 17 for more details).
Medical simulation—much like the simulators long used by aeronautics and military trainees—is another increasingly significant technological aspect of medical education. As Dr. Siragusa explains, “Medical simulation has grown by leaps and bounds in the past decade. Robust angiographic simulators and computer-based simulations allow trainees to gain experience in controlled environments.”
Dr. Siskin agrees: “It seems intuitive that trainees should first learn procedural technique with a simulator before learning on a patient. With today’s—and tomorrow’s—technology, that practice is becoming a reality and will ultimately better serve our patients.”
Although emerging technologies clearly have a great impact on how learning is changing, Dr. Funaki also cites “increasing regulation through organizations such as the Joint Commission and the Institute of Medicine. For example, new duty hour regulations have created educational challenges—at times, it seems as though we’re training a generation of shift workers. I’d like to see ‘evidence-based practice’ applied to these rules before implementation.”
Dr. Siragusa shares another factor in the evolution of IR education: “The political climate of academic medicine has posed significant challenges for training in IR. In the academic environment, institutions often have multiple training programs that all want to provide a robust educational foundation for their trainees. Much like a parent, all programs want their graduates to be prepared for whatever they want to do when they enter the workforce.” He concludes, “Unfortunately, this can lead to an environment with artificially increased competition issues that don’t reflect the global practice of medicine in the private community.”
