The People's Republic of China
This new column spotlights the growth of interventional radiology in countries around the world. We thank 2017 SIR Gold Medalist Gao-Teng, MD, FSIR, and 2016 SIR International Scholar Caoye Wang, MD, who live in China, and David A. Kumpe, MD, FSIR, who visits China every year, for their assistance with this article.
IR certification process
There is no official IR certification in China, but leading interventional radiologists hope to establish one eventually. Many IRs enter the field from radiology, surgery and oncology after a certain amount of training. Like many other parts of the world, in China, training follows the traditional academic rank. One can obtain a Bachelor’s or Master’s in Radiology and a PhD in a radiology subspecialty like IR. In the hospital of Gao-Jun Teng, all the trainees earn a PhD, which is not necessarily the case elsewhere. The trend now is that neurology surgeons and vascular surgeons are doing IR procedures, taking on a dual title of surgeon and interventional radiologist.
IR societies and meetings
Each of the 34 provinces, municipalities and other regions has its own society and conferences, as do the different areas of the IR domain. Major societies in China include:
- Chinese Society of Interventional Radiology (CSIR)
- Chinese College of Interventionalists (CCI)
- Committee of Minimally Invasive Therapy in Oncology
- Chinese Anti-Cancer Association
- Chinese Society of Oncology Interventional Radiology
- Chinese Society of Neurological Interventional Radiology
- Chinese Society of Vascular Interventional radiology
There are an estimated 200 IR meetings each year, with 100–5,000 participants at each meeting. In every city, 3–4 hospitals are involved in small workshops that cover special clinical cases; some of these workshops are financially supported by industry.
How IR differs
- China represents one of the largest if not the largest market for IR products and procedures in the world.
- Each year, 2 million noncardiology interventional procedures are performed.
- In 2016, percutaneous transluminal coronary angioplasty (PTCA) volume was higher than in the U.S.
- There is a tremendous number of hepatocellular carcinoma (HCC) patients because of the prevalence of hepatitis (particularly hepatitis B). Physicians have evolved some sophisticated interventional treatments that are not used in the U.S.
- China is also developing more stroke treatment programs due to the huge number of strokes, with 1.6 million mortalities since 2011.
Challenges of practicing IR
There are three challenges facing interventional radiologists in China:
- Manpower/clinical practice: There is a very large number of IR patients compared to the number of IR physicians. That means IRs do not have much time to spend with patients outside their procedures.
- Reimbursement: Not every patient has medical insurance, making it difficult for the doctor to treat the patient because affordability must be part of the assessment. In China, most IR is inpatient because there is no reimbursement infrastructure or programmatic examples in place for outpatient care. Doctors are reimbursed on the basis of the number of beds their patients occupy. Patients have some health coverage and the concept of “insurance” is gaining hold. But much of care, including expenditures for devices, is cash based.
- Occupational health/women in IR: The physical constraints of lead aprons and concerns about radiation exposure have been seen as constraints from IR careers for many female physicians. Developing better information and solutions to these issues would be an important step toward addressing manpower problems. To this end, we are working with the SIR Women in IR Section to see if we can create a similar program in our country.
SIR in China
- Since 2012, SIR has worked closely with the Chinese Society of Interventional Radiology as well as the national interventional oncology group.
- Chinese members have visited SIR headquarters and attended the SIR annual meeting.
- SIR has participated in the last six Chinese Society meetings, updating their membership on our activities.
Introducing JVIR China
The Journal of Vascular and Interventional Radiology is pleased to announce the launch of JVIR China, a new page on jvir.org that hosts abstracts from the latest issue translated to Chinese. This new page will shine a spotlight for a new audience on the tremendous research being published in the journal each month.
