Type:
Educational Exhibit
Keywords:
Not applicable, Workforce, Education and training, Education, CT-Angiography, Interventional vascular, Interventional non-vascular, Interventional Radiology
Authors:
L. Matthews1, A. Pervez1, Y. Xu1, V. Gkiousias1, M. Persad 1, G. Makris2; 1London/UK, 2Oxford/UK
DOI:
10.26044/ecr2020/C-10345
Background
Interventional Radiology is a sub-specialty of radiology, using minimally-invasive image-guided procedures to diagnose and manage diseases.
Structure of IR Training
In the UK it takes a minimum of 13 years training to qualify as an interventional radiologist. This is divided into four stages - Medical Degree (5 years), Foundation Programme (2 years), clinical radiology general training (3 years) and interventional radiology sub-specialty training (3 years) Fig. 1 .
Medical schools are expected to train medical students to become doctors who meet the professional values and behaviours outlined by the General Medical Council (GMC) in Good Medical Practice [1] and Outcomes for Graduates [2]. However, medical schools have autonomy in how they achieve this leading to variability in curriculum design of undergraduate medical programmes. As a consequence medical students have varying degrees of exposure to specialties such as radiology. Bhogal et al argue that there is a lack of radiology representation in the undergraduate curriculum [3]. This sentiment is echoed by a survey of medical students at a UK university who felt there was a lack of exposure to radiology, particularly in pre-clinical years [4]. To tackle this the The Royal College of Radiologists (RCR) has created an undergraduate radiology curriculum to help medical schools incorporate clinical radiology into their undergraduate programmes [5].
After graduation all doctors enter a two year Foundation Programme during which they continue general training [6]. Radiology posts in the Foundation Programme are rare making it difficult for doctors interested in radiology to gain radiology experience. The RCR recommends alternative ways to gain exposure including organising taster sessions in the radiology department and taking part in audits or research in imaging [7].
Doctors wishing to pursue a career in IR currently apply for clinical radiology training. This is a six year run-through programme, comprised of three years diagnostic radiology training (ST1-3) followed by three years sub-specialty IR training (ST4-6) [8].
Whilst interventional radiology is currently recognised as a sub-specialty of clinical radiology there may be a mandate for change as 80% of members of the British Society of Interventional Radiology (BSIR) voted in favour of interventional radiology becoming a specialty in the UK [9]. This could have implications for the IR training pathway.
IR Workforce and Recruitment Challenges
The demand for IR services is forecast to increase as the scope and complexity of IR procedures continues to expand. This poses a significant challenge in a field which already has variable service provision across the UK with many hospitals having indirect or no access to IR services [10]. Only one in five UK trusts [11] currently meet the RCR standard of six or more interventional radiologists needed to run an effective and sustainable 24 hour IR service [12]. This is primarily due to an insufficient number of trained interventional radiologists, with an estimated 36% shortfall of 379 interventional radiologists across the UK [10]. There are high vacancy rates in consultant posts with 14% of non-vascular interventional radiologist posts and 8% of vascular interventional radiologist posts unfilled in 2018 [11]. The current cohort of trainees is insufficient to fill this gap, with only an estimated 20 registrars set to complete UK specialist training and enter the UK workforce in 2019 compared to the 61 needed to fill the current consultant IR vacancies [11].