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The Home of Bitesize Interventional Radiology Education An Introduction to Interventional Radiology Dr Robert Bakewell ST6 Interventional Radiology Addenbrooke’s Hospital, Cambridge robert.bakewell4@nhs.net The Home of Bitesize Interventional Radiology EducationOverview ● What is interventional radiology? ● A brief history ● What do we do and how do we do it? ● Who is IR for? ● A typical week for an IRWhat is Interventional Radiology?What is Interventional Radiology? ● Interventional radiology = minimally invasive image guided surgery ● Utilising a foundation in medical imaging interpretation combined with advanced procedural skills to diagnose and treat a wide range of disease throughout all organ systems of the body across all age groups.A brief historyThe Father of Interventional Radiology ● Charles Dotter 1920- 1985 Pioneer of angioplasty ● ‘If a plumber can do it for pipes, we can do it for blood vessels’What do we do and how do we do it? ● Is it blocked? Unblock it. Angioplasty, venoplasty, stent, drug eluting devices. ● Is it leaking? Block it, cover it, divert it. Embolisation (coils, plugs, particles, liquids), stent graft (EVAR/FEVAR), nephrostomy, biliary drain. ● Is it a cancer? Diagnose it, kill it, shrink it Ablation (radiofrequency, microwave, cryo, ‘electroporation’), TAE, TACE, SIRT. ● Benign but symptomatic? Shrink it, drain it. Prostatic artery embolisation, uterine artery embolisation, all drainage proceduresMajor (and ever increasing) role in cancer diagnosis, therapy and symptom control.Who is IR for? ● Problem solvers ● Innovators ● Clinicians at the forefront of medical technology ● Close partners with industry ● Good hand-eye coordination ● Calm under pressure ● Teamwork and adaptabilityA Typical Week Key points: Heavy on intervention. Autonomy but must be adaptable to deal with emergencies. Encouragement to develop advanced subspecialty interest.Case 1Case 2CIRSE. Penumbra. MedtronicQuestionsThe Home of Bitesize Interventional Radiology Education Interventional Neuroradiolog Dr Dilina Rajapakse Consultant Diagnostic and Interventional Neuroradiologist The Home of Bitesize Interventional Radiology Education ● Subspecialty of intervention WhatisINR? radiology specializing in minimally invasive image- based techniques and procedures used in diagnosis and treatment of diseases of the head, neck, and spine ● Diagnostic Neuroradiology Foundation training Training 3 years of general radiology training 3 years of subspecialty training +/- Fellowship Job Plan Monday Tuesday Wednesday Thursday Friday Weekend Angiography GA list Reporting MDT Admin 1 in 5 oncall Angiography GA list Acute SPA ReportingCasediscussionMechanical Thrombectomy - StrokeEmbolisation of AneurysmEmbolisation of AneurysmEmbolisation of AneurysmEmbolisation of Spinal FistulaPreoperative embolisation of JNAAVMThankyou!The Home of Bitesize Interventional Radiology Education How to Become a Radiologist Dr Chris Grieco and Alexander Tan The Home of Bitesize Interventional Radiology EducationOverview ● Steps to become a radiologist ● How and when to apply ● Why become a radiologist ● What can I do now The Homeof Bitesize Interventional Radiology Education X @doctorgrieco and Dr TanStepstoBecomeaRadiologist Cambridge University Rob You are here (Hopefully) ST6 Chris and D AlexHowandWhentoApplyWhen ● F2 (3/4/∞/any other speciality) ● September for academic training via Oriel ● October for non-academic via Oriel ● There are also options to apply for February intakeHow ● Three components ○ Portfolio ○ MSRA ○ InterviewPortfolio - Think About as a StudentCommitment to Speciality ● Multiple significant radiology work exposures ● Two taster weeks (3+ days - ideally one in big hospital and one in smaller) ● Student Selected Components - even if not radiology specific can relate to imaging ● If you have not intercalated yet an imaging themed intercalated Bachelor of Science ● Attend conferences (CIRSE is incredible and free for students!!!)Leadership National Radiology Committee Position (personal advice - don’t just do it for the points) Examples which have medical student positions: European Trainee Forum (CIRSE) British Society of Interventional Radiology (BSIR) and Trainees Section (BSIRT) IR Juniors Society of Radiologists in Training (SRT) Royal College of Radiologists (RCR) British Institute of Radiology (BIR)Teaching ● Organise a teaching programme over 3+ ● Qualification months for max points ● 2+ Teach the teacher days - FutureLearn ● Get evidence for what you do ● Cambridge run ultrasound teach the teachers as a med student, get involved with teaching other students and get your supervisor to write letter explaining your role ● Cambridge University Hospitals - Integrated Foundations of Medical Education (iFME) can lead to postgraduate certificate of medical education (PGcert) ● Open University - Take your teaching onlineAudit, Quality Improvement and Research ● Contact us more than happy to help and advise! ● Audit - Lead 2 x 2 cycle closed-loop audits for max points related to radiology ● Research - do some sort of postgraduate qualification - not realistic for most (if you insist, consider doing it in medical education as this will fulfill teaching qualification and research boxes) ● Realistic maximum for research - 1x National or international conference poster presentation as first author or 1x publication in radiology related journal as first authorPrizes ● Scoring well at university counts - distinction/merit ● Lots of prizes available from radiology societies, the harder sounding ones are often easiest to obtain, very few people apply for these or submit essays ● Personal experience - I ran a 3+ month IR Bites webinar series and fortuitously was given the MedAll ‘Exceptional Educator’ prizeWhyBecomeaRadiologistWhy ● Watch Mr Radiologist on YouTube for his 50 reasons from an ex-surgical trainee ● For Chris - love anatomy, tech, future boom, hands-on procedures, short procedures - more dopamine hits for Gen Z minds, procedures early in career, nice work - no unnecessary documentation on long ward rounds, dictaphones, coffee, peace and quiet and focused work, one task at a time, one patient at a time with proper connection, huge scope to be inventive and innovative, research, private potential ● You could become a paediatric interventional oncology radiologist or a general diagnostic radiologist, so many options. ● The other alternatives are frankly terrible…WhatCanIDoNowWhat Can I Do Now? Show up Be keen, but not too keen “Begin with the end in mind” - Stephen Covey Be active, not passive Tirtl.co.uk or eLogbookOverview ● Steps to become a radiologist ● How and when to apply ● Why become a radiologist ● What can I do now? The Homeof Bitesize Interventional Radiology Education X @doctorgrieco and Dr Tan