Opinion Article | Volume 6 - Issue 1 | Article DOI :
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Austin Jin Xian See
Birmingham Medical School, UK
Corresponding Author:
Austin Jin Xian See, Birmingham Medical School, UK
Abstract
Interventional Radiology (IR) as a speciality presents the need for a focused specialist training pathway
Introduction
Interventional Radiology (IR) as a speciality presents the need for a focused specialist training pathway1. At the heart of IR are technology, innovation and patient-centred care2. The training pathway should aim to provide optimal IR workforce while maintaining high standards by incorporating relevant core clinical and specialist IR skills, personal and professional development, and integrating a holistic and effective clinical pathway3. This journey should begin from Medical School and continue throughout one’s career.
Optimal Training Pathway
A. Medical School
Early IR exposure in Medical School can cultivate interest4. The key approach includes interactive lectures, group seminars and problem-based scenarios with IR application.
Basic IR related skills including hand-eye coordination could be introduced during clinical years with simulation-based training. Every IR training centre should offer opportunities for taster sessions or a structured student-selected component programme.
B. Foundation Years (FY)
Patient care by FY can be extended to day case IR patients and clinics. This would enhance interaction with the IR team, generate insight into IR practice and develop interest.
C. Diagnostic Radiology Training
A 2.5-year modified curriculum containing relevant core diagnostic radiology with a strong emphasis on disease recognition and clinical relevance would form a solid foundation5. Some modules can be condensed e.g. breast imaging and nuclear medicine, providing relevant exposure without unnecessary depth. Radiology exam preparation can be supported by virtual high quality and effective teaching from national experts.
D. Specialist IR Training
This is a 2.5-year focused vascular and non-vascular IR curriculum incorporating a 6-week surgical ward rotation to enhance clinical skills, communication and patient-centred care6,7. Formal regional and specialist training networks should be established.
Simulation technology can standardise training by allowing all trainees equal access reducing training variability by refining technical ability and shortening procedure time to improve patient outcome and experience7-10. IR innovation and research can be encouraged through integrated clinical engineering and technology initiatives. Regular high-fidelity training on non technical skills of communication, teamwork, leadership and decision-making is essential10. Interventional Radiologists are medical specialists, not technicians11,12.
The examination model will consist of a modified diagnostic radiology exam after 2.5 years and a specialist IR exam before completing training.
E. Junior consultant (first 2 years)
A mentor support scheme would provide ongoing reflective learning and identify gaps. The opportunity should exist for acquiring further development elsewhere in the country or abroad, where appropriate. This would help drive innovation by exposing them to different systems and techniques.
Role of Interventional Radiology Societies
The relevant College of Radiology and IR Societies are central in developing the IR curriculum. It can also support talent recruitment, trainee progress and training network. It is key to implementing a high-quality virtual training programme, provide synergism in innovation and research, and underpin mentorship and leadership in IR.
Conclusion
An optimal IR training pathway involves a focused and practical IR programme incorporating core clinical and specialist IR skills, with an emphasis on innovation, technology and patient-centred care. A comprehensive 5-year diagnostic and IR programme extending to junior consultant level would ensure optimal clinical, technical and professional development.
References
1. The Royal College of Radiologists. Clinical Radiology Specialty Training Curriculum. [Internet]. 2020 [cited 2020 July 08] Available from: https://www.rcr.ac.uk/sites/default/files/clinical_radiology_ curriculum_2021.pdf
2. Interventional News. A Glimpse Of The Future: The Next Decade Of Interventional Innovations. [Internet]. 2020 [cited 2020 July 10]. Available from: https://interventionalnews.com/next-decade-interventional-innovations/
3. The Royal College of Radiologists. Clinical Radiology UK workforce census 2019 report. [Internet]. 2020 [cited 2020 July 08]. Available from: https://www.rcr.ac.uk/system/files/publication/field_ publication_files/clinical-radiology-uk-workforce-census-2019-report.pdf
4. European Society of Radiology (ESR) and Cardiovascular and Interventional Radiological Society of Europe (CIRSE). Interventional radiology in European radiology departments: a joint survey from the European Society of Radiology (ESR) and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE). Insights into Imaging [Internet]. 2019 [cited 2020 July 10];10(1). Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6375097/
5. European Society of Radiology (ESR) The future role of radiology in healthcare. Insights Imaging [Internet]. 2010 [cited 2020 July 06];1(1):2–11. Available from: https://www.ncbi.nlm.nih.gov/pmc/ articles/PMC3259353/
6. Gordon M, Darbyshire D, Baker P. Non-technical skills training to enhance patient safety: a systematic review. Med Educ. 2012;46(11):1042-1054.
7. Midulla M, Pescatori L, Chevallier O, et al. Future of IR: emerging techniques, looking to the future . . . and learning from the past. J Belg Soc Radiol 2019;103(1):12.
8. Nayahangan LJ, Nielsen KR, Albrecht-Beste E, et al. Determining procedures for simulation-based training in radiology: a nationwide needs assessment. Eur Radiol. 2018;28(6):2319-2327.
9. Buljac-Samardzic, M., Doekhie, K.D. & van Wijngaarden, J.D.H. Interventions to improve team effectiveness within health care: a systematic review of the past decade. Hum Resour Health 2020; 18(1):2.
10. Mandal, I. and Ojha, U., 2020. Training in Interventional Radiology: A Simulation-Based Approach. Journal of Medical Education and Curricular Development [Internet]. 2020 [cited 2020 July 10]. Available from: https://journals.sagepub.com/ doi/10.1177/2382120520912744
11. Baerlocher MO, Asch MR. The future interventional radiologist: clinician or hired gun?. J Vasc Interv Radiol. 2004;15(12):1385-1390.
12. Maingard J, Kok HK, Ranatunga D, et al. The future of interventional and neurointerventional radiology: learning lessons from the past. Br J Radiol. 2017;90:20170473.
Citation
Xian See AJ (2021) Optimisation of training pathway in Interven tional Radiology. SM J Radiol 6: 2.
