IR Residency Update. Chuck Ray, MD, PhD University of Illinois COM

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1 IR Residency Update Chuck Ray, MD, PhD University of Illinois COM

2 Acknowledgement Vicki Marx, M.D.

3 IRs as clinicians. Evolution of IR Perform inpatient consultations Operate outpatient clinics Admit patients Provide focused clinical care with longitudinal follow-up IRs as specialists. Interventional oncology Women s health Venous disease Peripheral arterial disease Pediatrics Interventional Radiologist

4 Evolution of IR Imaging Procedures IR Patient care 2012 ABMS specialty status (IR)

5 Evolution of IR ABMS ACGME Approved 2012 Approved 2014 IR be recognized as a unique with a unique training program specialty IR IR/DR

6 Clinical Care in IR?

7 Clinical Care in IR Periprocedural care Specific activities - Before, during, and - Outpatient clinic after procedures - Inpatient service - Focused care related - Admitting service to procedure - MutiD conferences

8 Clinical Care in IR Evaluation and Management (E&M) Coding Smouse H. Seminars in IR 2006; 23; 305

9 Clinical Care in IR Evaluation and Management (E&M) Coding Kwan S. JVIR 2012; 23:887. Khan N. JVIR 2005; 16: 1753

10 Clinical Care in IR in the Age of Health Care Reform How to provide clinical care: - Safely - Efficiently - With high quality

11 Clinical Care in IR in the Age of Health Care Reform How to provide clinical care: - Safely - Efficiently - With high quality High Quality Low Cost

12 New training program Purpose To facilitate optimal patient care in IR To provide trainees with the tools they need to deliver this care - as imagers, proceduralists, and clinicians Interventional Radiologist

13 IR Residency Key Elements Greater focus on clinical care: outpatient clinics, inpatient consultation and admission, and critical care More time to master the procedural and clinical domains of IR (1 additional year) New opportunity for trainees to enter into IR from medical school

14 IR Residency While at the Same Time Maintain core competency in DR Not extend length of training Bring people in from medical school but also allow entry from DR Do not leave any (many) programs behind

15 IR Residency Recognize Many Stakeholders DR programs, PDs: big/small - with or without IR fellowship Department chairs IR programs: big/small - with or without DR - ratio of DR residents to fellows

16 IR Residency Comply with ACGME Mandate All current IR training programs must convert to the new system Within 5-7 years (2020)

17 IR Residency Fortuitous advent of the new ABR exam paradigm - Frees up the 4 th year for electives Nevertheless, designing a system that meets the stated objectives and that will work for (almost) everyone has been a challenge.

18 RRC Tasks IR Residency Program Requirements FAQs Application Forms Procedure Logs Milestones Site visits and review

19 IR Residency Integrated Program - Medical school match - Internal DR transfer Independent Program - DR graduate - ESIR 2 nd year entry Clinical Internship

20 ESIR DR programs wishing to provide residents with sufficient IR training to qualify for advanced entry into the 2 nd year of an Independent IR residency must have prior approval from the RRC for their ESIR training program: DR programs must specify the IR training that the ESIR resident will receive in PGY2-5 (12 IR or IR-related rotations and 500 procedures) DR programs must have adequate IR facilities and personnel to provide IR training.

21 SlLIDE FROM Midwest Chairs 2016 Current ACGME Accreditation Status Integrated IR Residency Programs 62 applications for Integrated IR programs have been submitted to ACGME The RRC approved 8 programs during the Nov 2015 meeting These are eligible to participate in the next NRMP Match cycle (Match Day in March 2016) More program approvals will take place at the RRC meetings in Jan and April 2016

22 SLIDE FROM Midwest Chairs 2016 The approved integrated programs are: Brigham U Pennsylvania MGH Washington U U Michigan U Kansas Georgetown Vanderbilt

23 SLIDE FROM Midwest Chairs 2016 Current ACGME Accreditation Status Integrated IR Residency Programs ACGME will begin consideration of applications for Independent residency sometime in 2016 date TBA Departments with approved integrated programs will submit a shortened application. Site visits will be limited to programs that have not been site visited for an integrated program To ensure no gap in graduation of trainees after June 30, 2020, it is recommended that applications be submitted by July

24 Current status of training programs Current training programs entering the match

25 Current status of training programs Current training programs entering the match 61 accredited programs entering the 2017 match ~120 positions ~40 ESIR programs Most plan on taking internal PGY 3-4 residents Handful of Independent programs applied for accreditation. None certified. All will launch simultaneously on July 1, 2020

26 Current status of training programs Current training programs entering the match 2017 data 558 applicants 418 US medical grads ~2/3 applying for both IR and DR residency spots

27 What are our own data?

28 What are our own data? Currently approved program? Yes No Pending

29 What are our own data? Participating in 2017 Match Yes No 0

30 What are our own data? Positions per PGY5/6 year #1 #2 #3

31 What are our own data? How will spots be funded? Converted DR spots Converted DR and fellowship spots New GME funding New Dept funding

32 What are our own data? When will fellowships be phased out? Unknown

33 What are our own data? Will you apply for independent residency positions? Yes No Probably Unsure

34 What are our own data? ESIR? Yes Pending approval No

35 Interventional Radiologist

36 Thanks for your attention! About the picture ask David

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