Food for thought

Created - 05.10.2011

Like many of you I have just returned from Munich after attending CIRSE. It was much more than just an endless feast (mostly beer and sausages!). The highlight for me was the keynote speech by Professor Jon Moss. The main theme was one of reflection on our own practice. How much of what we do is evidenced based? How can we improve our practice? And why aren't more if us involved in IR research? Most surgical trainees undertake an MD...why not IRs? 

There are lots of parallels between us and the surgeons. We like to think of ourselves as clinicians but are we really acting as such? How many trainees take part in regular clinic? Having clinic means you make the decision about whom you intervene upon and it is a vital part of our practice. Surgeons don’t let others tell them whom to operate on! Clinic time gives you an identity to the rest of the hospital. This is where consent can be properly obtained and expectations managed. We, as trainees must get involved in clinic and when looking for a consultant job and insist that a clinic session appears on our job plan. It's much easier to sort it at the start.

Prof Moss went to say just because we make small holes in patients doesn't mean that there are small risks. Out of hours biliary intervention carries a very high mortality. We need to be the clinician and decide if we should really be starting a procedure in the first place. What surgeon would take on an operation with an 60% mortality without giving it considerable thought?

Finally, and probably most pertinent to us, should IRs really be doing diagnostic radiology at all as a consultant? To be a good Interventionalist you first need to be a good diagnostician. Our training is short and we need to master both, as best we can. But as a consultant should we be diluting our practice with plain film reporting? Is the writing on the wall for those who dabble in both? Clinic time is so important to us and we may need to drop something to fit it into our job plans.

Closer to home, with study leave budgets dwindling but the importance of a thorough training being emphasized more than ever, all trainees are in difficult position. The BSIR recently set up it's first advanced practice course for senior trainees and the feedback has been excellent. The BSIRT has been fostering closer links with industry in order to get more IR trainees onto industry sponsored courses. These are not part of the IR curriculum but can offer some excellent hands on experience. Some courses offer practice on animal models not available in the UK. There is now a list of the opportunities available on the website. If you need more info feel free to contact any member of trainee council.

The BSIRT are trying to forge closer links with the other Radiology training societies, the Society of Radiologists in Training and Junior Radiology Forum. We think that this will help to raise the profile of IR and encourage greater integration. We will be under the new leadership of Dr Rajat Choudhury from Southampton after the annual meeting in November, so for me it’s thank you and goodbye. I’m sure Rajat will do an excellent job representing you and leading the society for the next year.

Mark Regi