Reflections of an IR Fellow

Created - 16.12.2023

“Next time you do one of those, you’ll be a consultant”...

Hearing these words from the scrub nurse as I was finishing a recent case really brought home that I was entering the final weeks of my time as an Interventional Radiology registrar here in Sussex. Whilst I am excited about taking the next step in my career, recent weeks have brought occasional bouts of imposter syndrome and fears about whether or not I am truly ready to finish my training. But as a colleague recently told me – “you will never feel ready as the more you know, the more you know you don’t know!” Otherwise described as ‘conscious incompetence’, this concept is a well established part of the learning process, and is recognised as the stage of learning at which real progress can be made. This certainly ties in with that other often-repeated wisdom that the steepest learning curve in medicine comes in the early stages of consultant life. As well as looking forwards this has also been a time for reflecting on my experiences as a trainee to see if I have learnt any lessons beyond the essential skills of putting the right device in the right place, in the right
patient and at the right time. Training in Sussex is split between the tertiary centre in Brighton and surrounding district general hospitals which offer a varying degree of IR services. Understanding the services available in all of these hospitals and the different ways in which they are delivered has been an invaluable aspect of my training. Whilst some services are appropriately centralised, it has become clear that IR is just as essential to the delivery of safe and effective care in a DGH as it is in a major trauma centre. As IR continues to develop and offer acute, elective and cancer services across almost all hospital specialties, it is ideally suited to thrive in a varied DGH environment. This variety is an inherent benefit of working in a specialty based on technique rather than body part, and is well-reflected in the working life of trainees here in Sussex. Lists are filled with a ready supply of ischaemic limbs and aneurysms allowing trainees to develop the skills required for arterial intervention whilst experiencing a wide range of non-vascular procedures and the ever-present demands of biopsies and drains. Taking ownership for the delivery of these less complex procedures served as a useful step towards more independent practice. Reflecting and learning from successes and complications in lower-risk environments has been invaluable for building confidence and troubleshooting skills which can be applied to all aspects of working life. So as I come towards the end of my time as a trainee, it is clear that the lessons learnt are not restricted to the IR suite or the reporting station. I valued being encouraged to work independently and to learn from things that did (and didn’t) go well as a result of my own decisions. More importantly, I have been increasingly reminded of the essential role we as interventional radiologists can and should be playing in delivering care to patients across all hospital settings. I hope to be able to build on these foundations over the coming years, to survive the impending learning curve and move towards ever-increasing ‘competence’!

Joe Keighley, IR Consultant

2023