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Myths in Interventional Radiology

April 6, 2019

The internet is a beautiful thing. Trainees who used to harbor silent concerns (like I did, years ago) can now seek advice anonymously on various online physician forums. Some common themes that come up, especially for women, are encapsulated here. This is a post about common myths in interventional radiology, some of which keep qualified women from pursuing the field.  

I would love to go into interventional radiology (IR), despite being discouraged by those in my program. “Lifestyle” is a frequently cited reason I’m told to consider a different field of radiology. They say being female, small in stature, an immigrant, and not from a physician family are all reasons not to pursue a career in IR.

I have many doubts, and could use some guidance. I know many of you are juggling a career and family, but I would greatly appreciate any advice.

Trainees can be given some really bad advice, even in the year 2019. Let’s dive in, shall we?

Common Myth #1: “You shouldn’t pursue interventional radiology because of the lifestyle.”

As an interventional radiologist (or insert other amazing occupation here), sometimes you get to literally save someone’s life. They are bleeding to death, and you stop it. They have clots in their lungs, and you clear them. I ask you, is there a better lifestyle than that?

I guess what people are getting at, is that in some fields of medicine, you can go home and expect not to be called in the middle of the night for emergencies. And, the assumption goes, women should choose those fields. But many doctors are on call for emergencies, and attending to them is some of the most important work we do. As the cliche goes, “If it were easy, everyone would do it.” Being a doctor is sometimes back-breaking work. But if you know you have the hands and gifts to guide wires through people like a stealthy life-saving ninja, you should do it. My baby sleeps peacefully through many of the emergencies I attend to. A common myth in IR is that women don’t aspire to this kind of lifestyle. 

Common Myth #2: “You can’t practice interventional radiology if you’re small and/ or female.”

Wrong! Interventional radiology is about deft fingers, good judgement, and being cool under pressure. It’s not about brute force. I have exited a case sweaty at times, from wearing a lead suit, and placing a shunt through a fibrotic liver. Sometimes, I use a hand drill to sample a piece of diseased bone from the spine or pelvis. But these things don’t require a certain height, weight, muscle mass, or gender. This is just one of the common myths in interventional radiology. 

In fact, the height of a fluoroscopy table can be adjusted for any operator. The length of wires used in IR lends itself best to a team of a primary operator and assistant, not a single person with a large wingspan. Placing a needle precisely is related to hand-eye coordination, not to the operator’s reproductive equipment. Therefore, the idea of excluding someone from IR because they are petite and/ or female is terribly sexist.

I have a tiny friend, who is strong in body and mind. She’s an orthopaedic surgeon, who sets fractures and replaces joints. This kind of work is far more physically demanding than that found in IR, yet her stature doesn’t hinder her in any way. So if someone tells you you need to be a certain size for IR, please laugh at them for me. They’ve simply observed the status quo of many tall dudes in our field, and drawn the wrong conclusion.

Common Myth #3: “Forget about IR… because you weren’t born in the U.S.”

Many in our specialty are immigrants. I myself am first-generation born in America.

IR is a global community. You see it when you go to the annual Society of Interventional Radiology (SIR) meeting, or the CIRSE meeting in Europe. I met a medical student in Kenya years ago, when I was a radiology resident on an away rotation. This year, she presented at SIR. She is an IR fellow at The Dotter Institute, the birthplace of interventional radiology.

Dr. Josef Rosch, who also spent part of his career at the Dotter, pioneered TIPS, the placement of transjugular intrahepatic portosystemic shunts, and was a Czech immigrant! People who suggest immigrants can’t become interventional radiologists are sorely mistaken.

Common Myth #4: “You won’t be able to get into a training program if you’re not from a physician family.”

Some students in my medical school class came from physician families, but many did not. Some from physician families left school with less debt, or drove nicer cars to class. But not having these advantages by no means excluded me from the medical specialty of my choice.

Medicine remains a meritocracy in many ways. Although nepotism and competitive advantages persist, classmates who sought competitive residency positions worked hard, sweated every exam, and took a year or more off to do research. For me, the keys to getting into a competitive residency were good test scores, getting my interview act together, being personable, and showing interest.

Many people, in fact, believe physicians should come from various walks of life, not just physician families. The GEMS Program was recently announced by Dr. Alan Matsumoto, whose family provided an endowment to the SIR. The program will provide travel grants to students from underrepresented groups in IR, who wish to do away rotations in interventional radiology during their clinical years of med school. These visiting rotations confer many benefits, allowing people to get to know you. Therefore, decision makers often favor those who did away rotations when those individuals apply for residency positions. Away rotations can be costly, however. In this way, the GEMS program is a way to help decrease the opportunity gap for students interested in IR who have fewer resources.

Common Myth #5 : Women physicians are too busy juggling career and family to help you. 

There are many women in medicine to help support your budding career. Some female physicians support other women simply by existing in their field, so you don’t have to be the first or only one. Others are motivated advocates, like me with my blog. There’s Agnes Soberg, co-founder of the Radiology Chicks Facebook group, and Sasha Shillcutt, founder of Brave Enough. We are a few examples of women who can serve as a resource. Find someone you connect with, and shoot them an email! That women are too busy with their responsibilities or families is just one of the common myths in interventional radiology. 

Not a myth:  A caring mentor is essential.

Training is a period of uncertainty for all, even without the myths we are fed, and naysayers’ discouragement. It’s natural to feel doubt during this time. It’s impossible to know just what to expect of the future. All trainees need opportunities to speak to those with more experience. We all need guidance from time to time. That’s why I’ve dedicated this blog to empowering you as a future interventional radiologist.

Not only is the internet connecting us like never before, with personal accounts like mine, but since 2017, SIR has hosted an online mentor match available to all members, at all stages of their careers. So if you can’t find the right mentor(s) in your area, you can search for one online. You can filter by gender, region, career stage, or interest. You can filter for private or academic practice. If you have multiple interests, try out multiple mentors. The webpage even has resources like helpful hints as to how to structure the mentor/ mentee relationship to get the most benefit.

The ultimate truth:

If you have a dream, whether it’s to become a surgeon, a pilot, or an astronaut, you can’t just turn it off or “forget about it.”

If you are interested in a career in interventional radiology, you likely won’t forget about it. Our field is too heartbreakingly elegant. Interventionalists get to diagnose and treat. Often the first to recognize pathology first-hand, IRs can also get the first crack at treating what they find. Practicing this specialty is a gift, and when someone tries to discourage a would-be IR, citing reasons like those above, I just can’t abide it.

Dismiss naysayers

I trained for an Ironman triathlon once. I was 25 years old, and had held the dream of completing an Ironman since I was a kid. My father and I watched the competition on TV, and witnessed an eighty year old nun competing in Ironman Kona. She flew across black lava fields on her racing bike. I adored the stories of those competing, and was inspired by the common drive we have to test our own limits.

A co-worker at the time, an out-of-shape, former competitive swimmer, told me I had no business being in that race. That it should be reserved only for elite athletes, who were much faster than I. I was taken aback, and couldn’t understand why someone would discourage my goal. Using his rebuke as fuel, I plowed through my final months of training, and rejoiced at the finish. In just over thirteen hours, I was an Ironman finisher. It was one of the best days of my life, and I’m so glad I didn’t let that guy’s negativity thwart my drive to do what I knew I had always wanted to do.

Similarly, becoming an interventional radiologist is no picnic. Like an Ironman, there is a long training pathway, with moments of glory and failure along the way. But if you have the desire and drive to do it, you just know it.  

Listen to yourself, not these common myths in interventional radiology. After all, no one knows you better than you do.

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