How I Finally Decided on the Right Specialty for Me

Stephanie K. Nguyen


March 08, 2018

About this time last year, I wrote a piece about what to consider when choosing a specialty. Now that I've gone through most of the core clerkships, I have a better idea of what my interests are and the aspects of my future career that I want to prioritize. After many, many long hours of careful consideration, I've chosen interventional radiology.

This question that gets thrown around often when I mention my interest in interventional radiology is "What is it?"

Most people are familiar with diagnostic radiologists, who are physicians that specialize in a multitude of imaging modalities, such as CT scanning, fluoroscopy, ultrasound, and MRI to diagnose and treat diseases. Interventional radiologists also go through diagnostic radiology training in order to use their skills in the same imaging modalities while guiding instruments, such as catheters, intravascularly to treat diseases. These procedures are considered minimally invasive, generally lead to quicker recovery time, and are less costly than traditional surgery.

Here are four of the major considerations I used to arrive at my decision.

Consideration 1: Scope of Practice

One of the biggest draws of interventional radiology for me is the scope of practice. Off the top of my head, I can't think of any place in the body on which an interventional radiologist does not work. This means that your day-to-day procedures can vary quite drastically. Common procedures include angioplasty, transjugular intrahepatic portosystemic shunt (TIPS), radiofrequency ablation, uterine fibroid embolism, chemoembolization, aneurysm coiling, abscess drainage, and needle biopsy, just to name a few. With my personality type, few things are worse than doing the same thing day in and day out. Thus, having lots of variety in my schedule is appealing. Another interest of mine is working with cancer patients. Given the current landscape of oncologic treatment and palliative care, interventional radiologists will continue to be seminal members of the care team.

Interventional radiology is generally considered to be a consult service, but some institutions have an inpatient admitting service as well as outpatient consults and follow-up clinics. From talking to established experts in the field, a push for more longitudinal care of patients may occur in the near future. This means that by being an interventional radiologist, I will have the experiences of dealing with consults and also having patients that I will build a relationship with over time. I like that this field is primarily a consult service because it's satisfying to intervene and resolve an immediate problem that the patient has. However, with the push for routine management of certain patient populations, I anticipate it to be equally satisfying to build rapport with patients and be able to care for them with more continuity.

Consideration 2: Flexibility

With the field of interventional radiology being so broad, for the most part, you are able to build your practice around the procedures that you enjoy doing. It is possible to have a clinic that specializes in cosmetic varicose vein treatments, but if you want to do practically every procedure under the sun, you can probably find a position that will allow you to do so.

Moreover, as an interventional radiologist, you are dual board-certified in both diagnostic radiology and interventional radiology. This means that you can work solely as a diagnostic radiologist if you desire. This is a great option if certain life events make it difficult to maintain a full interventional radiology schedule. Working from home would also be possible with teleradiology. I don't ever intend to go solely to a diagnostic radiology practice, but it gives me peace of mind to have contingency plans just in case life throws me a curveball.