Applied Radiology

Dr. Keller is the Cook Professor of Interventional Therapy, Diagnostic Radiology, and Surgery at Oregon Health
Sciences University, Portland, OR. He is also the Director of the Dotter Interventional Institute and Chair of the Department of Diagnostic Radiology.

The 26th Annual Meeting of the Society of Cardiovascular and Interventional Radiology took place in San Antonio, TX from March 3 through March 8, 2001, attracting a record number of registrants. Each year attendance at this meeting has increased, and the SCVIR is now the second largest radiology meeting, exceeded only by the annual meeting of the Radiological Society of North America (RSNA).

For this year, seven interventional radiology fellows and one radiology resident were sponsored by Nycomed Amersham to attend the meeting and to participate in the "medical reporters" program. Each fellow was given the assignment to write a state-of-the-art, practical review article on a topic of his or her choice based on relevant interventional papers presented during the meeting. Three referees evaluated each manuscript. Dr. Peter Bromley received the award for the best manuscript for his article on endovascular repair of abdominal aortic aneurysms. Dr. Jeremy Simon's manuscript reviewing uterine fibroid embolization was the runner-up. These eight articles form the content of this supplement to the July 2001 issue of Applied Radiology .

For four years, the Nycomed Amersham medical reporters program has contributed to the educational experience of all the participating interventional radiology fellows. Education and training of vascular and interventional radiologists are two important subjects that presently are undergoing intense scrutiny and debate. Traditional training in vascular and interventional radiology has resulted in the production of "clones" of previous and present-day interventional radiologists. This training has predominantly been limited to acquiring a defined set of technical skills. The result is an individual who is great with catheters and guidewires but who often lacks sufficient clinical experience to compete effectively with other medical disciplines such as cardiology, vascular surgery, and nephrology that are now performing procedures that have traditionally been in the domain of interventional radiology.

The American Board of Radiology took an important step in addressing the problem of insufficient clinical training by creating a new clinical pathway for vascular and interventional radiology. Basically, this pathway reduces rotations in diagnostic imaging and increases those in vascular and interventional radiology and clinical services. This action, although significant, is not widely utilized and therefore, by itself, is insufficient to address the shortage of clinically oriented, competitive vascular and interventional radiologists. One major drawback of our present system is that the sole pathway to vascular and interventional radiology training is through diagnostic radiology. When one considers that only 5% of all medical school graduates go into diagnostic radiology and less than 10% of diagnostic radiology residents choose a career in vascular and interventional radiology, it is evident that a major problem exists. In order for vascular and interventional radiology to survive and flourish, additional new pathways must be established to attract trainees from surgical and internal medical backgrounds who already possess the requisite clinical skills. These pathways will then offer an abbreviated course in diagnostic imaging leading to vascular and interventional radiology fellowships.

Accepting trainees from other disciplines will not only benefit vascular and interventional radiology but will also be necessary for its long-term health and survival. Additional benefits to vascular and interventional radiology are provided through programs like this one sponsored by Nycomed Amersham and supported by Applied Radiology . This program has a positive ripple effect that benefits many, including the fellows who have participated in it, their fellowship programs, and their future employers, and, of course, the subscribers of Applied Radiology who have the opportunity to read these excellent review articles. The radiologic community, especially those of us involved with vascular and interventional radiology training and education, express our gratitude to Nycomed Amersham and Applied Radiology for their generosity, dedication, and commitment, which have made this "medical reporters" program a continued success.