Interventional Radiology (IR) training in East of England
Interventional Radiology (IR) is a growing specialty and training is now a 6 year (3+3) programme with 3 core years of general radiology followed by 3 subspecialist years of interventional radiology training. At present this training is delivered on a scheme by scheme basis as per the information below (Cambridge, EBH and Norwich).
In order to maximize training opportunities across the Eastern Region there is close collaboration between schemes and a drive to a more formal centralization of IR recruitment and delivery of training. This approach will allow for better matching of trainees to training opportunities outside their own scheme and will help with exposure to case mix. Currently appointments and IR training are still delivered locally via the existing radiology schemes - please see relevant information on each training programme below.
The interventional radiology department in Addenbrooke's hospital has 2 body angiography suites and a hybrid endovascular theatre. We are currently a team of 8 Consultants expanding to 10 in the near future. We cover a 24/7 service for many regional specialities including: vascular surgery (elective and emergency EVAR and TEVAR), level 1 trauma centre, transplant surgery, hepatobiliary surgery as well as all other local surgical and medical specialities.
Core IR training
During the 3 cores years of FRCR training all trainees at Addenbrookes will have a 3 month module in Interventional radiology. During this module trainees will be expected to meet the mandatory competencies for diagnostic reporting with respect to aortic and peripheral vascular imaging. They will also have opportunities to experience and practice a wide range of interventional cases. The timetable will be specific to each trainee depending on subspecialist interests and stage of training.
Sub specialist IR training
The Cambridge radiology training scheme based at Addenbrooke's hospital offers subspecialist training in Interventional Radiology. As per the RCR guidance this is now a 6-year training programme, beginning with 3 years of core radiology training followed by 3 years of subspecialist IR training. Appointments are made by competitive interview during year 3 of core training. Each year there is 1 post available for trainees on the Addenbrooke's radiology training scheme. The trainee will spend the majority of their training at Addenbrooke’s with regional placements possible for up to 1 year which will be planned on an individual basis.
Our department has 2 body angiography suites and a hybrid endovascular theatre. We are currently a team of 8 Consultants expanding to 10 in the near future. We cover a 24/7 service for many regional specialities including: vascular surgery (elective and emergency EVAR and TEVAR), level 1 trauma centre, transplant surgery, hepatobiliary surgery as well as all other local surgical and medical specialities. We provide comprehensive coverage of the IR curriculum with trainees obtaining around 1000 cases over the 3-year training programme.
We are currently working towards a more regional collaborative approach to subspecialist IR training to allow a more flexible access to IR and to enhance the variety of training available across the region. This process is constantly evolving. Exact details will be available in year 3 of core training for applications to IR in year 4.
Core IR training
During the first three years of training all trainees will complete a core module in interventional radiology within a trust within EBH. The aim of the core module is to provide experience with interventional procedures, develop competencies in diagnostic reporting relevant to IR, as well as provide insight into IR as a subspeciality. Work schedules will vary between trust but will be designed to provide a broad range of basic experience.
Sub specialist IR training
Each year two trainees are appointed to the three-year interventional radiology training pathway following competitive application and interview. For years 4 and 5 one post is based in the east of the region (based at the Mid and South Essex Foundation Trust (Broomfield, Southend and Basildon Hospitals) and Colchester Hospital) whilst the other is based in the west of the region (encompassing rotations through Princess Alexandra Hospital and East and North Herts NHS Trusts).
For their subspeciality training sessions, our trainees will be based in the angiography suites as well hybrid theatres. In addition to providing acute and outpatient interventional radiology services, our IR consultants also support other specialities such as vascular surgery and urology teams with image-guided intervention. Trainees will be expected to get involved at every opportunity and to maintain a logbook of cases.
In our efforts to promote regional collaboration and enhance training opportunities, trainees in the sixth year may rotate through either the Cambridge or Norwich programmes. Further details will be provided to trainees in due course.
The Norwich interventional radiology (IR) training scheme started in the early 2000s and became formalised when the Norwich Radiology Academy was established in 2006.
The Interventional Radiology Unit covers a population of approximately 750,000 and is extremely busy with increasing demand from all referral sources. Currently, we have access to one full time suite and share access to a second shared suite. Our planned new four-suite unit will allow us to meet the growing demand for interventional radiology, and to substantially increase our ability to deliver a day case service. The increase in our structural capacity will also allow us to increase our training capacity in interventional radiology.
The Interventional Radiologists work closely with their vascular surgical and other colleagues to provide the full spectrum of emergency and elective interventional procedures including TIPSS, interventional oncology and complex endovascular stent graft procedures (FEVAR, IBE and BEVAR). We are in the process of setting up a prostate artery embolisation service and discussions are underway to develop a stroke thrombectomy service.
Core IR training
In September 2019, we formalised a new 3-month IR core module for junior trainees at ST 1-3 level which trainees are expected to complete prior to commencing their on-call. This will include training in interventional radiology and cardiac imaging. Trainees are also expected to complete DOPS assessment on simulation based vascular procedures as part of their module sign-off in addition to other expected WPBAs outlined in their module objectives.
For junior trainees who have expressed interest in IR, we are very supportive and extra sessions in IR have been arranged for them during core training to enhance their experience before joining the subspecialty training. All trainees will be attending the Academy with the IR fellows and follow a similar structure where they are allocated topics to present and get the opportunity to perform basic vascular procedures on the simulator.
Sub specialist IR training
Fellows join the formal 3 year IR training scheme when they enter year 4 of the radiology training. Trainees spend majority of the training at the Norfolk & Norwich University Hospital but are expected to be posted to another IR unit within the region for 6 months in their ST5 year in order to gain more experience.
IR fellows are scheduled to spend their time in the IR suite in addition to diagnostic reporting, on call commitments (with IR on-call in the final year of training) and simulation training at the academy. In the last 18 months, we have introduced formalised weekly IR teaching chaired by a consultant. The fellows are allocated a topic to present from the IR curriculum with a discussion relating to the underlying evidence. Trainees are given the opportunity to simulate cases on our updated MENTICE G5 simulator. Simulation is incorporated in training and fellows are expected to complete assessments on various simulation-based cases.
For further information please see our website: www.imagingacademy-eoe.co.uk/