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Interventional Radiology
OVERVIEW
Loma Linda University Medical Center offers three accredited training pathways for those interested in interventional radiology.
All three training programs are designed to create outstanding interventional radiologists equipped to become pioneers and leaders within this exciting and rapidly evolving specialty.
1) Integrated IR/DR Residency
2) ESIR/DR Training Pathway
3) Independent IR Residency
Integrated IR/DR Residency
The Integrated IR/DR Residency is a 5-year residency with emphasis on both diagnostic radiology (DR) and interventional radiology (IR), which is started after completing a preliminary year in surgery (preferred), medicine, or transitional year. The five-year residency curriculum focuses primarily on DR in the first three years with additional IR and clinical rotations, IR call and clinic exposure. In the final two years, focus shifts to predominantly IR to prepare graduates for jobs in both academic and private practice settings.
The program is designed to offer a combination of diagnostic and interventional radiology through a rich educational experience in image-based diagnosis, as well as image-guided procedural education, with a focus on peri-procedural patient management. Education in the integrated program fosters individual development and practice of technical skills, as well as clinical judgment. Selection to these “Advanced” positions (beginning in PGY-2 year, one full year after the match) occurs each March through the NRMP main match. We currently offer two positions per year.
While we do not have a linked internship in order to provide applicants with maximum flexibility, we have a strong working relationship with the Loma Linda University surgical residency leadership and many of our residents have completed a preliminary surgical internship at LLU.
Early Specialization in Interventional Radiology (ESIR)
Early Specialization in Interventional Radiology (ESIR) is a training option for DR residents who decide they want to pursue a career in IR to expand their exposure to interventional radiology and the clinical management of IR patients. Diagnostic radiology residents who decide to seek training in IR must complete a two-year Independent IR Residency after graduation; however, completion of the ESIR pathway grants the trainee credit for 1 of the 2 required years.
ESIR training is completed within the 4-year diagnostic radiology residency. It requires a total of 11 interventional radiology or interventional radiology-related rotations (minimum of 44 weeks) and an ICU rotation of at least four continuous weeks. ESIR candidates must still complete the required year at an independent IR residency to finish their IR training and be eligible for the American Board of Radiology (ABR) IR/DR Certifying Exam.
Selection to the ESIR Pathway occurs at the end of the PGY-3 year. The program is approved for up to 3 ESIR positions per year, although availability may vary from year to year depending on current program complements.
Independent Interventional Radiology
The Loma Linda Radiology Program offers an ACGME-accredited independent IR residency program (sometimes referred to as a fellowship), for graduates of a DR program. This residency may be 1-2 years in length, depending on whether the trainee completed the ESIR pathway during their radiology residency.
Clinical Work
Interventional radiology at LLUMC offers exposure to a wide variety of conditions and procedures. Trainees gain expertise in all of the major pillars of VIR, including peripheral arterial disease, complex venous pathology, interventional oncology, trauma intervention, biliary and transplant interventions, lymphatic disorders, etc. A strong, collegial relationship with vascular surgery, coupled with shared responsibilities for the PAD case load, offers our trainees a unique opportunity and excellent training in the treatment of patients with peripheral arterial disease, both clinically and procedurally.
In addition, we have a very active interventional oncology program that includes chemoembolization, radioembolization, cryoablation and RFA. We are also active in therapeutic procedures including uterine fibroid embolization, TIPS, IVC filter placement/retrieval, dialysis access interventions, DVT thrombolysis and thrombectomy, venous angioplasty, stenting, arterial embolization, endoleak embolization, and thoracic duct embolization. Nonvascular interventional procedures include, but are not limited to, biopsy and drainage of all major organ systems, hepatobiliary interventions including stone removal and biliary stenting, genitourinary interventions including access for PCNL, stone manipulation, stenting, stricturoplasty and management of leaks, and interventions of the GI tract including percutaneous gastrostomy, gastrojejunostomy, direct jejunostomy, cecostomy and tranesophageal feeding tubes.
Our division provides full interventional coverage for Loma Linda University Children’s Hospital, the only major pediatric hospital in the region. Our trainees gain unique experience in routine and exotic, high-end pediatric procedures alike. We staff a dedicated pediatric angiography lab two days a week, with additional pediatric interventions sprinkled throughout the daily schedule in our adult IR rooms. Although the majority of time is spent at Loma Linda University Medical Center in an academic university hospital setting, our trainees are also exposed to the community-based radiology setting at nearby Redlands Community Hospital and an outpatient IR experience at Loma Linda University Surgical Hospital. Residents also gain valuable experience caring for military veterans during their time at the Loma Linda VA hospital. The high case volume and early, progressive trainee autonomy ensures a plethora of training opportunities and ultimately maximizes comfort with a large variety of techniques and patient management scenarios.
Interventional Call
For DR residents, all IR call is taken during rotations on the IR service. For IR/DR and ESIR residents, the majority of IR call is taken during rotations on the IR service with additional sporadic calls when off service.
Educational Conferences and Resources
Weekly conferences include liver tumor conference and a multidisciplinary vascular conference run by IR and vascular surgery. Residents present cases at the monthly Morbidity and Mortality conference, which helps trainees and attendings learn from complications and past mistakes and to strive for better outcomes in patient care. Journal Club takes places monthly at a nearby restaurant; residents take turns analyzing and presenting articles, gaining valuable insight on how to critically review the literature. Each morning, all planned procedures for the day are discussed with the residents and attendings on service, providing an opportunity to discuss clinical management, varying technical approaches, and evidence-based medicine. Residents are allowed time off to attend one educational conference per year.
Facilities
The primary site for IR trainees, LLUMC, is currently equipped with five interventional suites for IR, neuro IR and pediatric interventions, which include high-quality ultrasound machines, intravascular ultrasound (IVUS) and intra-cardiac echo (ICE), 3D cone beam CT and roadmap capabilities. IR plans to soon occupy two additional high-end angiography suites in the OR. We possess a CT suite dedicated entirely to cross-sectional procedures such as biopsies, drains and ablations, with access to several more CT and MRI scanners throughout the campus for interventional use. Three additional procedure rooms are utilized for procedures which do not require fluoroscopy or CT. Workstations are available in a common work area for reviewing studies and staffing consults. Attending physician offices are immediately adjacent to the procedural area and outpatient clinic space is just one floor down. All of our affiliated hospitals and facilities are within a few miles of one another.about the facilities may be found here.
Applicant Information
Applications to the Integrated IR/DR residency program will be accepted only through the Electronic Residency Application Service (ERAS). A completed application requires 3 letters of recommendation. At least one letter of recommendation must be from a radiologist, preferably an interventional radiologist. Interview slots will be offered in October and will take place in December and January. All interviews will be conducted virtually.
Need more information?
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Program Coordinator
Claudia de Dios Uribe MD, IR/DR
Program Director
Kyle Cooper, MD, IR/DR
Assistant Program Director
Mohammad Kassir, MD, IR/DR