Wisdom in Interventional Radiology: There’s More to Practice Than Just Technical Skills

Almost 10 years have passed since the last CARJ special issue on Interventional Radiology. This CARJ decennial special issue on Interventional Radiology (IR) would probably have looked different if the COVID-19 pandemic had never happened. However, as we emerge from the COVID pandemic, I would argue that the challenges in (IR) are less about individual procedures and instead about navigating a new set of disruptive factors like; supply chain issues, product unavailability and staff absence along with unprecedented clinical demand. Despite these challenges, innovation lies at the heart of IR, and I have no doubt that IRs across Canada and the world will find ways to overcome these challenges.

Based on these challenges, this issue does not focus on procedural aspects of IR, but instead takes us on a journey looking at broader concepts such as wisdom, well-being, Equality, Diversity and Inclusion (EDI), communication and leadership. This issue was written by interventional radiologists for interventional radiologist so that we can reflect, occasionally laugh and hopefully feel a growing sense of optimism in what has been a challenging time for healthcare and the world at large. Six articles were chosen for this issue:

Rules for Interventional Radiology

55 Rules for Interventional Radiologists! ¹ As VIR fellowship director for over 20 years at University Health Network and Mount Sinai Hospital, University of Toronto, Professor Kachura has trained over 100 fellows, and distilled experience into a series of rules that will leave any reader wiser. Having had the privilege of undertaking the VIR Fellowship at University Health Network Toronto myself, some of these rules have echoed in my mind for the past few years and served as a source of comfort and stability in the ups and downs of practice as an IR – hopefully, these rules can have a similar positive impact on you and this article will be enjoyed for years to come.

Strategies for Well-Being in Interventional Radiology

I recently watched, Dr Glaucomflecken, a comedian and ophthalmologist giving a commencement address at Yale Medical school reminding physicians that ‘We are terrible at asking for help, we think we can do it all and overcome any challenge by ourselves… we give so much of our ourselves in the service of others because that’s what doctors do, and that’s great until there is nothing left to give’ (see Rule No. 1 in ‘Rules for Interventional Radiology’)! ² Our mental and physical well-being is not only essential for ourselves but also for our patients and colleagues. When we feel good at work, we are more likely to perform at our best and be productive members of the team. ‘Strategies for Well-Being in Interventional Radiology’ takes a real-world look at the important issue of well-being and provides direct advice on how to navigate the challenges of life as an IR. ³

Leadership in Interventional Radiology – Fostering a Culture of Excellence

We are all leaders in some form. In this article, senior IRs reflect upon some of the challenges impacting IR today and provide strategies for overcoming them. ⁴ Leadership concepts such as fostering a culture of excellence, developing clinical practice, managing industry relationships and creating a legacy are all discussed and ultimately a framework is provided for leaders in IR to consider.

Workforce Diversity of Interventional Radiology Physicians in North America: Reflections on the U.S. Experience

Equality, Diversity and Inclusion (EDI) is a term heard with greater frequency – and for good reason! What does EDI mean for IR specifically and how do we achieve this? This article provides data from the US on the status of EDI within medicine and IR. ⁵ Whilst there has been some progress, it highlights that more work is needed. The article also provides specific strategies to bridge current gaps in EDI and IR. We are reminded that ‘landmark innovations in medicine have flourished from a diversity of ideas’. ⁵

Consent in Interventional Radiology – How Can We Make It Better?

Consent is a critical aspect of every procedure, yet this importance doesn’t seem to be reflected in its weight in medical teaching curricula. As with anything in life, there is always room for improvement and consent is no exception! There are unique factors within the IR environment that allows us to potentially fall short in optimal consent processes. ‘Consent in Interventional Radiology – How Can we Make it Better’ takes a critical look at the consent process and how it relates to IR. ⁶

Looking into the Future: The Current and Future State of IR in Canada

This CARJ decennial IR issue concludes with a look at the current and future state of IR in Canada. ⁷ The road ahead for IR in Canada is fraught with challenges at a local, provincial and national level. As IRs, our roles go beyond simply performing procedures needing to ensure optimal training for future generations, availability of new technology, sustainable staffing and funding models whilst ensuring high-quality care as a clinician.

On behalf of CARJ, we hope that readers will find value in the articles within this decennial issue. Who knows what the world will look like in another 10 years when the next special issue in Interventional Radiology is released? Perhaps the rate of technological innovation will increase such that the world 10 years from now might be unrecognizable. Regardless of technological advancements, it is our sincere hope that the wisdom found in this issue will be relevant not only 10 years from now but maybe even 50, 100 or 1000 years ahead!