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Combined Interventional/Body Radiologist – Hamilton General Site, ON
Can you share your journey into interventional radiology and what inspired you to pursue this specialty?
I first entered medicine determined that I wanted to be in a technical specialty and work with my hands. Initially, I was drawn to ENT due to my interest in anatomy and for the ability to work with intricate structures. Over several electives, I realized that ENT was not the right fit. But while participating in head and neck tumor board, I gained admiration for the leading presence of the radiologist. Fortunately, I matched into radiology and it was during a residency rotation in interventional radiology that an “ah-hah” moment occurred – I realized that IR was the perfect mix of highly technical surgery with minimally invasive interventions that can have profound impacts on patients. I found my calling very quickly and have enjoyed the privilege of working in this field ever since.
How do you balance work and personal life in a demanding field like interventional radiology?
Interventional radiology is an intense specialty but there is a lot of flexibility within the field. Unless desired otherwise, most interventional radiologists still do a fair amount of diagnostic radiology in their work. I am working in a group that does 50/50 IR and DR. This has been ideal in offering a different pace and clinical variety in between busy, and sometimes demanding IR days. With knowledge in both IR and DR, interventionists are in a special position to adjust the intensity of their work according to the demands of their personal life and through different stages of life. There are also many different types of IR practices, such as academic, community, outpatient based and private practice. There is really no one way to be an IR. Because of this, I would argue that IR is probably the most flexible in terms of work demands among all other procedural-based specialties.
I have recently finished my training and have taken up a job at a tertiary hospital with a wide variety of complex cases and emergencies. In selecting a place of work, I cannot emphasize how important it is to be in an environment where you feel supported. You do not come out of fellowship having learned everything about IR and the learning never stops as you progress through an ever-evolving field of IR. It is essential for your work satisfaction and longevity to have supportive colleagues willing to back you up when you are in a complex case or scrub in together when you are learning a new technique. Although work is hard, it is much better when you have good colleagues working together as a team.
Being early career, I am enjoying dedicating my time and efforts to a demanding work schedule. Although I understand that working too much may not be ideal for the long term, I am aware that burn out is a real issue and I consciously make an effort to disconnect during my time away from work and prioritize daily self-care such as catching up with friends, working out, and making healthy recipes.
What are some key challenges you faced as a woman in interventional radiology, and how did you overcome them?
Personally, I have battled with imposter syndrome, especially being a trainee and early career attending. In general, I feel women in male-dominated fields such as surgery tend to undervalue their skills despite being technically equal or superior to their male colleague. In training, I found that I have to do a procedure independently a number of times and have done my due diligence in reading the literature before I consider myself competent. Other colleagues may feel comfortable with a procedure after doing it a few times. I have also struggled with being told that I am “too shy”, when I may simply prefer to address patients and colleagues in a more soft-spoken manner. Over time, as my team has gotten to know me, I realized that my softer approach is not necessarily a weakness, but rather an advantageous quality which is quite appreciated and can foster closer-knit relationships with my IR support team and with my patients.
How has the landscape of interventional radiology evolved over the years, especially in terms of gender representation?
I have found radiology and especially interventional radiology to be an evolving landscape during my training and start of independent practice in terms of gender disparity. When I became interested in IR during residency, I found my IR attendings to be initially surprised then particularly encouraging and supportive in making sure that I am offered ample opportunities to succeed. When I started applying for fellowship, I did not feel that being a female applicant disadvantaged my application in any particular way. Recently having been through a job searching process, I was also pleasantly surprised that radiology groups are making a conscious effort to close the gender gap, and very quickly settled into a position that was a great fit for me. My overall experience as a female IR has been promising and I believe that the field of IR is ready to embrace more female physicians. I encourage anyone who may be interested to have confidence in diving into the field.
What role do you think diversity plays in enhancing the practice of interventional radiology?
Female IR physicians have much to add to the field. There is a growing domain of IR that targets women’s health issues such as uterine fibroid embolization, pelvic congestion syndrome, varicose veins, and breast cancer-target therapies. With this, there are increasing opportunities for women IR to take up specific interest in women’s health and to better understand and address the unique needs pertaining to women. A more diverse IR team is also able to identify health outcomes that vary by gender and background leading to better patient comfort, communication and satisfaction. Female representation in IR can serve as role models and mentors for other aspiring female interventionalists. Personally, my career would not have been the same without the female IR mentors who supported me throughout my path in IR. Having access to mentorship and role models is crucial for encouraging more women to pursue the career in IR and supporting their professional development
Are there any specific organizations or conferences that you recommend for networking and career development in interventional radiology?
Attending the CAIR ASM has been the highlight of each year. As a trainee, I had the opportunity to have the conference funded and attend trainee day more than once and thoroughly enjoyed the experience each time. It is an opportunity to make friends with other trainees who are going through the same experience as you, meet IRs across different Canadian institutions, and rub shoulders with the giants of the field from whom you have a lot to learn from. The Canadian IR field is a closely knit group and there is no better opportunity to get to know people than coming to the ASM. SIR and CIRSE are two other conferences that you may consider attending to network and be inspired at.
What advice do you have for women who are aspiring to enter the field of interventional radiology?
If you are interested in IR, I would seek every opportunity to gain exposure to IR in medical school and residency to determine whether this is the field for you. In medical school, IR is not necessarily the most available specialty to rotate in but do not be discouraged and keep trying by participating in IR in and out of school. It may be the most wonderful field you have ever known. Once you have determined that this is your calling, do not let the gender disparity discourage you. IR as a field is ready to accept more female physicians and you will be surprised to find many mentors with open arms to support you along the way. The work intensity of IR can seem intimidating but there are so many ways to make an IR practice work for you, leading to long lasting and rewarding career. Be confident in yourself and trust that you are more than capable despite how challenging it may seem sometimes. You will have good days and bad days. The reality is you will have losses where a procedure may not have gone the way you had hoped or had a complication that you wish you could have foreseen. Know that you are not the only one it happens to and that these experiences are invaluable in making you even better physician.
The work intensity of IR can seem intimidating but there are so many ways to make an IR practice work for you, leading to long lasting and rewarding career.
Dr. Machan is an early Canadian proponent of interventional radiology. A clinical practitioner at the Vancouver Hospital and an associate professor at the University of British Columbia, he continues to innovate while guiding others on their own paths to growth and success. His company created and licensed the paclitaxel coated stent, which has improved the lives of people with peripheral arterial disease.
I was rostered to be in Interventional Radiology suites on one day of that week. Completely oblivious of what it was, I went and attended. The first patient on the list was an IVC filter insertion. I had no idea what the procedure involved and thought it would take hours. I was introduced to the consultant and I saw him prepping for it. I was chatting with the nurses and in 5 minutes the operator turned around and said ‘DONE’.
I first entered medicine to be a cardiac surgeon. But when I assisted to a cardiac valve replacement and coronary bypass… I realized the surgery was interesting but way too long for my taste!
As a Professor of Radiology at the Université de Montréal, former Vice Dean of the Faculty of Medicine, and Director of the Diagnostic Radiology Program, Professor Dubois has consistently demonstrated exemplary leadership and expertise in the realms of interventional radiology, particularly in the diagnosis and treatment of vascular anomalies.
Seeing the range of procedures that IRs performed, the innovation involved in the day to day practice and industry side of things drew me even more to the career.
The Canadian Association for Interventional Radiology (CAIR) will be holding an in-person Annual General Meeting (AGM) for its voting members in good standing on May 23rd, 2024 at 2:50 pm at the Westin Calgary in Calgary, AB, during CAIR's Annual Scientific Meeting.
Diversity in the doctors in IR means more understanding in the diversity of our patients and providing an overall more inclusive place for our patients to come to for their health concerns. It matters greatly when there are cultural or language barriers to getting treatment, and having a specialty with many physicians from all walks of life can help alleviate some of those barriers.
As the future leaders in interventional radiology, this is your opportunity to showcase your knowledge, skills, and innovative approaches to the wider professional community. We invite you to submit your most intriguing and instructive cases for consideration and presentation.
The purpose of the CAIR Award is to recognize those who have made significant contributions and provided extraordinary service to the Canadian Interventional Radiology Association and/or the discipline of Interventional Radiology.