As we embark on the journey towards recognising interventional radiology (IR) and interventional neuroradiology (INR) as formal clinical specialties, it is crucial to contextualise our efforts within the historical progression and current challenges facing this ever-evolving field. Over the past decades, IR and INR have become an essential part of modern healthcare, driven by the rapid progression of minimally invasive, image-guided techniques and increasing clinical demand. The unique position of IRs and INRs as dual specialists in both diagnostic and interventional radiology provides an unmatched advantage to provide cutting-edge patient management. However, its evolution from within a diagnostic discipline has also meant that IR and INR suffer from a lack of identity, leading to inconsistency of service provision with respect to patient access and safety, practitioner training and workforce mobility. The role of IR and INR as therapeutic specialties and the value they provide to consumers, clinicians and health systems is thus underestimated and underutilised.
The path to securing IR and INR's status as formal clinical specialties lies in strengthening their clinical practice and profile within health systems, leading to a clearer identity and capacity to advance scientific and clinical endeavours. Failure to adapt to the evolving healthcare landscape risks relegating IR and INR to a low-key service, undermining its potential to deliver comprehensive patient care. By embracing clinical specialisation and encouraging links to diagnostic radiology, we can ensure the long-term viability of these emerging specialties as distinct specialties within the medical profession.
IR and INR are well accepted as legitimate fields of specialty practice by local medical and surgical colleagues. IRs and INRs possess specialist level knowledge and skills to deliver integral patient care in public and private hospitals and have a complementary role in the practice of other specialist groups, recognised to be vital for the provision of safe, high-quality patient care. Whilst all radiologists share core competencies upon completion of RANZCR’s five-year accredited Clinical Radiology Specialist Training program, IR and INR require advanced technical and clinical knowledge, expertise and skills obtained through further post graduate training. Without specialty recognition, post graduate training cannot be provided through a national quality framework, and therefore we cannot ensure patients will receive high-quality, consistent interventional care no matter where they live. This will provide the critical foundation for significant future growth and sustainability of IR and INR.
Today, many patients are well-informed and recognise the world class medical system they have access to. Patients expect their treating clinicians to be specialists, trained to a standard that enables the delivery of consistent and high-quality care. Modern IR and INR practice is clinically focused and is involved in diagnosing, treating and managing diseases across the health spectrum in both adults and children. IRs and INRs provide longitudinal in- and out-patient care, such as undertaking patient consultations, developing treatment plans and outpatient management of conditions and pathologies. Optimal patient care requires IR and INR to be a part of a comprehensive, multidisciplinary approach. However, due to a lack of recognition, patients do not always have appropriate access to comprehensive IR and INR services, and continuous, co-ordinated care provided by specialist IRs and INRs.
There is currently no formal or accredited training program for advanced IR and INR practice in Australia and New Zealand, and the alternative education structures available to obtain postgraduate training are informal, unaccredited or rely on international alternatives that are not specific to the Australian and New Zealand regulatory framework. RANZCR has developed two new, contemporary and accredited training programs that build on the basic procedural skills and competency attained in the RANZCR Clinical Radiology specialist training program and formalise the patient care aspect of clinical competency in IR and INR. These programs will soon be released for member consultation, and ultimately be submitted for accreditation with the Australian Medical Council (AMC) and Medical Council of New Zealand (MCNZ).
Developing these dedicated training pathways will provide medical students and radiology trainees with a clear pathway towards a career in IR and INR, increasing awareness and driving interest for the fields of practice, consolidating their role as clinically focused specialties in their own right.
Central to our advocacy efforts is the need to highlight the cost-effectiveness of IR and INR care to patients and healthcare systems. IR and INR are ideally positioned to take advantage of the important trend towards value-based healthcare. Day-case services exemplify the integrated, streamlined care pathways that IR and INR services can offer, delivering cost-effective, high-quality care while maximising patient outcomes.
IRs and INRs must actively engage in leadership roles at local and national levels, advocating for the recognition and advancement of IR and INR within healthcare policy and management spheres. Specialty recognition will help drive and support local advocacy efforts and will encourage additional investment in IR and INR training, infrastructure and systems to facilitate additional growth.
Crucially, we must strengthen partnerships within diagnostic radiology to advance the mutual growth and expansion of both fields. A good interventional radiologist must first be a great diagnostic radiologist and being specialists in image interpretation sets IRs and INRs apart from other image-guided specialties. Combining specialties of diagnostic and interventional radiology will unlock the complementary nature and full potential of image-guided minimally invasive procedures, to ensure the continued relevance and impact of radiology in modern healthcare.
The path to recognising IR and INR as full clinical specialties demand concerted effort, strategic vision, co-operation and unwavering commitment from all stakeholders. By confronting challenges head-on, embracing innovation, and advocating for change, we can secure a vibrant and sustainable new future for IR and INR.
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Thank you for your continued dedication to excellence in radiology and for your support of interventional radiology and interventional neuroradiology.
RANZCR progress update on interventional radiology and interventional neuroradiology
Evolution of interventional radiology and interventional neuroradiology: Towards recognition as formal clinical specialties
Understanding the impact of interventional radiology and interventional neuroradiology on existing specialties
Revolutionising patient care: The influence of interventional radiology and interventional neuroradiology
Interventional radiology patient experience: How uterine fibroid emobolisation changed a young woman’s life
Interventional radiology patient experience: My interventional radiologist was a godsend