The future for radiologists is also interventional
Interventional radiology is a subspecialty providing minimally invasive image-guided diagnosis and treatment of disease. The number of procedures performed by interventional radiologists is extensive, ranging from the purely diagnostic such as angiography and cholangiography to the therapeutic, covering vascular and ablative applications. In recent years there has been a shift away from diagnostic angiography with the arrival on the market of high performance CT and MRI angiography systems which provide reliable and non-invasive alternatives.
Radiologists are by no means the only medical specialty performing interventional techniques as cardiologists and vascular surgeons have been quite successful in developing interventional skills, so much so that interventional cardiology has grown into a discipline of its own. In fields such as peripheral arterial disease treatment for example, it would seem that interventional radiologists have lost out to other specialties even though in some European countries like Germany they still have a significant share of this work. There is, however, a wide range of other areas, especially in interventional neuroradiology and oncology where interventional radiologists hold a quasi-monopoly.
In Europe, the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) established in 2013 the first edition of the European Curriculum and Syllabus for Interventional Radiology which aimed at harmonizing training across European countries while supporting the European Board of Interventional Radiology (EBIR) examination in interventional radiology. CIRSE also works together with the European Society of Radiology (ESR) to attract more clinically-oriented medical students to interventional radiology. The steady growth of the ageing population in Europe and other industrialized countries and the resulting higher incidence of strokes and cancer cases combined with the multiplication and development of interventional techniques will boost the demand for interventional radiologists in the near future. Already now, there is a shortage of interventional radiologists in some countries, notably the UK where 25% of hospitals cannot provide minimally invasive procedures to their patients on a 24/7 basis because of a lack of recruitment of interventional radiologists in the National Health Service (NHS). This situation is having a clearly detrimental effect on patient care in some parts of the country. According to the Royal College of Radiologists (RCR), there are just 414 interventional radiologists in the NHS whereas 735 of them would be needed to provide 24/7 on-call service everywhere. In comparison, France has about 1,250 interventional radiologists while Germany totals over 1,000. In emerging countries, the shortages can be huge, such as in India where there are only 596 registered interventional radiologists, i.e. one per every 2,18 million population. The challenge for radiologists is to recognize the value of being close to the patient and embrace clinical care.