Who We Are and What We Can Become: An Analysis of Professional Identity Formation in IR

Purpose To characterize the unique experiences, values, and perspectives of interventional radiology (IR) fellows. Materials and Methods Sixteen fellows from 4 US vascular and IR programs were interviewed within 2 months of beginning and 2–3 months following their 2015–2016 fellowships about patient interactions, training experiences, and views of IR and other specialties. Interviews were systematically analyzed for dominant themes by using constructivist grounded theory. Four interviews with 2015–2016 interventional cardiology fellows, 16 interviews with IR attending physicians, and online descriptions of IR were also analyzed for context. Themes were compared qualitatively and quantitatively. Results Interobserver agreement was good for interview themes (κ = 0.70; P <.0001). IR fellows’ professional identity emerged primarily from radiologic and surgical interests, with distinct emphasis on being “innovators,” “thinking differently,” and “needing to adapt and advertise abilities to survive.” Fellows’ descriptions of patient care were more clinically focused than past interviews with attending physicians (P =.05), but clinical interests common in medical specialties were limited, and descriptions of “nonprocedural patient care” were primarily periprocedural (81%). Descriptions of the future of the field conveyed competing pressures, loose role definition, and disconnect between academic and private-practice IR. Conclusions IR fellows share professional interests, views of their field and others, and descriptions of patient care, but there is uncertainty regarding future roles of the specialty and a need for more specific and unified definitions of nonprocedural patient care in IR.