Pregnancy and less than full time working in IR

Your rights during and after pregnancy (bma.org.uk)

Health & Safety and Pregnancy in Clinical Imaging and Radiotherapy Departments: A Guide for pregnant women, breast feeding women

Health & Safety and Pregnancy in Clinical Imaging and Radiotherapy Departments: A Guide for pregnant | SoR

Pregnancy and Work in Diagnostic Imaging Departments, Second edition | The Royal College of Radiologists (rcr.ac.uk)

Pregnancy and the Working Interventional Radiologist - PMC (nih.gov)

Pregnancy Toolkit

https://www.sirweb.org/practice-resources/toolkits/pregnancy-toolkit/navigating-pregnancy/

IR Part Time

IR Careers: Part Timer? Aka Chasing the Unicorn

Tim Ward

Traditionally IR in a DGH has been a part of a general radiology post i.e. a subspecialisation. This is no longer viable in my opinion. Nationally we are 44% down. 735 to provide 24/7 vs 414 according to RCR figures. We are a rare and valuable commodity. Recruitment at many hospitals is impossible and as on call rotas become more frequent to fill the gaps there is a diminishing appeal to the small numbers of new trainees looking for consultant posts. We cannot afford to waste our skills and training sat in offices reporting plain film when there are patients failing to receive the optimum minimally invasive treatments at our workplace or in a neighbouring trust. We should be pedalled as gold dust to provide for our neighbours and mean while acute and critical work should be centralised to fewer units with all complex IR and out of hours services in those Trusts.

A recent survey due to be published, conducted in the Severn deanery catchment, examined the reasoning behind trainees decisions not to pursue a career in IR. My anecdotal access to this information pre-publication provides a lot of insight. Although around 90% enjoyed practical procedures and the patient contact a career in IR is seen as the poor cousin to cross-sectional imaging in terms of work / life balance with only 11% deeming it acceptable as a career. Long, unpredictable days; emergency work load; on call (its presence, intensity and frequency), to name the headliners. In contrast a cross-sectional career is seen as far more compatible with a family life and the ability to leave work at a predictable time.

So are all IR jobs 13PA, split site 1:3 on call from Hell or is that the magical sound of hooves?

Can IR provide a work life balance?

Yes.

The traditional DGH model of an IR has a split of cross-sectional, IR and MDT work fringed with SPA. 2-3 PAs per week of IR is probably average. There is plenty of potential to drop work not relevant to the practice of IR in the pursuit of part-time status and thus have no impact on maintenance or development of practical skills, career progression and the ability to contribute meaningfully to an IR on-call rota. If anything, I do more IR sessions on an 8 PA contract than I used to do on 11 PAs due to the increase in workload as services have developed and other sites have come within our jurisdiction. I would argue that as a rare resource, (ref RCR workforce consensus), an IRist could, even should, justifiably be deployed across several sites and cover exclusively procedural work or IR related imaging such as CT or MR angiography. Essentially based at the “hub” and deployed to the “spokes” with all out of hours work for the region undertaken at the hub to reduce the frequency of the on call.

Unfortunately the on call will never go away completely and it will never match the ultra-low frequency cross-sectional rotas seen in large units. What we can do is manage the intensity by agreeing a few ground rules with the establishment. We insist on Consultant to consultant referrals. We don’t undertake semi-elective work where there is no clinical urgency. We do not adhere to the “do everything” policy in the pursuit of clinical influence and power. The spectre of “middle of the night” IR placed naso-gastric tubes or i.v. cannulas demanded by a universally de-skilled cohort of

clinicians is held fully at arm’s length. “Build it and they will come” is all very well and good but can you staff this burgeoning structure? Pragmatism prevails.

Can I train in IR part time?

Of course you can...but it takes longer! My caveat to that would be to consider taking a deep breath and plunging into the Fellowship or year 6 full time, 12-18 months, to build up a momentum and body of experience to carry through to Consultancy.

Can I really practice IR as a Consultant part time?

I am a part time Interventional Radiologist. I work in the hub unit of a regional vascular service in the South West of England. I am the clinical service lead for IR. I am not, nor have I ever been in this era of gender fluidity, a woman.

I ride the Unicorn!
I doubt this makes me unique but I suspect I am a rare beast. Why?

Gender bias? If I were a woman with a family would my choice to go part time have appeared far more acceptable, perhaps a given.

Guilt? Work ethic? Peer pressure? Disapproval of the “Conservative Old Guard”?

My reasons? My wife is a surgeon. Her work diary tells us she works an average of 16PAs a week, (although only paid 11); we have 2 young children; it is nigh impossible for her to go part time in her current role and even dropping a PA is steeply challenged by colleague resource to take up that slack. Beyond that is the grinding surgical process that demands relentless clinic/ theatre list/ ward round/ follow up clinic/ on call surge in demand/ 2 week cancer waits etc. all on a rolling continuum through any given week. This does not sit comfortably in a part time framework. She loves her vocation, (thankfully). It was far easier for me to step into the evolving parental void.

There are plenty of medical partnerships that work on 2 full time contracts. There are plenty of children who seem well adjusted brought up with Nannies, Grandparents or other third party childcare. There are also plenty that are not....it’s a choice...it’s personal.

Are there any other justifications than childcare for adopting a part time role? Personally I think yes. I also run a small holding, a holiday let and massage my male mid-life ego crisis by entering increasingly ridiculous sporting challenges. My mental health took a knock whilst a full-time consultant and not only did that need healing but there was a recognition that the combination of events at that point in life, (2 full time medics, 2 full-on children, a smidge of private practice, a separate business and smallholding), was totally anaerobic and the bailiffs of oxygen were calling in the debt.

There are so many other worthy reasons for adopting a part time approach that are oft frowned upon by the old conservative establishment. The opportunity to pursue another goal in life can only enrich the contribution to the medical component. Sport, music, art, a second business, voluntary work, ....