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Elective Experiences in IR - Keenan Wells

Keenan Wells is a foundation doctor who has recently completed an interventional radiology elective at Keele Medical School. Today we hear about his incredible experiences.

What was your elective rotation?

My elective was a 4 week placement at my local interventional radiology department at Royal Stoke Hospital.

How did you organise the placement?

I had originally planned to go abroad for my elective, but because of coronavirus it forced me to do one locally. I contacted a consultant neuroradiologist through the links which I had fostered through my time in my university radiology society. Finding like-minded individuals who are also passionate about radiology was a key aspect to getting this elective organised early, and proves how collaboration with others can make things happen quickly.

What kind of experiences did you have?

The hospital had a dedicated interventional day case unit with three theatres. Each theatre was kitted out with various levels of equipment; one was cramped and was beginning to show its age - as was the equipment within it, where one other had just had a multi-million pound ARTIS icono installed, which was used mostly for neurointerventional procedures. It was an elegant machine, and everyone in the theatre was still learning the ropes of how to best operate it. I would highly recommend seeing one in action if you are able. The interface between clinician and groundbreaking technology is very interesting to see in motion.

The IR service at this hospital was a 24/7 thrombectomy service, which is something I had read about and was excited to observe. There were many times where the list was interrupted by a few emergency cases, and everything would get pushed back, but seeing such a time-sensitive procedure being carried out so deftly and with such obvious resolution of symptoms was an exceptional experience.

I would arrive in the morning at about 9am and look at the lists in each theatre to see what operations were being carried out that day. There were many cases where I shadowed the consultants and watched a patient journey from the initial consenting process, procedure, and then back to recovery. This meant that I could appreciate the process holistically. The quick turnaround of minimally invasive cases impressed me.

Often in spare moments, or while waiting for transport for the patient, I would speak to the staff, learning about how radiographers contribute and assist in each unique case. It was a fantastic experience and really highlighted how multi-disciplinary care can happen right. There were such rich mixes of people in the theatre. Consultants, registrars, students like me, radiographers, nurses, medical device representatives, and Siemens engineers.

The consultants were all friendly and approachable, and were keen to let me scrub in to get a closer look, and explain the procedure step by step.The variety of cases performed was incredible, and it is one of the key draws to a career in interventional radiology - there’s so much variation! To name a few, I saw angioplasties, Hickman lines, nephrostomies, prostate artery embolization liver tumour chemoembolization, arteriovenous fistula embolization, emergency thrombectomy, aneurysm coiling, biliary stents, vertebroplasty, among many others. There was scarcely an area of the body untouched, and it was nice to come in during the morning and expect to see something totally new, even after a few weeks.

How was the city/area as a whole?

I had previously studied in Newcastle-Under-Lyme at this same location, so I was well-acquainted with the area. While the surrounding area is post-industrial with a lot of deprivation, it has a rich history. The area's past also makes for an interesting healthcare population - with many people carrying pathology from working in the local pottery industry. The hospital itself is a fantastic place to work and train. As a major trauma centre, there is always something interesting to see, and like I mentioned previously, having experience of a 24/7 thrombectomy service was brilliant. All the staff are well used to seeing students out and about. I would highly recommend an elective in interventional radiology after my time in the department.

Any other advice?

Interventional radiology has a lot of passionate people who involve themselves in it. I think that if you show a keenness and willingness to learn more about the speciality, there will always be a senior who is equally interested in teaching you or helping you out with projects. Asking around for research opportunities can be helpful, as there is normally something going on, and it will help you develop another important skill set in a field as innovative and novel as interventional radiology.

As a final note, I would recommend carrying around something you can read about the procedures before you watch them, especially if the procedure is technically challenging, or you cannot get close enough to see what is going on to the patient first-hand and need to watch the screens.

Overall, just try to get involved, and see if it’s for you

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