Name: 你想成為一名介入放射科醫生嗎 [第 47 集］ (So You Want to Be an INTERVENTIONAL RADIOLOGIST [Ep. 47])
Uploaded: 2025-10-26T18:03:05.000Z
Duration: 12 min 29 s

So you want to be an interventional radiologist leaving the image reading in the dust in replace of hands on operations?

所以你想成為一名介入性放射科醫師，捨棄影像判讀，改做實際操作嗎？

This is the reality of Interventional Radiology Dr.

這才是介入性放射學的真實樣貌，醫師。

Jubbal medschoolinsiders.com welcome to our next installment in so youo Want to Be.

Jubbal medschoolinsiders.com 歡迎來到我們 so youo Want to Be 系列的下一集。

In this series we highlight various medical specialties to help you choose the best fit for you.

在這個系列裡，我們會介紹各種醫學專科，幫助你選擇最適合你的。

You can find the other episodes on our so youo Want to Be playlist.

你可以在我們的 so youo Want to Be 播放列表裡找到其他集數。

Subscribe to the channel to vote on future specialties.

訂閱我們的頻道，來投票決定未來的專科。

Radiology can be broken down into two distinct paths, diagnostic radiology and interventional radiology.

放射學可以抽成兩個不同的路徑：診斷性放射學和介入性放射學。

The basic difference is that diagnostic radiology primarily deals with diagnosing disease, whereas interventional radiology primarily deals with treating disease.

主要的差別在於，診斷性放射學主要負責診斷疾病，而介入性放射學主要負責治療疾病。

Diagnostic radiologists do not usually take the images, but

診斷性放射科醫師通常不會自己取得影像，而是

instead spend the majority of their time looking at the finished scans and and providing interpretations of them for the clinical physician who ordered the scan.

而是花大部分時間看掃描影像，並為開立影像檢查的臨床醫師提供判讀。

Interventional radiology, on the other hand, involves using medical imaging technology to treat and sometimes diagnose conditions using imaging guidance, typically a kind of real time X ray called fluoroscopy.

另一方面，介入性放射學則是利用醫療影像技術，在影像導引下治療，有時也診斷疾病，通常是使用一種稱為 X 光透視的即時 X 光。

Interventional radiologists often manipulate long thin wires called catheters to the site or organ of interest to then perform a procedure.

介入性放射科醫師常會操作稱為導管的細長導線，將其導引至目標部位或器官，然後進行手術。

Such procedures are known as minimally invasive, as traditional invasive surgeries require far more cutting than a needle stick or small incision.

這類手術被稱為微創手術，因為傳統侵入性手術需要比針刺或小切口多得多的切割。

Interventional radiologists operate all over the body, including putting in lines and tubes to drain abscesses or kidneys, lysing blood clots, embolizing bleeding, angioplasty and stenting, fixing aneurysms by filling them with wire coils, stenting the liver in cirrhotic patients and removing clots causing stroke.

介入性放射科醫師的執刀範圍遍及全身，包括置入導管和引流管來引流膿瘍或腎臟、溶解血栓、栓塞出血、進行血管成形術和支架置放術、透過金屬線圈填塞動脈瘤來修復動脈瘤、為肝硬化患者的肝臟置放支架，以及移除造成中風的血栓。

Interventional oncology includes treatments for liver and kidney cancer such as free freezing or microwaving tumors, dropping radioactive beads into tumors and killing off blood supply to the cancer.

介入性腫瘤學包括治療肝癌和腎癌，例如冷凍或微波腫瘤、將放射性粒子注入腫瘤，以及切斷腫瘤的血液供應。

This is a rapidly evolving field that's given cancer patients more options.

這是一個快速發展的領域，為癌症患者提供了更多選擇。

The first distinction we need to make clear is the difference between interventional radiology and diagnostic radiology.

我們需要先釐清的第一個區別是介入性放射學和診斷性放射學之間的差異。

Doctor's are experts in anatomy and pathophysiology throughout the body and have practical knowledge of medical physics.

醫師是全身解剖學和病理生理學的專家，並具備醫學物理的實務知識。

The basis of their work comes down to reading and interpreting images.

他們工作的基礎是閱讀和判讀影像。

介入性放射科醫師同時喜歡影像判讀和實際操作。

The basis of their work comes down to completing image guided procedures.

他們工作的基礎是完成影像導引的介入性治療。

However, IRs are also certified in diagnostic imaging as this is the foundation for their procedures.

不過，介入性放射科醫師也持有診斷影像的證照，因為這是他們進行介入性治療的基礎。

Overall, the IR lifestyle is worse than doctor, but it can still vary once you're done with training.

整體來說，介入性放射科醫師的生活方式比診斷性放射科醫師差，但訓練結束後還是會有所不同。

There are IR attendings who were close to general surgery hours and others who were closer to doctor hours and doctor has one of the best lifestyles in medicine.

有些介入性放射科醫師的工時接近一般外科，有些則接近診斷性放射科醫師，而診斷性放射科醫師是醫學界裡生活方式最好的專科之一。

IR call is usually home call, meaning you can be called in from home at any hour and on weekends for urgent interventions.

介入性放射科醫師的on-call通常是居家on-call，這表示任何時間或週末，你都可能需要從家裡被叫進醫院處理緊急的介入性治療。

These happen often, meaning you may have to go in at 3am or multiple times over the course of a weekend at a busy center or large hospital.

這種情況很常見，意味著在繁忙的中心或大型醫院，你可能需要在凌晨3點或週末的任何時間多次進醫院。

Scheduled IR cases can start between 7 to 8am and run until 5 to 6pm this is in addition to call.

排定的介入性放射學病例通常在早上7點到8點開始，一直到下午5點到6點結束，這還不包含on-call的時間。

較不繁忙的醫療中心病例會比較少。

The lifestyle hours call and procedures depend on the practice type you are working in.

你的生活方式、工時、on-call和病例數，都取決於你工作的執業類型。

For example, not all IRS operate every day.

舉例來說，並非所有的介入性放射科醫師每天都會執行手術。

Academic IRS may only do procedures and have a day off for admin and research.

學術界的介入性放射科醫師可能只做手術，而行政和研究則有專門的休假。

In academic centers where a number of high end procedures are performed, IRS are usually quite busy.

在執行許多高階手術的學術中心，介入性放射科醫師通常會非常忙碌。

In general, there are more interventional oncology and complex hepatobiliary procedures like TIPS done in academic settings as these patients benefit from having a multidisciplinary care team that may also include oncologists or hepatologists.

總體來說，學術界進行的介入性腫瘤學和複雜肝膽手術（例如 TIPS）較多，因為這些病患能從跨領域照護團隊中獲益，團隊中可能還包含腫瘤科或肝臟科醫師。

Private practice IR physicians often do a combination of IR procedures and Dr.

私人執業的介入性放射科醫師通常會結合介入性手術和醫師

Procedure only jobs in private practice are normally the exception rather than the rule.

私人執業中純粹的手術職位通常是例外，而非常態。

This means that it can be difficult to maintain the case volume needed to maintain skills for more complex procedures and that's another reason there are more of those done in academics.

這意味著要維持執行複雜手術所需的病例量來精進技巧可能會很困難，這也是學術界進行更多這類手術的另一個原因。

However, any IR trained physician can perform whatever procedures they are comfortable with and have the staff for, and

然而，任何受過介入性放射學訓練的醫師都可以執行他們覺得自在且有團隊支援的手術，

that's why private practice IR settings vary widely depending on the specific group.

這也是為什麼私人執業的介入性放射學環境會因個別團隊而有很大差異。

One nice benefit of a private practice IR career is that it can generally be tailored to your desires.

私人執業的介入性放射學職涯有個好處，那就是通常可以根據你的期望來量身打造。

On average, private practice IRS will make a bit more than academic irs, as is the case for all specialties.

平均來說，私人執業的介入性放射科醫師會比學術界的同行賺得稍多，這在所有專科都是如此。

There's also a distinction between general IR and those who choose to specialize.

一般介入性放射學和選擇專精的介入性放射科醫師之間也有區別。

Further, more general IR involves lines and tubes and acute interventions like bleed embolization, percutaneous nephrostomies and coli tubes.

此外，一般介入性放射學更多涉及導管、引流管以及急性介入治療，例如止血栓塞、經皮腎造廔術和膽道引流管置入。

More specialized IR tends to be done at larger and academic centers and includes complex vascular and hepatobiliary work such as TIPS procedures stenting the liver in cirrhotic patients.

更專精的介入性放射學通常在較大型和學術中心進行，包含複雜的血管和肝膽疾病治療，例如針對肝硬化病患的肝臟支架置入（TIPS）。

Interventional oncology is also becoming a subfield that includes tumor ablation and embolization.

介入性腫瘤學也正成為一個次專科，包含腫瘤燒灼和栓塞治療。

Other niches include pediatric ir, which often deals with pediatric vascular anomalies and and neuro ir, which includes stroke, thrombectomy or brain aneurysm coiling.

其他的利基領域包括小兒介入性放射學，常處理小兒血管異常；以及神經介入性放射學，包含中風、取栓或腦動脈瘤栓塞術。

Let's clear up some of the misconceptions about interventional radiology.

讓我們來釐清一些關於介入性放射學的迷思。

A common misconception is that IR is ideal for those who want to be surgeons.

一個常見的迷思是，介入性放射學最適合那些想當外科醫師的人。

You might choose to become an interventional radiologist because you have an interest in surgery, but

你可能會選擇成為一名介入性放射科醫師，是因為你對外科手術有興趣，但

Diagnostic imaging still takes up a large portion of residency training and you'll need to have a deep understanding of it in order to become an ir.

診斷影像學在住院醫師訓練中仍佔有很大一部分，而你必須深入瞭解它才能成為一名介入性放射科醫師。

If you're passionate about surgery and dislike like imaging, a surgical specialty will be a better fit.

如果你對外科手術充滿熱情卻不喜歡影像學，外科專科會更適合你。

Some have the misconception that neuroir is becoming the domain of neurosurgery and there's no longer a future for radiologists to do neurointerventional procedures.

有些人誤以為神經介入性放射學正逐漸成為神經外科的領域，放射科醫師不再有機會執行神經介入治療。

While it's true that the majority of radiologists aren't interested in neuro ir, there are programs out there that will train interested radiologists in nir.

雖然大多數放射科醫師對神經介入性放射學不感興趣，但確實有一些訓練計畫能培訓有興趣的放射科醫師。

Becoming an interventional radiologist takes six to seven total years.

成為一名介入性放射科醫師總共需要六到七年。

There are three options to choose from for pursuing this career path.

追求這條職涯道路有三種選擇。

Training for this path includes one intern year, three years of doctor training, and

這條途徑的訓練包含一年實習、三年醫師訓練，以及

兩年的專注介入性放射學訓練。

The path begins with diagnostic radiology since diagnostic skills form the basis for interventional procedures.

這條路徑始於診斷性放射學，因為診斷技巧是介入性手術的基礎。

Next is early specialization in IR, also known as ESIR, which includes one intern year, four years of Dr.

接下來是介入性放射學的早期專科化，也稱為 ESIR，包括一年的實習、四年的醫師訓練，以及

Residents who realize early on that they want to do IR.

住院醫師，他們很早就意識到自己想做介入性放射學。

They'll do more IR rotations during their Dr. Years than their Dr.

他們在醫師訓練期間會比他們的醫師

同期學員有更多的介入性放射學輪調。

Their last year of Dr. Training, year five will be mainly focused on IR rotations.

他們醫師訓練的最後一年，也就是第五年，將主要專注於介入性放射學的輪調。

For this path, you need to know quite early on that you want to do IR in order to get the required 500 IR procedures during your doctor years.

對於這條路徑，你需要在早期就確定自己想做介入性放射學，才能在醫師訓練期間完成所需的 500 例介入性放射學手術。

Last is the independent IR residency which takes the longest at 67 years.

最後是獨立的 IR 住院醫師訓練，這需要最長的時間，6 到 7 年。

This training includes one intern year, four years of doctor, and two years of a separate IR fellowship.

這項訓練包括一年的實習、四年的醫師訓練，以及兩年的獨立 IR 進階訓練。

Residents who realize late in residency that they want to do ir.

在住院醫師訓練後期才意識到自己想做 IR 的醫師會選擇的。

Therefore, they need two years of fellowship training in order to complete the necessary IR procedure volume.

是以，他們需要兩年的進階訓練才能完成所需的 IR 手術量。

Although interventional radiology is in many ways a sub specialization of diagnostic radiology, already there are paths to further specialize after becoming an ir.

雖然介入性放射學在許多方面都是診斷性放射學的進階專科，但已經有在成為 IR 醫師後進一步專科化的路徑。

Although you will gain experience with virtually all IR procedures during IR residency, some IRs develop a specific niche they become experts in, such as interventional oncology, pediatric IR or ultrasound guided biopsies.

雖然你在 IR 住院醫師訓練期間會接觸到幾乎所有的 IR 手術，但有些 IR 醫師會發展出特定的專長領域，例如腫瘤介入治療、小兒介入治療或超音波導引切片。

Additional fellowship years are available for pediatric ir, which often deals with pediatric vascular anomalies, and

另外還有小兒介入治療的額外進階訓練年，這通常處理小兒血管異常，以及

for neuro ir, which deals with strokes and cerebral vascular diseases.

神經介入治療，這處理中風和腦血管疾病。

However, the majority of IRS do not pursue these extra fellowships.

不過，大多數的介入性放射科醫師不會追求這些額外的進階訓練。

There's a lot to love about working as an interventional radiologist IR is a rapidly evolving field with cutting edge technology and new interventions being developed all the time.

身為一位介入性放射科醫師，有很多值得喜愛的地方，IR 是一個快速發展的領域，擁有尖端科技，並且不斷有新的介入治療被開發出來。

This means you can help forge a young field, find R and D opportunities and make connections in the biomedical industry.

這意味著你可以協助開創一個年輕的領域，尋找研發機會，並在生物醫學產業建立人脈。

It's a huge scope of practice that enables you to intervene all over the body.

它的執業範圍非常廣泛，讓你能夠介入全身的治療。

There's a large variety of diseases, organ systems, patient acuity and patient population, so there are many different niches you can establish yourself in.

有各式各樣的疾病、器官系統、病人病情嚴重程度和病人族群，所以有很多不同的利基市場可以讓你建立自己的專業。

IRs are also DRC certified, so depending on your interest, you can do part IR and part doctor as an attending.

介入性放射科醫師也通過 DRC 認證，所以根據你的興趣，在擔任主治醫師時，你可以 part IR and part doctor。

There's a great deal of flexibility in ir, so you'll be able to focus on the areas that most interest you.

IR 有很大的彈性，所以你可以專注在你最感興趣的領域。

There's also minimal rounding and social work.

而且，查房和社會工作也比較少。

If those doctor duties sound unappealing to you, you'll also have job security as mid levels won't be doing complex IR work anytime soon and you'll earn a hefty paycheck.

如果這些醫師的職責聽起來讓你卻步，你也會有工作保障，因為中階醫護人員短期內不會從事複雜的 IR 工作，而且你會賺取豐厚的薪水。

Interventional radiologists like like diagnostic radiologists make about the same at over $480,000 a year, with specialists making even more.

介入性放射科醫師和診斷性放射科醫師一樣，年薪都超過 480,000 美元，專科醫師的收入甚至更高。

Your income is more determined by your practice type and niche rather than whether or not you are a diagnostic or interventional radiologist.

你的收入更多取決於你的執業類型和專精領域，而不是你是診斷性放射科醫師還是介入性放射科醫師。

But best of all, you can instantly help people and literally save lives through acute interventions like bleed embolizations and thrombectomies.

但最棒的是，你可以透過像出血栓塞和血栓切除術等緊急介入措施，即時幫助人們，真正拯救生命。

While interventional radiology has a lot to offer, it isn't for everyone.

雖然介入性放射學有很多優點，但它並不適合所有人。

First off, the lifestyle and being on call can be challenging.

首先，生活方式和值班可能會很有挑戰性。

Due to the nature of specialty, you will often have to come in on weekends and be woken in the night for emergencies.

由於這個專科的性質，你經常需要在週末進醫院，並在夜間因緊急情況被叫醒。

Like many procedural specialties, residency won't be a walk in the park either.

和許多操作型專科一樣，住院醫師的訓練也不會是輕鬆的。

Are you more interested in the money or your work life, balance and family life?

你是更看重金錢，還是你的工作與生活平衡和家庭生活？

There's not a right or wrong answer here, but

it's important to understand this going in in some community practices, IR can become a line and drain service, doing all the procedures no one else wants to do.

重要的是要了解，在某些社區診所，介入性放射學可能會變成一個「打雜」和「後送」的服務，做所有別人不想做的檢查。