Episode # 670 • 18 Aug 2026
Understanding IR Attrition: Causes & Solutions
Why do nearly half of IR residents consider leaving the specialty, and what can be done to change that? On this episode of the BackTable Podcast, Dr. Neil Jain interviews Dr. David Mittelstein, an integrated IR resident at UC San Diego and co-chair of the SIR RFS Recruitment Committee, about the findings of a national SIR survey on interventional radiology resident attrition. They discuss what drives uncertainty, from lifestyle and call burden to job market fears, and highlight the program features that encourage retention, such as structured training, high case volume, and a culture of camaraderie.
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Timestamps
00:00 - Introduction
04:31 - From Biomedical Engineering to IR
07:41 - Recruitment Committee Mission
12:37 - Match Trends Warning Sign
15:12 - Survey Design Demographics
20:21 - What Factors Matter
25:04 - Why Residents Consider Switching
30:23 - Recommendation 1 IR Curriculum
32:32 - Recommendation 2 More IR Rotation
34:10 - Recommendation 3 Build Camaraderie
38:30 - Advice for Residents Who Are Doubting
41:00 - What’s Next for RFS Recruitment
43:20 - Wrap Up
Resources
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More about this episode
The conversation explores free-response themes from the survey, where 78 percent of residents cited lifestyle concerns, 31 percent pointed to job market uncertainty, and 22 percent mentioned call experience as reasons for questioning IR. Retention was linked to structured training (38 percent), high case volume and procedural experience (35 percent), and program camaraderie (18 percent). Dr. Mittelstein and Dr. Jain review three concrete recommendations to improve retention, examine early changes at programs like Georgetown, and offer practical advice to residents who may be quietly doubting their path in IR.
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