Essential Guide for DO Graduates: Researching Interventional Radiology Residencies

Understanding the Landscape: DO Graduates and Interventional Radiology

Interventional Radiology (IR) is one of the most competitive and rapidly evolving specialties—and as a DO graduate, you face a unique set of considerations when researching residency programs. You’re not only targeting one of the most selective fields, but you also have to think carefully about how osteopathic training, COMLEX vs USMLE scores, and program culture influence your chances in the IR match.

For interventional radiology, “researching programs” isn’t just looking at a list and circling a few big names. It’s a deliberate, structured process—one that can meaningfully change your odds of matching into IR and landing in an environment where you’ll actually thrive.

This guide walks you through a practical, step-by-step program research strategy tailored specifically for a DO graduate interested in interventional radiology residency (both Integrated IR and Independent IR pathways), with a strong focus on:

• Where DO applicants are most likely to be seriously considered
• How to interpret program websites and hidden signals
• How to filter, prioritize, and evaluate programs
• How to use data (not just “vibes”) to build a realistic, optimized list

---

Step 1: Clarify Your IR Pathway and Applicant Profile

Before diving into how to research residency programs, you need a clear understanding of your trajectory in interventional radiology and where you stand as an applicant. Your goals shape which types of programs you should even be researching.

1. Integrated IR vs Independent IR: What Are You Targeting?

There are two main IR training pathways:

1. Integrated IR Residency (IR/DR)

   • Match directly out of medical school (NRMP categorical residency).
   • 6-year program: 1 clinical year + 5 years DR/IR.
   • Highly competitive, especially at academic centers.
   • Many DO students interested in IR will target this pathway.

2. Independent IR Residency (Post-DR)

   • Completed after a full Diagnostic Radiology (DR) residency.
   • You’d first match into DR, then later apply to an independent IR residency.
   • For a current DO student or new graduate, your immediate focus is on DR programs that are IR-friendly (strong IR divisions, ESIR pathways, etc.).

Action point:
Decide which is your primary target:

• If you’re a DO applying directly from med school → you’re likely targeting Integrated IR (with DR as a backup).
• If you’re in or entering DR already → focus your research on Independent IR programs and ESIR-friendly DR residencies.

Throughout this article, we’ll emphasize the Integrated IR match, but the program research strategy applies to both.

2. Honestly Assess Your Applicant Profile

Researching programs effectively requires knowing where you fit in the spectrum.

Consider:

• COMLEX scores (and if applicable, USMLE scores)
• Clinical grades (Honors/High Pass, especially in core rotations and radiology/medicine/surgery electives)
• Research output (IR/radiology-related projects, posters, publications)
• IR exposure (shadowing, electives, sub-I, IR interest group leadership, SIR membership)
• Letters of recommendation (from IR attendings, radiologists, proceduralists)
• Red flags (gaps, failures, professionalism concerns, late decision about IR)

For a DO graduate residency applicant, also reflect on:

• Did you take USMLE Step 1 and/or Step 2 CK?
• Are your COMLEX scores competitive for IR/DR at university programs?
• Do you have advocacy or mentorship from IR physicians familiar with the IR match?

Practical self-categorization (rough guide):

• Highly competitive DO applicant for IR/DR: strong COMLEX and USMLE scores, honors, IR research, strong IR letters, good home IR department or strong away rotation performance.
• Moderately competitive: solid scores but maybe limited research, or late IR decision, or fewer IR letters, or little home IR exposure.
• Underdog/at-risk: low scores or failure(s), minimal IR research or letters, no home IR, minimal radiology exposure.

Your honest self-assessment will guide:

• How aggressively to reach for big-name academic IR programs.
• How many mid-tier, community-based, or DO-friendly programs to prioritize.
• Whether to adopt a dual-application approach (e.g., IR/DR + DR, or DR plus preliminary medicine/surgery backup).

---

Step 2: Build a First-Pass List of IR and DR Programs

Once you know your target pathway and profile, you can begin building your unfiltered master list. This is not yet your final application list—just your starting point.

1. Identify All Relevant IR/DR and DR Programs

Sources to start with:

• ACGME / AMA FREIDA (FREIDA Online)

  • Filter by: Specialty → “Interventional Radiology – Integrated” and “Interventional Radiology – Independent”
  • For DR → “Diagnostic Radiology”
  • Export or manually compile all programs into a spreadsheet.

• Society of Interventional Radiology (SIR)

  • SIR often has lists or directories of IR training programs and resources.
  • Check for integrated and independent IR residency program lists.

• NRMP and ERAS program directories

  • Use them during application season to confirm ACGME codes, program type, and positions available.

Include:

• All Integrated IR programs you might conceivably consider
• DR programs with strong IR presence (for Independent IR later, or ESIR)
• Institutions with known IR fellowship or independent residency

2. Label DO-Friendliness Early

As a DO graduate, you must quickly identify which programs:

• Explicitly accept COMLEX only
• Strongly prefer or require USMLE scores
• Have a track record of matching DOs (for IR or DR)

Early indicators you can use:

• Program websites:

  • Look for: “We accept both DO and MD applicants”
  • Look for: “USMLE required” vs “COMLEX accepted” vs “USMLE strongly recommended”
  • Check current and past resident lists for DOs.

• FREIDA filters (COMLEX accepted, DO-friendly flags, etc., though these can be incomplete).

Create columns in your spreadsheet:

• DO-friendly? (Yes/No/Unknown)
• COMLEX accepted?
• USMLE required?
• Current DO residents? (Y/N)

You’ll refine this as you research more deeply.

---

Step 3: Deep-Dive into Program Information: What Actually Matters

Now you have a master list. The next step is systematic, focused research on each program. This is where DO applicants can gain a real strategic edge.

1. Core Data: Size, Structure, and IR Track Details

For each program (IR/DR and DR with IR possibilities):

Collect:

• Program type: Integrated IR, Independent IR, or DR with ESIR
• Number of positions per year
• Hospital type: large academic center, hybrid academic-community, or community-focused
• Level-1 trauma center? Major referral center? (often stronger procedural exposure)
• Presence of ESIR (for DR programs)
• IR call and case mix: complex oncology, trauma, vascular disease, stroke thrombectomy, outpatient procedures, etc.
• Number of IR attendings and IR fellows (if any)

How to find this:

• Program website → “Program Overview,” “Curriculum,” “Clinical Training”
• SIR program pages
• Institution’s radiology department pages (sometimes more detailed than GME pages)

This data helps you answer:
“If I match here as a DO graduate, will I actually become a strong IR physician with broad exposure?”

2. Signals Relevant to DO Graduate Residency Applicants

You are not just asking “Is this a strong IR program?” but also “Is this realistic and supportive for me as a DO?”

Look for:

• History of DO residents

  • Check the “Current Residents” page for IR/DR and DR.
  • If 0 DOs in 5+ years → likely not DO-friendly (or extremely competitive for DOs).
  • If DOs present multiple years in a row → strong signal of openness.

• COMLEX vs USMLE stance

  • Explicit acceptance of COMLEX can save you from unnecessary applications.
  • If USMLE is “required,” and you don’t have it, drop that program.
  • If USMLE is “recommended,” but not mandatory, you may remain in contention; consider your competitiveness.

• Affiliation with osteopathic schools

  • Programs linked to a nearby DO school or rotating DO students often have more experience with DO grads and may value osteopathic clinical training.

• Program leadership attitudes

  • Look for interviews, podcasts, or written statements from PDs or APDs.
  • Clues like “We value diverse educational backgrounds” vs “We give priority to applicants from top-tier allopathic schools.”

Create a column in your spreadsheet:

• DO-friendliness score (1–3)
  • 3 = multiple DOs in program, COMLEX accepted, explicit DO support
  • 2 = occasional DOs, unclear but not exclusionary
  • 1 = no DOs, USMLE required, or strongly MD-dominant

3. Training Quality: Case Volume, Autonomy, and Outcomes

In IR, actual hands-on procedural exposure matters tremendously. When evaluating residency programs:

Focus on:

• Case volume and diversity

  • High volume in bread-and-butter IR (biopsies, drain placements, ports, GI bleeds) plus complex procedures (TACE/TARE, Y-90, TIPSS, advanced venous disease).
  • Exposure to both inpatient and outpatient IR clinics.

• Resident autonomy and graduated responsibility

  • Are residents performing procedures vs mostly observing?
  • Are integrated IR residents embedded early in IR, or just in later years?

• Protected didactic time

  • Regular IR conferences, tumor boards, M&M, journal clubs.
  • Structured board preparation (IR/DR board performance may be mentioned).

• IR match or fellowship outcomes (for DR graduates)

  • Where do DR residents go for independent IR?
  • Strong IR fellowship placement is a good sign if you’re DR→IR bound.

Some of this info may be public; some you’ll need to clarify via:

• Virtual info sessions
• Direct emails to chief residents or coordinators
• Residents’ social media (e.g., program Instagram showcasing IR activities)

---

Step 4: Ranking Programs by Fit: Location, Culture, and Lifestyle

Once you’ve gathered objective program data, the next major piece is personal fit. A prestigious IR program that doesn’t align with your life priorities may not be the best choice.

1. Geographic and Personal Considerations

Ask yourself:

• Where can I actually see myself living for 5–6 years?
• Are there absolute no-go regions (due to family, health, safety, finances)?
• Do you prefer:
  • Urban vs suburban vs smaller city?
  • Proximity to family or support systems?
  • Specific climate or cost of living?

In your spreadsheet, add:

• Geographic preference (High/Medium/Low)
• Cost of living (High/Medium/Low)
• Support network nearby? (Y/N)

Avoid overloading your list with programs in places you’d be truly unhappy to live; burnout risk is real in IR.

2. Program Culture and Educational Philosophy

Program websites and socials often give a surprising amount of information about culture:

Look for:

• How residents are described
  • As a “team,” “family,” “colleagues,” or mostly as “workforce”?
• Wellness and support statements
  • Are there concrete examples (wellness days, mentorship programs) or just buzzwords?
• Diversity and inclusion efforts
  • Visible commitment can matter, especially for underrepresented applicants.

For DO graduates, program culture can also influence how well your osteopathic background is integrated and respected.

Questions to explore (via open houses, emails, or social media):

• Do DO residents feel included and supported academically?
• Are there structured mentorship opportunities with IR faculty?
• How approachable are attendings?

Mark in your sheet:

• Culture fit (1–3) – based on your impressions from residents, PD talks, and online presence.
• Mentorship opportunities (Low/Medium/High)

3. Lifestyle, Call, and Workload

IR training is demanding. Look for:

• Call schedule:

  • Frequency of IR call (home vs in-house).
  • DR call structure during earlier residency years.

• Work hours:

  • Are work-hour compliance and wellness addressed directly on the site or by residents?
  • Do residents describe a survivable schedule?

• IR clinic and longitudinal care:

  • Programs emphasizing patient continuity may be more fulfilling but also busier.

You can note:

• Call intensity (Low/Medium/High – based on info)
• Perceived work-life balance (1–3)

All of this will help you compare programs beyond just name recognition.

---

Step 5: Strategic Use of Data, Networking, and Hidden Information

Beyond websites and directories, the strongest insights about programs come from direct contact, networking, and data interpretation.

1. Use Match Data and Reports Intelligently

For the osteopathic residency match into IR (Integrated IR/DR):

• Review NRMP’s “Charting Outcomes in the Match” for DO applicants and for IR/DR specifically if available.
• Examine:
  • Average COMLEX/USMLE scores for matched vs unmatched IR/DR applicants.
  • Number of applications, interviews, and ranks for matched DOs.
  • Proportion of DO vs MD matches into IR/DR and DR.

This helps you:

• Benchmark where your scores stand relative to successful IR applicants.
• Estimate how many programs you might need to apply to, based on competitiveness.

If your metrics are well below the typical range for matched IR/DR applicants, your program research strategy should:

• Emphasize DR programs with strong IR exposure and ESIR pathways.
• Include more DO-friendly DR programs.
• Possibly incorporate a dual-app track or reconsider your initial IR vs DR-first plan.

2. Networking: Talking to the People Who Know

For IR, networking is especially important and can strongly influence your understanding of individual programs.

Key contacts:

• Home institution IR attendings

  • Ask where they trained and where their colleagues trained.
  • Ask which programs are known to be DO-friendly and which are more closed.
  • Seek honest assessments of your competitiveness for certain tiers of programs.

• IR residents and fellows (especially DOs)

  • Find them via:
    • SIR resident and fellow sections
    • Social media (Twitter/X, LinkedIn, Instagram)
    • School alumni network
  • Ask practical questions:
    • “How supportive is your program of DO grads?”
    • “What is the IR case volume and autonomy like?”
    • “How many DOs are in your program now or have matched recently?”

• Recent DO graduates who matched IR/DR or DR→IR

  • These are gold for DO-specific advice and can help you avoid missteps.

Always be respectful of time; ask focused, specific questions. Capture their insights in a dedicated column: Insider notes.

3. Virtual Open Houses, Webinars, and Social Media

Most IR and DR residency programs now use online platforms to showcase themselves.

Strategies:

• Attend virtual information sessions

  • Prepare 2–3 thoughtful questions about IR training, DO applicants, and program culture.
  • Note the PD’s attitude toward DOs and non-traditional paths.

• Follow programs on social media

  • IR divisions often highlight interesting cases, QI projects, diversity initiatives, and resident life.
  • Look for evidence of DOs being featured just like MD colleagues.

• Program-specific webinars (SIR, radiology interest groups)

  • These can offer insights into how IR training is evolving and which programs are considered leaders or hidden gems.

This qualitative data helps you refine your Culture fit, Training quality, and DO-friendliness scores.

---

Step 6: Narrowing Down and Prioritizing Your Application List

By now, you should have:

• A comprehensive spreadsheet with detailed notes on each program
• Scored columns for DO-friendliness, training quality, culture, geography, and lifestyle
• Additional insights from conversations and virtual sessions

The last step is transforming research into a targeted, realistic application strategy.

1. Categorize Programs: Reach, Target, and Safety

Using your profile and the data you’ve collected:

Define:

• Reach programs

  • Super competitive institutions or those with very few/no DOs historically.
  • Often top-tier academic IR centers.
  • Apply if you have at least partial alignment (scores, research, strong letters).

• Target programs

  • Programs where your stats (scores, research) are similar to or slightly above the average successful applicant profile.
  • DOs are present, COMLEX accepted or USMLE available.
  • Strong enough IR exposure and training.

• Safety programs (relative term in IR; still competitive)

  • Clearly DO-friendly, multiple DOs in past classes.
  • Geographic or reputation factors may reduce overall applicant pressure.
  • Solid training, perhaps smaller name recognition.

In your sheet:

• Add Tier: Reach/Target/Safety

For IR/DR, many DO applicants may end up with:

• A modest number of true IR/DR programs (especially if weaker metrics)
• A broader base of DR programs with ESIR and strong IR presence
• Possibly some categorical IM/prelim medicine or transitional year programs as a backup if doing complex dual-app strategies

2. Balance Quality, Quantity, and Cost

Consider:

• Application fees and interview travel (if in-person)
• Time constraints for interviewing
• Emotional bandwidth—interview fatigue is real.

For a DO graduate aiming at IR:

• Many apply to a wide net of programs due to competitiveness.
• However, blind over-application without thoughtful research wastes money and doesn’t necessarily increase match odds.

Your program research allows you to:

• Drop programs that clearly won’t consider DOs or are highly misaligned.
• Focus on programs where your DO background and profile are genuinely competitive.

3. Re-Review for Red Flags and Deal-Breakers

Before finalizing:

• Remove programs that:

  • Explicitly do not accept DOs or require USMLE you don’t have.
  • Have serious red flags (recent loss of accreditation, major resident exodus, severe toxicity as reported through trustworthy channels).
  • Are in locations you realistically would not rank.

• Highlight programs that:

  • Have strong DO representation and success stories.
  • Offer unique IR training opportunities aligned with your interests (oncologic IR, trauma, peripheral vascular, etc.).
  • Have mentors or faculty you’ve already connected with.

You should end up with a curated list—still broad enough for safety, but sharply focused through careful research.

---

Putting It All Together: A Sample Program Research Workflow

Here’s an example of a simple, actionable program research strategy for a DO graduate targeting IR:

1. Week 1–2

   • List all Integrated IR and relevant DR programs from FREIDA, SIR, ERAS.
   • Create spreadsheet with initial columns (Name, Location, Program Type, DO-friendly?, COMLEX/USMLE policy, DO residents?).

2. Week 3–4

   • Deep-dive into each website to fill in: case volume (if available), ESIR presence, call type, IR faculty size, IR/DR graduation outcomes.
   • Assign early DO-friendliness, Training quality, and Geographic preference scores.

3. Week 5–6

   • Reach out to mentors, IR attendings, and DO IR residents for targeted insights.
   • Attend virtual open houses and refine Culture fit and Lifestyle scores.

4. Week 7

   • Use NRMP and Charting Outcomes data to benchmark yourself; adjust “reach/target/safety” labels.
   • Remove obviously misaligned or unrealistic programs.

5. Week 8

   • Finalize your apply list: a balanced portfolio of IR/DR, DR with strong IR, and appropriate backup programs if needed.

This structured approach transforms a chaotic process into a deliberate, data-informed strategy tailored to your goals as a DO graduate.

---

FAQs: Researching Interventional Radiology Programs as a DO Graduate

1. Do I need to take USMLE as a DO if I want to match into Integrated IR?

Not strictly, but it can significantly broaden your options. Some IR/DR programs:

• Require USMLE (COMLEX alone is not accepted).
• Strongly prefer USMLE, even if they say they “accept COMLEX.”

If you have strong COMLEX scores and do not want or cannot take USMLE, focus your research on:

• Programs explicitly accepting COMLEX without USMLE.
• Programs with a clear track record of matching DOs into IR/DR or DR.

If you’re early enough in your training and serious about IR, USMLE Step 2 CK can be especially valuable for expanding your IR match possibilities.

2. How many IR/DR programs should I apply to as a DO?

There’s no universal number, but because IR is highly competitive and DO representation is lower than MD:

• Many DO applicants apply to a broad range of IR/DR programs (often 30–50+), plus DR programs with strong IR.
• The optimal number depends on your competitiveness.
• Your research should identify where you realistically have a shot and avoid wasting applications on programs that never take DOs or are far outside your range.

Using your program spreadsheet and DO-friendliness scores will help ensure that each application is purposeful.

3. How can I tell if a program will actually let me do meaningful IR cases as a resident?

Look for:

• Evidence of high IR case volume and a large enough IR faculty.
• Curriculum details showing early and repeated IR rotations for integrated residents.
• ESIR pathways for DR residents (often a good marker of a robust IR division).
• Resident testimonials, social media posts, or open-house comments about procedural exposure and autonomy.

When in doubt, ask residents directly:
“How many independent cases are integrated IR or ESIR residents doing by their third or fourth year?” Their answers will be more telling than generic website statements.

4. What’s the best way to find DO-friendly IR programs?

Combine multiple methods:

• Check resident rosters on program websites for DOs in IR/DR and DR.
• Filter for COMLEX-friendly programs in FREIDA (but don’t rely on this alone).
• Ask your IR mentors and DO alumni where DOs have matched IR/DR in recent years.
• Attend virtual open houses and specifically listen for or ask about DO representation.

Then encode that into your spreadsheet as a DO-friendliness score and prioritize programs that have demonstrated willingness to train DO graduates.

---

By treating program research as a structured, deliberate process—not an afterthought—you can significantly improve your chances of a successful osteopathic residency match into interventional radiology, or onto a DR pathway that keeps IR fully within reach.