An interventional radiologist is a physician who treats disease with image-guided, minimally invasive procedures. To become one, you finish college, four years of MD or DO school and a clinical year, then either a five-year integrated IR residency or a diagnostic radiology residency followed by an independent IR residency, and pass the ABR board exams, about 14 years in all.
That count starts on the first day of college, and the longest independent route adds a year, for 15. The early steps are the same as every other route into medicine, which our guide on how to become a doctor in the United States covers in detail. This page focuses on the part that is specific to IR: the two residency formats, the ESIR track, board certification, the work itself, and what the job pays.
What an Interventional Radiologist Does
The Society of Interventional Radiology describes IR as the minimally invasive, image-guided treatment of conditions that once required open surgery. Interventional radiologists use ultrasound, X-ray, CT and MRI to see inside the body while they work through a needle or a thin catheter, which can shorten hospital stays and lower the risk of complications. The specialty traces back to the 1960s and Dr. Charles Dotter.
The conditions IRs treat, as listed by SIR, include:
- Uterine fibroids: uterine fibroid embolization, which avoids surgery and preserves the uterus
- Cancer: image-guided biopsy, ablation and embolization; IRs who focus on cancer are often called interventional oncologists
- Peripheral arterial disease: stenting and clot-dissolving therapy (thrombolysis)
- Deep vein thrombosis and pulmonary embolism: thrombolysis and IVC filters
- Back pain and joint pain: including knee osteoarthritis, tennis elbow and frozen shoulder
SIR’s page for trainees adds stroke and trauma to that list. The ACGME’s 2026 program requirements define the specialty as covering diagnostic imaging, image-guided procedures, and the evaluation and clinical management of patients, so IR is not purely a procedure job. Accredited programs must have an IR clinic or outpatient office, separate from the procedure rooms, for consultations and follow-up visits, and residents learn peri- and post-procedural care alongside the procedures themselves.
Is an Interventional Radiologist a Surgeon?
No. Interventional radiologists train in radiology, not surgery, and they work through small skin punctures under imaging guidance rather than open incisions. Their board certificate from the American Board of Radiology is a combined interventional radiology and diagnostic radiology (IR/DR) certificate, so every IR is also trained to read diagnostic images. If you want the reading-room side of the field, see our explainer on what a diagnostic radiologist does day to day.
Integrated vs Independent IR Residency
There are two ACGME-accredited ways to train in IR. Both end with the same ABR IR/DR certificate. The lengths below come from the 2026 ACGME interventional radiology program requirements and the 2026 ACGME diagnostic radiology program requirements.
| Integrated IR residency | Independent IR residency | |
|---|---|---|
| When you apply | As a fourth-year medical student | During a diagnostic radiology residency |
| Clinical year | A separate prerequisite year (60-month format) or built into the program (72-month format) | Part of the DR residency (a separate year, or the 60-month DR format) |
| Radiology training | 60 months: 36 months focused on DR in PGY-2 to 4, then a final 24 months focused mainly on IR | 48 months of DR, then 24 months of IR |
| With ESIR | Not applicable | DR residents who complete ESIR may enter at the second year, so IR training can take 12 months |
| Total training after medical school | 6 years | 7 years, or 6 with ESIR |
| ABR time limit (from July 1, 2026) | Five-year residency completed within 10 years | Two-year residency completed within four years |
| Board certificate | ABR IR/DR | ABR IR/DR |
The integrated route suits students who know early that they want IR. The independent route lets you train as a diagnostic radiologist first and decide on IR during residency. SIR’s overview of IR residency routes describes the same three options: integrated, independent, and independent with ESIR.
What Is ESIR in Radiology Residency?
ESIR stands for Early Specialization in Interventional Radiology. It is a block of IR training completed inside a diagnostic radiology residency so that the resident can start an independent IR program at the second-year level. Under the 2026 ACGME diagnostic radiology requirements, an ESIR curriculum must include at least 11 IR and IR-related rotations (at least eight of them in the IR section under IR faculty), one critical care rotation of at least four continuous weeks, and at least 500 IR or IR-related patient procedural encounters. The DR program gives the resident written verification of completion. The ABR adds that ESIR graduates may only need one year of independent IR training if their IR program director approves.
Which IR Pathway Should You Choose?
Pick integrated if you are sure about IR by your third year of medical school and your application is ready for a smaller, competitive specialty. Pick the DR route if you are drawn to imaging but still undecided, or if you want a fallback: a DR graduate who does not enter IR is still a board-eligible diagnostic radiologist. Our guide on how to become a diagnostic radiologist covers the DR residency in more depth.
Step-by-Step Path to Becoming an Interventional Radiologist
Step 1: Finish College and the Pre-Med Courses
Any major works if you complete the prerequisite sciences and take the MCAT. Physics is worth extra effort, since radiation physics is tested on the ABR board exams later. Spend these years building real clinical experience. Students who want to see imaging work up close can read our guide to radiology shadowing for pre-health students. Clinical time abroad also counts: IMA’s pre-med internships abroad place students in hospitals abroad, where, under supervision of licensed clinicians, interns take vital signs, help with patient intake and join ward rounds.
Step 2: Earn an MD or DO Degree
Medical school takes four years. Both MD and DO graduates enter IR residencies. Use your clinical years to complete a radiology or IR elective, join your school’s IR interest group (SIR lists these student groups), and look for an IR research project, since SIR funds student research grants and awards.
Step 3: Apply and Match Into Residency
You apply through ERAS and rank programs in the NRMP Main Residency Match; our ERAS residency application guide walks through the timeline. Integrated IR is small. In the NRMP 2026 Main Residency Match, integrated IR programs offered 70 PGY-1 positions and 168 PGY-2 positions. U.S. MD seniors filled 74.4% of those PGY-2 positions and 96.4% were filled overall. PGY-2 positions have grown every year since 2022, when there were 123.
Because integrated positions are limited, plan your radiology electives and research early. For context on how IR compares with other fields, see our list of the most competitive medical specialties.
Step 4: Complete the Clinical Year
For the 60-month integrated format, the ACGME requires a prerequisite year of direct patient care with at least 36 weeks in direct patient care, in anesthesiology, emergency medicine, family medicine, internal medicine, neurology, obstetrics and gynecology, pediatrics, surgery or a surgical specialty, or a transitional year. Radiology electives during that year are capped at a combined eight weeks and must be hands-on, not observational. In the 72-month format, the program provides the clinical year itself: at least six months of inpatient care including one month of critical care, one month of emergency medicine, and two more months of inpatient or outpatient care.
Step 5: Finish IR Residency
By the end of training, the 2026 ACGME rules require each IR resident to complete at least 23 IR or IR-related rotations, at least 18 of them core IR rotations under an interventional radiologist, plus one full-time critical care rotation. Residents train in biopsies, drainage procedures, angioplasty, embolization and other percutaneous procedures, and they log their cases. They also complete at least 700 hours of supervised training in radionuclide handling. Residents get paid throughout; our breakdown of how much resident doctors make covers salary during these years.
Step 6: Pass the ABR Board Exams
The ABR IR/DR certification requirements call for two exams:
1. Qualifying (Core) Exam: taken after 36 months of residency. It is computer-based, given remotely over three days at about five and a half hours per day, and offered twice a year. It covers all of diagnostic radiology plus IR and physics, and the result is pass or fail. 2. Certifying Exam: a computer-based component of about four hours, taken in the calendar year you finish training, and an oral component of about three hours, taken the following calendar year. The oral exam is four 30-minute sessions with four different examiners covering image interpretation, procedures and periprocedural management. Candidates already certified in DR take only the oral component.
The ABR is changing this sequence. The computer-based IR/DR certifying component will no longer be offered after 2028, and beginning in 2029 candidates will take two oral exams, one in diagnostic radiology and one in interventional radiology, and must pass both. Your board eligibility window lasts six full calendar years after you finish residency.
Step 7: Get Licensed and Start Practice
The ABR requires a valid state or provincial medical license for certification (a training license is acceptable while you are still a resident). Once certified, interventional radiologists work in hospitals, outpatient IR centers and academic departments Call duties can include emergencies such as trauma and stroke, both of which SIR lists among the conditions IRs treat.
Interventional Radiologist Training Timeline
How Long Does It Take to Become an Interventional Radiologist?
Counted from the first day of college, the shortest routes take 14 years:
| Stage | Integrated route | Independent route | Independent with ESIR |
|---|---|---|---|
| College | 4 years | 4 years | 4 years |
| Medical school | 4 years | 4 years | 4 years |
| Clinical year | 1 year | 1 year | 1 year |
| Radiology residency | 5 years (IR/DR) | 4 years (DR) | 4 years (DR with ESIR) |
| Independent IR residency | None | 2 years | 1 year |
| Total after high school | 14 years | 15 years | 14 years |
Research years and leave can add time. Our timeline of how long it takes to become a doctor compares IR with other specialties.
Interventional Radiologist Salary
BLS does not publish a separate line for interventional radiologists. They fall under radiologists, and the BLS Occupational Outlook Handbook names interventional radiology as one of the specialties within that occupation. The May 2025 BLS wage data for radiologists covers 26,770 workers:
| May 2025 BLS annual wage | Radiologists |
|---|---|
| 10th percentile | 89,010 |
| 25th percentile | 216,800 |
| Median | 420,860 |
| Mean | 381,530 |
| 75th percentile | 506,010 |
| 90th percentile | 594,410 |
Figures are annual wages in US dollars. The radiologist median of $420,860 sits well above the $275,930 median for all physicians and surgeons in the same May 2025 data, and radiologists rank among the highest-paid doctors in the United States.
What Is the Job Outlook for Interventional Radiologists?
The BLS Occupational Outlook Handbook projects radiologist employment to grow from 28,700 jobs in 2025 to 29,600 in 2035, a 3% increase, or about 1,000 jobs. Physicians and surgeons as a group are projected to grow 4% over the same decade, with about 22,100 openings a year, many of them from retirements. BLS points to an aging population and rising rates of chronic disease, including cancer and heart disease, as the main drivers of physician demand, and those are two of the core conditions IRs treat.
Who Interventional Radiology Suits
IR tends to fit people who like hands-on procedures, think visually, and want to manage patients without doing open surgery. It also means call for emergencies, time in procedure rooms that use radiation, and a long training path that includes years of diagnostic radiology. If you like the idea of fixing a problem through a pinhole while watching it on a screen, and you also enjoy reading images, IR combines both.
Frequently Asked Questions
How many years does it take to become an interventional radiologist?
About 14 years after high school on the integrated route: four years of college, four of medical school, a clinical year, and a five-year integrated IR residency. The independent route takes 15 years, or 14 if you complete ESIR during diagnostic radiology residency.
What is the difference between integrated and independent IR residency?
Integrated IR is a single residency you match into from medical school, with three years focused on diagnostic radiology and two focused on IR after a clinical year. Independent IR is a two-year residency you enter after finishing diagnostic radiology, shortened to one year with ESIR. Both lead to the same ABR IR/DR certificate.
Do interventional radiologists go to medical school?
Yes. Interventional radiologists are physicians with an MD or DO degree who then complete an ACGME-accredited residency and ABR board certification.
How much does an interventional radiologist make?
BLS groups interventional radiologists with radiologists. In May 2025, the median annual wage for radiologists was $420,860, and the 90th percentile wage was $594,410.
What board certifies interventional radiologists?
The American Board of Radiology. Candidates pass the Qualifying (Core) Exam after 36 months of residency and then the Certifying Exam after training, earning a combined IR/DR certificate.
Can a diagnostic radiologist become an interventional radiologist?
Yes. A diagnostic radiologist who completes an accredited DR residency can apply to an independent IR residency, which lasts two years, or one year for residents who completed ESIR and are approved by their IR program director.
Is interventional radiology competitive?
It is a small specialty. In the 2026 NRMP Main Residency Match, integrated IR programs offered 168 PGY-2 positions, and 96.4% were filled, 74.4% of them by U.S. MD seniors.
