Hi, I’m Dr. Naveen, currently a final-year resident in DRNB Endovascular and Interventional Radiology at Max Super Speciality Hospital, Saket, New Delhi. This article is meant to give a practical overview of the training, case exposure, hands-on experience, and work culture in the program for future applicants considering this institute.

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About the Program

The DRNB Endovascular and Interventional Radiology course is a 3-year super-specialty training program conducted under the National Board of Examinations in Medical Sciences (NBEMS).

Eligibility

• MD Radiology
• DNB Radiology

Entrance Examination

Admission is through NEET Super Specialty (NEET-SS).

Exit Examination

At the end of the three years, candidates must clear:

• Theory examination
• Practical / clinical examination

Academic Requirements

• Thesis submission is mandatory
• At least one publication is required as per DRNB guidelines.

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Fees and Stipend

Approximate DRNB annual fee:
₹1 – 1.25 lakh per year

Monthly Stipend

Year	Stipend
1st Year	₹84,000
2nd Year	₹86,000
3rd Year	₹88,000 – ₹90,000

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Cath Lab Infrastructure

The main angiography suite uses the Philips Allura Xpert FD20/20, which is a biplane cath lab commonly used for neuro and complex vascular procedures.

Additional facilities include:

• Dedicated non-vascular IR suite
• Ultrasound-guided intervention rooms
• Fluoroscopy-guided procedure room

Patients are also occasionally admitted directly under the Interventional Radiology department.

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Structure of Training

Training is divided into three major units, and residents rotate through them during the three years.

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Unit 1 – HOD / Director Unit

Residents are predominantly posted here during the first year.

Working Hours

Usually 9:30 AM – 5:30 / 6 PM

Main Exposure

Non-vascular IR procedures:

• FNAC and biopsies
• CT-guided biopsies
• CT-guided abscess drainage
• Ultrasound-guided drain placements
• Permacath insertion
• Hemodialysis catheter placement
• PICC line placements

Advanced procedures include:

• PTBD
• PCN placement
• Sclerotherapy for vascular malformations

Vascular work includes:

• Emergency bleeding embolization
• GI bleed embolization
• Genitourinary bleed embolization
• TACE/UAE
• Bronchial artery embolization
• Pre-operative tumor embolization

Ablation procedures include:

• Thyroid ablation
• Liver tumor ablation
• Lung tumor ablation

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Unit 2 – Hepatobiliary & Transplant Interventions

Residents are mostly posted here during the second year.

This unit focuses heavily on liver transplant and hepatobiliary interventions.

Common procedures include:

• TIPS / DIPS
• BRTO / PARTO
• Transplant PTBD
• Portal vein interventions
• Splenic artery procedures
• Hepatic vein outflow interventions
• Transjugular liver biopsy
• HVPG measurements

Oncology interventions include:

• TACE
• TARE

Other vascular procedures include:

• Prostate artery embolization
• Uterine artery embolization
• Many non vascular procedures also done, predominantly post transplant drains and aspirations

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Unit 3 – Neurointerventional Radiology

Residents are predominantly posted here during the third year.

Major procedures include:

• Cerebral aneurysm coiling
• Flow diverter placement
• Mechanical thrombectomy for stroke
• AVM embolization
• Dural AV fistula embolization
• Spinal AVMs and spinal fistula treatment
• Pediatric vascular malformations
• Vein of Galen malformations
• Carotid artery stenting
• Intracranial atherosclerotic disease stenting

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Flexibility Between Units

Even though residents are assigned to specific units, the department maintains flexibility for learning.

If an interesting case is happening in another unit, residents can attend the procedure, provided they finish their responsibilities in their assigned unit.

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Case Spectrum at Max Saket

Neurovascular Interventions

• Mechanical thrombectomy
• Aneurysm coiling
• Flow diversion
• AVM embolization
• Dural AV fistula embolization
• Carotid artery stenting
• Intracranial atherosclerotic disease stenting
• Spinal vascular malformations

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Peripheral Vascular Interventions (Low volume )

Peripheral procedures include:

• Peripheral angioplasty
• Peripheral arterial stenting
• Peripheral thrombectomy
• Peripheral AVM embolization

Residents are also posted for two months at another institute with high peripheral arterial disease (PAD) / Aorta volumes.

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Venous Interventions

Common procedures include:

• Dialysis fistuloplasty
• Central venous angioplasty
• Central venous stenting
• Varicose vein treatments
• Venous malformation embolization

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Hepatobiliary, Renal & GI Interventions

Procedures include:

• PTBD (native and transplant)
• TIPS / DIPS
• Portal vein interventions
• Bleeder embolization
• Splenic artery embolization
• Hepatic artery thrombolysis
• Post-transplant hepatic artery stenting

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Tumor Embolization

Pre-operative embolization procedures include:

• Head and neck tumors
• Juvenile Nasopharyngeal Angiofibroma embolization
• Bone tumor embolization
• Pelvic tumor embolization

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Hands-On Training

Hands-on training in any interventional program can be somewhat subjective, but overall all three units provide good procedural exposure.

In the HOD unit, residents often perform:

• Their first arterial puncture
• Diagnostic angiograms
• Early embolization procedures
• Initial coil placements

This unit builds a strong procedural foundation.

In the hepatobiliary and transplant unit, residents usually:

• Start the case
• Perform arterial puncture
• Take diagnostic angiograms
• Navigate the main catheter and microcatheter

The consultant usually performs the critical step, such as:

• Stent placement
• Plug placement
• Final embolization

In the neurointerventional unit, residents commonly perform:

• Diagnostic cerebral angiography
• Long sheath placement
• Intermediate catheter placement

The amount of hands-on experience largely depends on your rapport with consultants and their confidence in your skills.

From my personal experience, I received good hands-on exposure in all three units, including taking/attempting  the portal vein puncture in two TIPS procedures.

The cath lab team is also extremely supportive:

• Skilled technicians
• Experienced nursing staff

Consultants are usually just outside the cath lab and guide during steps.

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Mentorship and Department Culture

All three consultants are experts in their respective fields and provide consistent mentorship throughout training.

The department culture is very supportive and non-toxic.

Some highlights include:

• Friendly working environment
• Frequent departmental lunches and small celebrations
• Good mentor-resident relationships

Each year the department has:

• 1 DRNB resident
• 1-2 fellows rotating through units

Because of this structure, the workload is well distributed, and residents usually do not experience excessive stress.

Residents are also encouraged to attend and present at national and international conferences.

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Pros of the Program

Wide Case Spectrum

One of the biggest advantages of the program is the broad spectrum of interventions, including:

• Neuro interventions
• Hepatobiliary interventions
• Transplant interventions
• Oncology interventions
• Venous interventions
• Emergency embolizations

The only areas with relatively limited exposure are:

• Peripheral arterial disease
• Aorta–related procedures

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Strong Neurointervention Exposure

Residents spend 8–12 months in the neurointervention unit, which is a major advantage for those interested in neurovascular procedures.

Exposure includes:

• Stroke thrombectomy
• Aneurysm coiling
• Flow diverters
• AVM/AVF embolization
• Carotid artery stenting/ICAD.

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Case-Based Learning

Teaching is mostly case-based rather than lecture-based.

Learning happens through:

• Real patient cases
• Cath lab discussions
• Procedure-based teaching

Occasionally there are interesting case discussions every few weeks or months.

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Work Hours

Work hours depend on the unit you are posted in.

Unit 1 – HOD Unit

9:30 AM – 5:30 / 6 PM

Unit 2 – Hepatobiliary & Transplant Unit

10:30 AM – 7 / 8 PM

Neurointervention Unit

7:30 / 8 AM – 4 / 5 PM

Overall, work-life balance is reasonably maintained for a super-specialty program.

However, because interventional radiology includes emergencies such as:

• Acute bleeding
• Code stroke

it is recommended to stay close to the hospital so you can reach quickly and start emergency procedures until the consultant arrives.

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Final Thoughts

Overall, the DRNB Endovascular and Interventional Radiology program at Max Saket provides broad exposure across neuro, hepatobiliary, transplant, oncologic, and emergency interventions.

With good hands-on opportunities, supportive mentorship, and strong neurointervention exposure, it is a solid training center for residents interested in interventional radiology practice.

Thanks to Cafe Roentgen for giving me this opportunity!

– Dr Naveen Kumar

MBBS, MD, DrNB IR