Lifestyle of an interventional neurologist?

[RA1998]

Not that it would be the moment now, seeing that i'm just a med student who did not even get yet into a neurology residency program, but I was quite stunned to find out that there is a fellowship in neurology (you need to pursue more fellowships for this actually, lol), which comes to the "dark side", together with neurosurgeons, interventional cards and all the other specialities with huge compensations and very, very, I mean very awful lifestyle.

"Dude, you keep blithely stumbling over the right answer and not recognizing it. No one is keeping neurologists out of this business. If you do a neurology residency and want to do an interventional fellowship, you can sign right up. You’ll find work easily and be well-paid. But neurologists overwhelmingly don't want to. They became neurologists for many reasons, but leading reasons for a lot of them were A) not liking procedures and B) wanting a job with relatively fewer emergency calls. People nowadays commonly go into cardiology because they like procedures, pressure, and 2am STEMI pages, it’s a crummy analogy to choosing a neurology residency. Neurologists overwhelmingly are not interested in being stroke interventionalists. Hell, most of them aren’t even interested in being stroke neurologists. Neurosurgeons are well-positioned to dominate this field since we already have neurologic care expertise and don’t mind emergent 2am procedures, but there’s not really some secret neurosurgery cabal conspiring to shut down interventional neurology fellowship. The neurologists self-select and very few of them want to do this."- a neurosurgeon responding to a neurologist, I think, interested in pursuing interventional pathway.

What is your opinion about this sub-speciality? Do you know any interventional neurologists? Is it very hard to get in these fellowships as a neurologist, sharing the pie with radiologists and neurosurgeons who seem to dominate? Hell, is it worthy to do a 4 years neurology residency + 2 years vascular neurology + 2 years interventional? This kind of training is comparable in length and masochism with neurosurgery, lol. If you know some, are they still human? Not asking about compensation, less relevant seeing the other variables in the equation. Thanks in advance for your answers!

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[deathmerchant]

Not that it would be the moment now, seeing that i'm just a med student who did not even get yet into a neurology residency program, but I was quite stunned to find out that there is a fellowship in neurology (you need to pursue more fellowships for this actually, lol), which comes to the "dark side", together with neurosurgeons, interventional cards and all the other specialities with huge compensations and very, very, I mean very awful lifestyle.

"Dude, you keep blithely stumbling over the right answer and not recognizing it. No one is keeping neurologists out of this business. If you do a neurology residency and want to do an interventional fellowship, you can sign right up. You’ll find work easily and be well-paid. But neurologists overwhelmingly don't want to. They became neurologists for many reasons, but leading reasons for a lot of them were A) not liking procedures and B) wanting a job with relatively fewer emergency calls. People nowadays commonly go into cardiology because they like procedures, pressure, and 2am STEMI pages, it’s a crummy analogy to choosing a neurology residency. Neurologists overwhelmingly are not interested in being stroke interventionalists. Hell, most of them aren’t even interested in being stroke neurologists. Neurosurgeons are well-positioned to dominate this field since we already have neurologic care expertise and don’t mind emergent 2am procedures, but there’s not really some secret neurosurgery cabal conspiring to shut down interventional neurology fellowship. The neurologists self-select and very few of them want to do this."- a neurosurgeon responding to a neurologist, I think, interested in pursuing interventional pathway.

What is your opinion about this sub-speciality? Do you know any interventional neurologists? Is it very hard to get in these fellowships as a neurologist, sharing the pie with radiologists and neurosurgeons who seem to dominate? Hell, is it worthy to do a 4 years neurology residency + 2 years vascular neurology + 2 years interventional? This kind of training is comparable in length and masochism with neurosurgery, lol. If you know some, are they still human? Not asking about compensation, less relevant seeing the other variables in the equation. Thanks in advance for your answers!

I know several Interventional Neuro guys coming from Neuro background. Its definitely harder than getting into other fellowships but not that hard. Its just that these spots are less. Yes NES and IR are more dominant in this field but the number of neurologists is increasing and there is a good number of Neuro who are interested in this. The length of training is not that crazy if you consider medicine as a whole. Most people spend 5-7 years to subspecialize anyway. This one is 7 or 8 years total.
You are not super busy overall, but you are on-call way more often and have to be ready anytime of the day or night to go in.

 

[NDcienporciento100]

Neurologist can break into this field no problem! There is not enough volume at most places for example 3-4 neurosurgeons to do everything. That would be rare. Usually there is one neurosurgeon sharing call with one other neurosurgeon plus a radiologist and or neurologist. I will just say that it’s probably a little easier of a transition for a radiologist especially an IR or neurosurgeon. IR works with microcatheters all over the body performing procedures and our time spent on DR reading neuro makes us very good with anatomy. Neurosurgeons know this space intimately and they are natural proceduralist. Neurologist understand the patient clinically more then anyone and that’s important. You will here trash talk from each specialty saying why the other specialty’s sucks etc. The reality is that anything can be learned and all three bring something unique to the table. Good luck!

 

[NDcienporciento100]

Endovascular (be it in the brain or in some tibial artery) has been plagued by turf wars. Peripheral arterial disease was almost exclusively pioneered by interventional radiology. Even today new endovascular technology for the treatment of pad is mostly advanced by IR and IC. IR and IC really pushed the boundaries of what can be done endo. Usually in the PAD world vascular surgery shows up late to the game and learns. I’m not a hater of vascular surgery it’s just true. The vast majority of vascular surgeons still do not complex tibial work for example. I’m sure with time more of them will. Again showing up late to the game. Neuroendovascular is not like that. It really has been a shared venture between three specialty’s. The first commercial coil was from a neurosurgeon. The first flow diverter was from a radiologist. Cerebral angiography was actually first done by a neurologist. It’s a great collaboration!

 

[curiousneuro]

Not that it would be the moment now, seeing that i'm just a med student who did not even get yet into a neurology residency program, but I was quite stunned to find out that there is a fellowship in neurology (you need to pursue more fellowships for this actually, lol), which comes to the "dark side", together with neurosurgeons, interventional cards and all the other specialities with huge compensations and very, very, I mean very awful lifestyle.

"Dude, you keep blithely stumbling over the right answer and not recognizing it. No one is keeping neurologists out of this business. If you do a neurology residency and want to do an interventional fellowship, you can sign right up. You’ll find work easily and be well-paid. But neurologists overwhelmingly don't want to. They became neurologists for many reasons, but leading reasons for a lot of them were A) not liking procedures and B) wanting a job with relatively fewer emergency calls. People nowadays commonly go into cardiology because they like procedures, pressure, and 2am STEMI pages, it’s a crummy analogy to choosing a neurology residency. Neurologists overwhelmingly are not interested in being stroke interventionalists. Hell, most of them aren’t even interested in being stroke neurologists. Neurosurgeons are well-positioned to dominate this field since we already have neurologic care expertise and don’t mind emergent 2am procedures, but there’s not really some secret neurosurgery cabal conspiring to shut down interventional neurology fellowship. The neurologists self-select and very few of them want to do this."- a neurosurgeon responding to a neurologist, I think, interested in pursuing interventional pathway.

What is your opinion about this sub-speciality? Do you know any interventional neurologists? Is it very hard to get in these fellowships as a neurologist, sharing the pie with radiologists and neurosurgeons who seem to dominate? Hell, is it worthy to do a 4 years neurology residency + 2 years vascular neurology + 2 years interventional? This kind of training is comparable in length and masochism with neurosurgery, lol. If you know some, are they still human? Not asking about compensation, less relevant seeing the other variables in the equation. Thanks in advance for your answers!

As someone initially interested in NIR, I learned quickly that the lifestyle, to be honest, is pretty brutal. Unlike other interventional fields, NIR for a neurologist usually means mostly endovascular therapy for stroke, for which you need to be available and need to come in to the hospital at any time day/night. You would be sharing call and probably be on call anywhere from q2-4. However, if you love it, you can definitely get into it from neurology, just might take a little more work than from rads/neurosurg.