Stroke fellowship without neurointerventional

[buckley]

Hi! I'm a PGY2. One of the faculty asked me what I was thinking of doing after residency, and I told him I was interested in stroke, after which he proceeded to give me a pretty good lecture on how exciting the field of neurointervention is. I told him I was interested in just doing a stroke fellowship sans neurointervention, and the look I got I must say was pretty discouraging. Is it really a bad idea to do that? How *bad* are the hours of endovascular/neurointerventional fellowships? I'm actually very interested in neurorehab---contemplated PMR for residency but decided to do neurology instead.

And for PGY2s out there, is it just me or are you completely lost as well? There are days when I just want to do neurophys, then MS, then epilepsy...One thing that scares me is that I'm not liking the ICU setting so much (at least I didn't like it in prelim medicine year), so I think this is why Im trying to get away from the neurointerventional setting coz then most of my patients will be in the ICU ) But in terms of disease based interest, I really like stroke

Any--how-to-decide-what-to-do-after-residency advices would be most welcomed...I feel my PD thinks I'm directionless here...hahaha

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[typhoonegator]

You've been a neurologist for a month -- no wonder you don't know what you want to do with your life! Seriously, don't sweat it right now. You can't do harm to yourself by keeping an open mind. I'm a neurocritical care fellow, and when I was a PGY-2 I thought I was going into neuro-onc.

Stroke is a great specialty if you know what you are getting into. Put it this way, you'll always have plenty of patients. You will spend a lot of time in clinic doing secondary prevention, and possibly research. If that floats your boat, great! Neuro-IR is a completely different kettle of fish. You're in the hospital a lot, and are on call a lot. We call the neuro-IR fellow every time there is an acute stroke that might need angio, and they have to come in even if it is low-prob. Now, the people who do it love it, but if you're not sold on it, you could be in for a rough time. All of their patients end up in the ICU, and many of their daytime cases come from the ICU for vasospasm or coiling. So if you don't like the ICU, neuro-IR might be rough.

 

[aaddnl]

dont worry about what that attending said or the other people on here, you dont need to do neurointerventional to do stroke. in fact, most people dont, they usually do just stroke or just neuro-interventional. it is normal as you are learning the different areas of neurology to be undecided about your career path. you could think about doing a stroke fellowship, if you want to do more general neuro think neurophys. movement, ms, neuromuscular are good too.

 

[buckley]

Thanks guys
I know...i was surprised by the barrage of what-do-i-do-next questions when I have not even finished unpacking! But he did say that fellowship applications are next year and that he would want to support me so I think he was just asking for a direction, which I unfortunately suddenly do not have. Thanks for the inputs...I am keeping an open mind. I have every respect for critical care fellows out there. When I say i don't like the ICU environment, it's more of a personal preference. I just didn't like putting those intraarterial lines