Which neuro fellowships are the most popular? and why?

[erasable]

Which neuro fellowships are the most popular? and why?

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[OasisMan]

stroke
b/c they are the coolest

 

[TUGM]

Classically, EMG/Neuromuscular and EEG/Epilepsy (or combined Neurophysiology) fellowships have been the most popular, given that they add significant marketability for general neurologists. More recently, acute neurology has gained popularity - stroke and neurocritical care. These fellowships are a little less traditional, given that historically, neurology has been a relatively procedure-scarce field, and the opportunity to perform procedures and participate in acute scenarios really gets some people going.

 

[Postictal Raiden]

I have a feeling that interventional neurology will explode sometime in the near future.

 

[Hank Rearden]

You might be surprised to learn that the NIR field is already fairly saturated. Although more people are going for endovascular with all of the recent positive trials, this still isn't enough work to keep a NIR person going. They still have to coil a lot of aneurysms to make their salary. I think newly trained NIR people are finding it harder and harder to secure jobs in major cities where people are already entrenched.

 

[TUGM]

Neurointervention should never become just about acute stroke treatment - all interventionalists should be trained in the whole gamut of procedures, from stenting to coiling to minimally invasive spinal procedures. The major issue is the number of trainees coming out of random, small programs with inherently low case volumes. These programs need to have their fellowships suspended. Training should occur only at large tertiary care centers w/ adequate case volumes. One can definitely argue that practices should be limited such centers as well. Just my two cents on the topic (I have more cents, but I won't digress from the OP's topic at hand here.)

 

[bustbones26]

Neurointervention should never become just about acute stroke treatment - all interventionalists should be trained in the whole gamut of procedures, from stenting to coiling to minimally invasive spinal procedures. The major issue is the number of trainees coming out of random, small programs with inherently low case volumes. These programs need to have their fellowships suspended. Training should occur only at large tertiary care centers w/ adequate case volumes. One can definitely argue that practices should be limited such centers as well. Just my two cents on the topic (I have more cents, but I won't digress from the OP's topic at hand here.)

I agree! They should intergrate interventional spine into an NIR fellowship. A good number of radiology trained NIR docs are doing this.

 

[TUGM]

I agree! They should intergrate interventional spine into an NIR fellowship. A good number of radiology trained NIR docs are doing this.

The existing interventional spine doctors would spontaneously combust... or start trying to coil aneurysms themselves if this were to be proposed. I think the radiologists are well positioned for this kind of transition of procedure work. I definitely agree with you though, but I'm probably biased given my less-than-subtle enthusiasm for the field. It would be great to get more MIS work too. Right now it seems like NIRs really do vertebroplasty/kyphoplasty, fluoro-guided LPs, myelograms, and the extremely rare spinal angio. I would be super down with receiving extra training in RFAs, spinal stimulator insertion, nerve blocks, and pain procedures though.

From a neurology standpoint, I would like to see NIR include NCC time, some outpatient clinic work, and ability and bill for carotid/TCD studies. Those dual trained in NCC could potentially read and bill for cEEG in the ICU settings, along with other procedural work... I guess sort of like the glory days of icards. It might make for a more sustainable practice model.

 

[Epic786]

What about headache, neuro immunology and sleep medicine fellowships>?

 

[typhoonegator]

What about headache, neuro immunology and sleep medicine fellowships>?

Yes. They exist. They most certainly exist. If you're interested in headache, neuro-immunology, or sleep, they might be good for you. If you are not interested in them, then I would advise against pursuing them.

 

[Epic786]

Thanks! which one have the best private practice potential??

 

[typhoonegator]

Potential for what? Money? Happiness? Volume? Excellent parking?

Well, there are private-pay headache boutique clinics that pay very well. Those are hard to be a part of, and even harder to retain sanity when you give your cell phone number to headache patients. Neuro-immunology is for Jedi masters, and often also covers neuro-infectious disease, which covers a lot of HIV-related neurology. There is great neurology there. People good at neuro-immunology are highly sought but not particularly well reimbursed. Sleep can be lucrative but is dependent on the locale, and there are a lot of non-neurologists who are very good at sleep -- you will compete with them for patients, and I suppose parking as well, depending on the size of your town. The sleep pulmonologists might gobble up all the good parking spots.

Any specialty has potential, depending on the places you're willing to live and the sacrifices you're willing to make. I keep saying this, but CHOOSE SOMETHING YOU ENJOY DOING. If you want to make real money and drive a Ferrari then medicine is not the best choice.

 

[Leo Aquarius]

I'm interested in the fellowship that will give me excellent parking.

 

[OasisMan]

I'm interested in the fellowship that will give me excellent parking.

become a jack of all trades -- be able to perform multiple procedures in the outpt setting

disclaimer: i am in residency

 

[TUGM]

Also, look into purchasing your own parking cone.

 

[NOSfan]

Which neuro fellowships are the most popular? and why?

Thanks! which one have the best private practice potential??

I'd say an Interventional Pain fellowship offers the best of many worlds:

Physician quality of life, practice opportunity, competitive income, potential for patient improvement/satisfaction and opportunity to practice 'cutting edge' technology.

 

[Dharma]

I'd say an Interventional Pain fellowship offers the best of many worlds:

Physician quality of life, practice opportunity, competitive income, potential for patient improvement/satisfaction and opportunity to practice 'cutting edge' technology.

How tough is it for neurologists to land these fellowships? I know there are so-called "neuro friendly" programs out there but competition must be tight relative to gas and PM&R.

 

[michaelrack]

 

[typhoonegator]

Vascular neurologists manage primary and secondary prevention of cerebrovascular disease, including stroke, extracranial and intracranial cerebrovascular disease, and complications of cerebral small vessel disease, including vascular cognitive impairment, intracerebral hemorrhage, and amyloid angiopathy. Their armamentarium includes risk factor modification, medical therapy, blood pressure and lipid target strategies, diagnostic and longitudinal imaging strategies, etc. Vascular neurologists also read and interpret diagnostic cerebrovascular ultrasound-based studies such as TCDs and carotid duplex ultrasounds. They also diagnose and treat acute ischemic stroke.

 

[NOSfan]

How tough is it for neurologists to land these fellowships? I know there are so-called "neuro friendly" programs out there but competition must be tight relative to gas and PM&R.

Pain fellowships, in general, are very competitive nowadays. Largely in-part to what was mentioned in my post.

I would say, as with most fellowship opportunities, show your interest early and if at all possible rotate with the programs that you are targeting, regardless of discipline base. There is a good bit more crossover today than years past. For example, Anesthesia based programs accepting more candidates from non-anesthesia disciplines; however, you must be aware of the still ever present 'politics' involved with various programs.

Fortunately, I trained in an ACGME approved Neurology Pain Fellowship.

Hope this helps....and Good Luck!

 

[neglect]

Potential for what? Money? Happiness? Volume? Excellent parking?

The excellent parking spots go to those who show up earliest, not me.