Would an interventional neurologist or anybody pursuing INR care to comment on their experience?

[LuccaDO]

As an OMS-IV seriously looking at neurology I find the possibility of doing INR as a neurologist fascinating; it is an emerging field with several ongoing studies as to its efficacy. Having the mentally stimulating background in electrophysiology/EEG and training in treating diseases in which our current development in understanding is at the frontier of medicine coupled with the responsibility to perform some of the most highly intense and possibly acute (ischemia MCA stroke indication?) procedures seems like an excellent career route and combination of knowledge and skills.

There have been ongoing conversations regarding INR in these forums for 10-12 years now and from the searching in INR fellowship programs that I have done, most require: 4 years neuro + 1 year vascular/stroke fellowship + 2 years of INR (in some cases the first year is the "junior"/introductory year which is not ACGME accredited, with the second year being the "senior," accredited year. Forgive me if I sound naive about this whole process and/or field.

I was wondering if we had any SDN neuro residents/fellows/INRs out there pursuing/in the field or anyone who knows someone who is that could comment on their experience so far? Has the long process been worthwhile? What are some of the challenges you have faced? Did you find yourself well prepared after doing 5 years of postgraduate training to jump into intervention? Is there any advice you could offer a 4th year medical student?

Thank you!

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[Cpt.Zissou]

As an OMS-IV seriously looking at neurology I find the possibility of doing INR as a neurologist fascinating; it is an emerging field with several ongoing studies as to its efficacy. Having the mentally stimulating background in electrophysiology/EEG and training in treating diseases in which our current development in understanding is at the frontier of medicine coupled with the responsibility to perform some of the most highly intense and possibly acute (ischemia MCA stroke indication?) procedures seems like an excellent career route and combination of knowledge and skills.

There have been ongoing conversations regarding INR in these forums for 10-12 years now and from the searching in INR fellowship programs that I have done, most require: 4 years neuro + 1 year vascular/stroke fellowship + 2 years of INR (in some cases the first year is the "junior"/introductory year which is not ACGME accredited, with the second year being the "senior," accredited year. Forgive me if I sound naive about this whole process and/or field.

I was wondering if we had any SDN neuro residents/fellows/INRs out there pursuing/in the field or anyone who knows someone who is that could comment on their experience so far? Has the long process been worthwhile? What are some of the challenges you have faced? Did you find yourself well prepared after doing 5 years of postgraduate training to jump into intervention? Is there any advice you could offer a 4th year medical student?

Thank you!

Bump

 

[TUGM]

Disclosure: I'm a PGY-2 with the intention of pursuing NIR, at a busy academic program w/ busy NIR practice.

The pathway for neurologists is still an uphill battle. The radiologists tend to think neurologists have less experience with catheter work, imaging, and anatomy and the surgeons tend to think we lack the technical skills and so we still tend to get discounted. Although there are many NIR programs that accept neurologists, neurosurgeons seem to be the favorite picks applicants-wise.

The pathway to NIR is long - 7-9 years - regardless if you are a neurosurgeon, a neurologist, or a radiologist.

You will not be practicing electrophysiology and doing NIR at the same time, and if you are, that means you do not have a high enough NIR volume to really practice NIR and keep your skills sharp. Do not go into NIR to do purely acute stroke interventions. You will not have enough volume.

From what I understand, job market is saturated. Hours are long, calls are brutal. Whether or not it's "worth it" depends on your mindset and goals.

The few neurology trained NIR fellows/new attendings that I have spoken to seem very well trained.

Advice: If you want to pursue endovascular through neurology residency, you will have an uphill battle. Go to a neurology residency with prominent faculty, excel in your neurology rotations, do elective time in endovascular and neurosurgery, publish, publish, publish, and get recognized by prominent faculty. It becomes all about who you know for fellowship.

All this has been discussed before. Forum search.

 

[kchan99]

There are a couple of neurology trained NIR staff at my program. All of them did stroke fellowships before their interventional fellowships. When they're not doing endovascular procedures, they're running the busy stroke service or seeing patients in the stroke clinic. They don't do EEGs or EMGs. In fact, many neurologists, like your average stroke neurologist, don't do EEGs or EMGs.

There are neurointensivists who are interested in EEG monitoring. A colleague of mine did an epilepsy fellowship followed by a neurocritical fellowship.