Better route to INR fellowship and the new residency format

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I'm interested in neurointerventional and had a couple of questions. What's the better path for INR training, to do first IR then INR, or first diagnostic neuro then INR? I was just thinking that considering the technical and clinical skills you need for INR, a year of IR would be more helpful.

Also, I was wondering how fellowships will adapt to the new residency format where you can pretty much do whatever you want during the last year of residency. So let's say you spend that whole year doing INR or IR at your home program, will that decrease the duration of INR fellowship from 2 to 1 year?

I'd appreciate any comments from the more experienced residents/fellows/attendings.

I think that if you were to do INR, that I would try to integrate itduring residency. That would mean doing a total of 16 months of neurotraining during the 4 years of residency. I have one resident interested in INR and he will do a month of stroke neuorlogy in internship and then I will allow him to do 2 months of neuro each year (be it neuro-interventional/neuroradiology/neurosurgery/or neurology etc). Then the final year the resident can get 10 months of dedicated neurosciences (imaging/interventions) and then I would encourage them to do a 2 or 3 year neurointerventional fellowship with a lot of clinical and technical exposure. This will allow one to be quite competent to see patients in the office, follow them longitudinally and deal with the management of those patients in the unit and the floor.

I think you should do residency, neuro fellowship + INR tacked on at the end. I think that year of diagnostic neuro will help you in the long run. If you are very hands on trying to get in on as many INR cases as a resident, you will go far.

Originally Posted by phatfarm

I think you should do residency, neuro fellowship + INR tacked on at the end. I think that year of diagnostic neuro will help you in the long run. If you are very hands on trying to get in on as many INR cases as a resident, you will go far.

Currently most INR programs require a neurodiagnostic year followed by clinical and procedural training of 1-2 years. The combination is highly variable and depends on the program. There are some programs that start with IR followed by INR, but they are the exception to the rule. The ability to integrate additional clinical training and hands on INR and even IR training in residency, though, is definitely important to getting the most out of fellowship and being able to interact with and collaborate with like minded doctors from neuro and NSGY.