Neuro Hospitalist

[Telamir]

Hello, I'm a Neuro PGY-3, wondering about hospitalist jobs. While I like clinic, there's a lot of non-sults (chronic pain, fibro, dizzy chronic pain, memory probs w/ narcs, SOB R/O MG, etc) which as prompted me to pursue more of an inpatient job.

While I've considered some fellowships such as epilepsy, I find myself more attracted to the 7 on 7 off schedule, and hospitalists seem to be in decent demand with pretty good pay. I've been toying with the idea of doing a cerebrovascular fellowship vs just going directly into practice. In you guys' opinion, would the extra year of CV add much in terms of inpt based jobs? Would it add significantly to compensation?

Also, is it common for you to have an inpt service, or be more of a consultant?

---

Members don't see this ad.

 

[maddog2020]

Neurohospitalist is a hot job right now. Lots of demand for these and you are correct - they can demand a very good salary.
My opinion - a good portion of the hospitalist work is neurovascular (stroke) so a year of stroke fellowship would be very useful and would also make you more competitive. If a hospital wants to maintain JCAHO comprehensive stroke certification status, they have to have a few board-certified stroke neurologists. If you are board certified in stroke AND a hospitalist, you will have many opportunities for jobs and demand higher compensation. Good luck

By the way, there are several different models for neurohospitalists. At our place, we have a hospitalist that comes to work every day monday through friday (like a 7-5pm job) and then other people cover the nights and weekends. There are other models where the hospitalists works 7 or 14 days straight (including nights and weekends) and then has 1-2 weeks essentially on vacation.

 

[bustbones26]

Hello, I'm a Neuro PGY-3, wondering about hospitalist jobs. While I like clinic, there's a lot of non-sults (chronic pain, fibro, dizzy chronic pain, memory probs w/ narcs, SOB R/O MG, etc) which as prompted me to pursue more of an inpatient job.

While I've considered some fellowships such as epilepsy, I find myself more attracted to the 7 on 7 off schedule, and hospitalists seem to be in decent demand with pretty good pay. I've been toying with the idea of doing a cerebrovascular fellowship vs just going directly into practice. In you guys' opinion, would the extra year of CV add much in terms of inpt based jobs? Would it add significantly to compensation?

Also, is it common for you to have an inpt service, or be more of a consultant?

As I sit here and look at my inpatient consult list, I would enlighten you that the majority of my inpatient consults are also non-sults. Sorry, chronic pain, fibro, dizzy, etc. etc. all end up in the hospital for stroke/TIA rule outs. At my current hospital, they just end up readmitted all of the time with numerous repeat "stroke" work ups.

So while you may see those patients in status epilepticus, "real" strokes, etc. etc. You get hit with all of the BS on the hospital side as well.

 

[cerebral edema]

Hello, I'm a Neuro PGY-3, wondering about hospitalist jobs. While I like clinic, there's a lot of non-sults (chronic pain, fibro, dizzy chronic pain, memory probs w/ narcs, SOB R/O MG, etc) which as prompted me to pursue more of an inpatient job.

While I've considered some fellowships such as epilepsy, I find myself more attracted to the 7 on 7 off schedule, and hospitalists seem to be in decent demand with pretty good pay. I've been toying with the idea of doing a cerebrovascular fellowship vs just going directly into practice. In you guys' opinion, would the extra year of CV add much in terms of inpt based jobs? Would it add significantly to compensation?

Also, is it common for you to have an inpt service, or be more of a consultant?

Im in the same boat. Planning on vascular fellowship. Absolutely hate clinic.

 

[cerebral edema]

As I sit here and look at my inpatient consult list, I would enlighten you that the majority of my inpatient consults are also non-sults. Sorry, chronic pain, fibro, dizzy, etc. etc. all end up in the hospital for stroke/TIA rule outs. At my current hospital, they just end up readmitted all of the time with numerous repeat "stroke" work ups.

So while you may see those patients in status epilepticus, "real" strokes, etc. etc. You get hit with all of the BS on the hospital side as well.

Those people dont get admitted to my facility.

 

[Telamir]

We do get non-sults in the hospital as well. I just prefer them to the clinic. A hospital non-sult tends to be a one and done, with a clinic followup if necessary. Clinic non-sults tend to call, and some people adopt you as their "primary" as it were. I think you sort of have an out as a hospitalist in that regard.

I've been considering the CV fellowship. I can see how it adds to employment opportunities. Our hospital is a big stroke center, so we're pretty comfortable with stroke management as a whole, but still something to consider. I'd say it definitely adds something in complex stroke cases, or AVMs, aneurysms, etc.

Unfortunately, I can't do an outpt CV elective this year, so I'd be applying blind in that respect. I'm also thinking about lifestyle (there's a 75 y/o attending in my institution taking telemed at 2am, etc) which can be more complicated as vascular.

Thanks for the replies!

 

[Preictal]

Bump.

I may start searching for a 7-on 7-off neurohospitalist position, but I want to make sure I'm not setting myself up for burnout. What would a sensible, sustainable schedule/typical day look like? For example, would spending 7am to 4pm taking/seeing new consults and rounding in the hospital before heading home and taking call be reasonable? Any patient caps or other relevant issues I should consider or pay close attention to in a neurohospitalist contract?

Also, is it common for neurohospitalists to also have a clinic, and if so, how is it usually incorporated into the week?

I would appreciate any input from anyone able to answer. Thanks in advance.

 

[Telamir]

Well, this is funny.

I finished my residency/fellowship in June of 2018 and I'm currently a neurohospitalist with an academic affiliation at the local med school and teach med students/residents.

I do 1 week on 1 week off 12 hour shifts. Depending on jobs you can find one where you do discrete day and night shifts. I'd imagine if a place is busy enough or your get consulted enough that 7 on 7 off 24/7 would be pretty intense/burnout inducing.

I think neurology by the nature of the specialty can't cap. You can't divert strokes cause you're capped, and people won't stop seizing/consults won't stop coming. That being said one of the biggest QOL aspects is to be a consult only service.

I have no clinic.

 

[HueySmith]

Well, this is funny.

I finished my residency/fellowship in June of 2018 and I'm currently a neurohospitalist with an academic affiliation at the local med school and teach med students/residents.

I do 1 week on 1 week off 12 hour shifts. Depending on jobs you can find one where you do discrete day and night shifts. I'd imagine if a place is busy enough or your get consulted enough that 7 on 7 off 24/7 would be pretty intense/burnout inducing.

I think neurology by the nature of the specialty can't cap. You can't divert strokes cause you're capped, and people won't stop seizing/consults won't stop coming. That being said one of the biggest QOL aspects is to be a consult only service.

I have no clinic.

Could you comment on the current job markets for neurohospitalists?

 

[Preictal]

Well, this is funny.

I finished my residency/fellowship in June of 2018 and I'm currently a neurohospitalist with an academic affiliation at the local med school and teach med students/residents.

I do 1 week on 1 week off 12 hour shifts. Depending on jobs you can find one where you do discrete day and night shifts. I'd imagine if a place is busy enough or your get consulted enough that 7 on 7 off 24/7 would be pretty intense/burnout inducing.

I think neurology by the nature of the specialty can't cap. You can't divert strokes cause you're capped, and people won't stop seizing/consults won't stop coming. That being said one of the biggest QOL aspects is to be a consult only service.

I have no clinic.

Thanks for the reply. I wouldn't have thought to consider a cap but it was mentioned by a recruiter for one job. Perhaps that only applied to "elective" consults.

 

[deathmerchant]

There is definitely variability in how busy you will be. Someone in a previous thread had mentioned doing 110 hr weeks; while many others were working only few hours a day.
I think the most important thing you can find out during your interview- either from your co-attendings or from staff is if you have to stay for fixed hours or can you do your work and leave and take call from home. Also do you have to come in to ER for tpa, code strokes etc.
That was what I did and I just round from 3 hours in the day and then I'm home. Also as mentioned above, the other most important thing would be consult only vs primary.

Clinic is not common with a hospitalist sched, but it does happen. In fact I am starting to do clinic few half days( 1-4) a week during my ON week, just to see inpatient f/u (and usually only legitimate neuro stuff) hoping that i won't have to deal with many nonsults.

 

[deathmerchant]

Could you comment on the current job markets for neurohospitalists?

Checkout the previous thread " Neurology Compensation"

Neurology compensation