Neurointervention fellowship

[deathmerchant]

I was just wondering, whats the better way of goin into Intervention- through Vascular neuro or through NCC.
And better as in, 'better trained for it' and 'ease of getting it'.. ?

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[TUGM]

It's based on what you are most interested in. There is some overlap between the two subspecialties. Vascular neurology will make you a cerebrovascular disease specialist in the inpatient and outpatient setting. You will inevitably get training in pertinent imaging modalities. Also, at some places, the fellowship in vascular neurology is designed as a bridge into neurointervention.

NCC focuses solely on the inpatient treatment of acute neurological disorders, not only severe strokes, but also things like MG, GBS, TBI, TSI, coma, etc etc. You have much more internal medicine exposure, and develop more procedural skills. Anecdotally, some radiology and neurosurgery-run NIR departments prefer NCC applicants simply because they feel that it is more rigorous lifestyle/stress wise.

I doubt it makes too much of a difference, so if you're interested in one over the other, you could pursue that. Vascular neurology is 1 year. NCC is 2 years, though technically speaking, the ACGME requirements state that you only need training of 1 year in NCC prior to intervention - I think you would be hard-pressed to find fellowships which allowed you leave your NCC duties early though.

 

[typhoonegator]

NIR fellowship has a lot to do with who you know and who they know. I know several people who have done stroke and NIR, and several who have done NCC and NIR. A few of the NCC people still do some NCC in addition to the NIR, but the stroke people I know are all serving NIR needs alone, mostly because of billable time issues. NCC is clearly the more hardcore option and may impress some people more, but that isn't universal. I couldn't imagine going through a grueling 2 year fellowship in NCC and then basically not using those skills thereafter. Placing central lines isn't going to make you that much better at groin sticks, and certainly will not improve your skills at driving a catheter. And having a nuanced appreciation for managing cerebral salt wasting after SAH is not something that's going to come up when you're coiling vascular malformations and doing diagnostic after diagnostic after diagnostic. So I would talk to some of the NIR programs you like, and get their feel for what they most want to see in their applicants. These opinions aren't universal, and if you can get away with a 1 year stroke fellowship, you'll definitely have more gas in the tank for a pretty rough NIR fellowship experience.

 

[deathmerchant]

Thanks, that's what I thought. Although, I'm getting the feel that NCC people would have a slight edge over stroke . I think I'm more confused because subconsciously I don't want to leave all of the amazing neurology that I've learnt and learning and consider myself good at. And tbh stroke people do get stuck to only seeing stroke patients, which i fear could get monotonous.
Another question: Can and do NCC people see inpatient stroke patients, as Primary??

 

[typhoonegator]

Are you asking if NCC trained physicians can rotate as attending of the stroke service? That depends more on the hospital and your level of training than anything else. NCC people aren't trained in secondary prevention strategies the same way as vascular neurologists. Also, if you are going to be on service for a given week, why would you not take the critical care billing if you could?

 

[TUGM]

I see neurohospitalist jobs that want either stroke or NCC trained physicians, so maybe in that sense you can be "primary"

 

[thepretender67]

do you think neurointerventional is a good fellowship for someone that considered neurosurgery but decided on neurology for various reasons?

What type of neurologists generally apply for interventional? Is there a common thread among them?

 

[typhoonegator]

Uh, what were the "various reasons"?

And it's not like they're all redheads or something. They tend to be hands-on people who don't mind being in the hospital a lot, standing in one place, wearing a lot of lead. They live life at systolic pressure.