What are realistic call schedules that can be negotiated as an interventional neurologist (vascular)?

[someqsaboutstuff]

In a past thread I posted, someone mentioned an NIR attending having a 1 week on/2 weeks off call schedule. I was wondering how easy/difficult it is to work out such agreements. Are hospitals very aggressive to give you as much call as possible? Or are most NIRs part of private practices who all have different ways of splitting up call? If one does manage to negotiate an “X on/Y off” schedule, how difficult is it to practice a non-vascular subspecialty during the “Y-off” days?


Are the factors that influence these negotiations the same ones that influence most negotiations for attendings of any specialty (CV, prestige of training, location of practice, size of hospital/patient population, number of other attendings in same specialty), or are there any unique factors in NIR contract negotiations?

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[Aldertonghen]

The guy I know does NIR call plus procedures on his week on, and on his 2 weeks off he does a combo of telestroke, stroke and NIR clinic. He doesn’t do 1 week on 2 week off (like fully off) in the traditional sense- only NCC can do that.

 

[CnsCrit]

1 week on 2 weeks off doesn't really exist in NIR. These attendings are at comprehensive, high volume stroke centers, majority are not in private practice. This means there is a NIR on 24/7, sometimes with multiple cases going at once plus a busy schedule of elective cases - diagnostic angios, elective coilings, venous stenting, whatever. You aren't really going to be practicing in a non-vascular specialty of neurology, it just wouldn't make sense. Your interests would be either stroke, neurosurg, or radiology, so in your non-call time you'll probably be doing clinic or call for one of those fields. As a neurologist you would mostly be seeing stroke cases outside your call, but some do NCC, which is a longer pathway and less directly relevant to IR so it's less common.

Even in NCC, you may have one week on one off, but realistically you likely will do some work in your off time - admin, research or otherwise. An exception would be in a pure non-academic model.

 

[Clean7795]

Realistic ranges between 1 in 2 to 1 in 4 call. The frequency is determined by the number of NIRs, and most places don't have many.

You think you can negotiate call? The reason they're hiring in the first place is probably because they want someone to take more call.

If you do it, you better love it.

 

[ProReduction]

Correlation of Call Burden and Sleep Deprivation with Physician Burnout, Driving Crashes, and Medical Errors among US Neurointerventionalists

BACKGROUND AND PURPOSE: High call frequency can lead to inadequate sleep, fatigue, and burnout, resulting in detrimental effects on physicians and patients. We aimed to assess the correlation between the frequency and burden of neurointerventional surgery calls and sleep deprivation with...

www.ajnr.org

"Correlation of Call Burden and Sleep Deprivation with Physician Burnout, Driving Crashes, and Medical Errors among US Neurointerventionalists"

If you want anything close to a good life as a neuro-proceduralist, do Neurosurgery and go into Functional Neurosurgery. Things are only going to get worse for Endovascular people, whether from NS, Rads, or Neurology. Difference is that NS and Rads can jump ship.