Contemplating going straight neurohospitalist after residency vs a NH fellowship. Need advice.

[tPA Doc]

Contemplating going straight neurohospitalist after residency vs a NH fellowship. Need advice.

I come from a VERY stroke heavy program, so a stroke fellowship honestly was something I considered and started applying then withdrew from the match as I had so many NH offers that did not require it and I'm not joking when I say my residency was >85% stroke (my clinic was even more just stroke follow ups). My program is not that "famous/fancy" if you will and I am not sure i feel as comfortable with some of the everyday stuff ironically. I am debating a neurohospitalist fellowship for two reasons. First to give me more exposure to the stuff I know I missed during residency and two, the name attached with it.

I am looking for midwest or programs in the south (ie TX) and I do NOT want to work for a private group (for a number of reasons). I am also curious to those who completed a NH fellowship vs those that did not and work in NH roles what their take home is base + any additional incentives?

Of note, I do not ever plan on doing any outpatient.

My ultimate goal is not academics. I want to be financially independent.

I'd love input from the community. Thank you.

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[Postictal Raiden]

I never recommend a NH fellowship. In fact I feel the existence of such a fellowship is an insult to our core neurology residency training. However, you feel you didn’t get sufficient exposure to other neurological emergencies (MG, MS exac, status epilepticus, encephalitis, NMS, acute dystonia, etc), then perhaps doing a fellowship is necessary.

Instead of NH fellowship, I’d recommend doing a stroke fellowship to augment your strong stroke exposure and provide you with the credentialing necessary to become a stroke director.

Alternatively, a fellowship in a mixed CNP fellowship (50/50 eeg/EMG) would provide you with extra skill set and even knowledge in diagnosing and, to a lesser extent, treating NM and epilepsy disorders.

 

[tPA Doc]

I never recommend a NH fellowship. In fact I feel the existence of such a fellowship is an insult to our core neurology residency training. However, you feel you didn’t get sufficient exposure to other neurological emergencies (MG, MS exac, status epilepticus, encephalitis, NMS, acute dystonia, etc), then perhaps doing a fellowship is necessary.

Instead of NH fellowship, I’d recommend doing a stroke fellowship to augment your strong stroke exposure and provide you with the credentialing necessary to become a stroke director.

Alternatively, a fellowship in a mixed CNP fellowship (50/50 eeg/EMG) would provide you with extra skill set and even knowledge in diagnosing and, to a lesser extent, treating NM and epilepsy disorders.

I'm curious about the "prestige" of a big name program when I apply for jobs in the future or later in life. I should have mentioned I have no interest in ever doing any outpatient, so an EEG fellowship cold be useful only for reading EEG inpatient or for doing remote locums reading routines. What are your thoughts?

 

[sharkbaitwhohaha]

Do not do neurohospitalist fellowship. Its insulting and they (hospital administrators/others) are trying to milk the most out of training. This is what is happening in pediatrics and should be boycotted extensively from neurology residents. (boycott by not doing them)

 

[tPA Doc]

Can anyone who completed a NH fellowship comment on what they gained?

 

[sharkbaitwhohaha]

They probably gained a chip on their shoulder for wasting time doing a pointless fellowship to miss out on 300K

 

[xenotype]

I'm curious about the "prestige" of a big name program when I apply for jobs in the future or later in life. I should have mentioned I have no interest in ever doing any outpatient, so an EEG fellowship cold be useful only for reading EEG inpatient or for doing remote locums reading routines. What are your thoughts?

Neurophys/epilepsy fellowships are great for comfort and competence with continuous EEG and the EMU, and of course your routine EEG reads will be better. They aren't strictly necessary for neurohospitalist jobs. I would do it if you enjoy reading EEG. If not, skip. In fact, the main reason anyone should do a fellowship in anything in neurology is because they enjoy it and want to learn more. Overall you sound like someone that is ready to go straight out into a job and there is no problem with that especially if you did a stroke heavy program. You can always reach out to seniors/prior attendings/classmates you trust when complex questions come up- this is expected realistically the first 5 years as attending.