Did anyone go into Interventional Neurology? I had some questions.

[Ataraxy]

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I had some questions about interventional neurology and would love if someone can help me out.

1) What are the different pathways towards it and how long does it take after the normal 3-year neurology residency?
2) What is the average pay and work hours?
3) How is the job security? I heard from a student that pathways to interventional neurology were closing and that nsurg and IR were breaching into the normal workload.
4) How is the job satisfaction? Any resentments you had or limitations of the field?

 

[DrStephenStrange]

First of all, Neurology residency is 4 years. I'm only a PGY-1, but from what I understand the pathway from Neurology is usually 4 years of Neurology residency followed by 1-2 year(s) Stroke/vascular fellowship, then interventional Neurology. It's usually hard to get it without the stroke fellowship due to Neurosurgery residents also competing for those same spots.

Edit: Your post would probably get more traction if it was posted in the Neurology sub-forum.

 

[mrbreakfast]

You need to have completed either a stroke fellowship (1 year) or (rarely) a neuro-critical care fellowship (2 years) to be eligible for endovascular and neuro-interventional fellowship (2 years), so total training after residency is going to be 3-4 years minimum.

Neurosurgery and interventional radiology already do a lot in the field. I'm not an interventionalist but it's my understanding most places are going to hire you because you can do neuro-interventional in addition to your "normal duties." A interventional-trained neurosurgeon is still going to do neurosurgical cases; an interventional-trained IR doc is going to do other procedures; an interventional-trained stroke neurologist is going to handle inpatient consults, take tele-stroke, or attend (in academic centers), etc.

 

[Ataraxy]

First of all, Neurology residency is 4 years. I'm only a PGY-1, but from what I understand the pathway from Neurology is usually 4 years of Neurology residency followed by 1-2 year(s) Stroke/vascular fellowship, then interventional Neurology. It's usually hard to get it without the stroke fellowship due to Neurosurgery residents also competing for those same spots.

Edit: Your post would probably get more traction if it was posted in the Neurology sub-forum.

Thank you for the answer and for laying out the pathway and clarifying on the residency length. Thanks for the tip on taking a stroke fellowship.

I made a post in the neurology forum at the same time as this one and got only one reply, but it was a good one. Here it is below for anyone who was interested:

My current understanding:

1) Neurology, radiology, or neurosurgery. After neurology residency, you need to do either stroke (1 yr), or Neurocritical care (2 years) before doing the 2 year interventional neurology fellowship.
2) For stroke-NIR: 350-400k starting for academia, 600k+ for private practice in a decent area, I know a guy who makes 1.2m (3 years out) but lives in a smaller city in Arkansas and has call every other day. For NCC-NIR, pay is higher by around 50-100k for both as NCC bills more than stroke and you spend significant time in your other specialty.

Work hours is around 60-70/ week, but a 3 hour emergency procedure at 2am imo isn’t really comparable to an elective 9am 3 hour surgery.
3) NIR is now more open to neurology than ever before. 15% of NIR program directors have a neurology background (Analysis of Demographic and Educational Backgrounds of Interventional Neuroradiology Fellowship Program Director Workforce in North America), which is small but significant. It’s still super hard but not as hard as before.
4) can’t say because I’m a resident

 

[Ataraxy]

You need to have completed either a stroke fellowship (1 year) or (rarely) a neuro-critical care fellowship (2 years) to be eligible for endovascular and neuro-interventional fellowship (2 years), so total training after residency is going to be 3-4 years minimum.

Neurosurgery and interventional radiology already do a lot in the field. I'm not an interventionalist but it's my understanding most places are going to hire you because you can do neuro-interventional in addition to your "normal duties." A interventional-trained neurosurgeon is still going to do neurosurgical cases; an interventional-trained IR doc is going to do other procedures; an interventional-trained stroke neurologist is going to handle inpatient consults, take tele-stroke, or attend (in academic centers), etc.

Thanks for the reply! It looks like the total post-graduate training ends up being just as long as neurosurgery with comparable pay.

 

[Aldertonghen]

Thanks for the reply! It looks like the total post-graduate training ends up being just as long as neurosurgery with comparable pay.

The pay will be less than NSGY, because neither stroke nor NCC make as much as general NSGY. NCC-NIR make about as much as a radiologist trained NIR though, while Stroke-NIR makes a bit lesser than that.

If you’re interested in NIR, pick a residency where neurology controls the NIR dept. A program like UPMC is ideal.