Neurologists can certainly enter ENS fellowships. There was an editorial on the training guidelines that only specified neurosurgeons and neuroradiologists (for political turf war reasons) but the guidelines clearly allow neurologists as well. I've had this confirmed by interventional neuroradiologists who sit on the boards deciding this stuff.
I should mention that ACGME-approved ENS fellowships are rare. Many of the current interventional neuroradiology and endovascular neurosurgery fellowships are attempting to get ACGME accreditation.
Neurologists have been training in interventional neurology, but unfortunately the future of this continuing (and growing) is very uncertain at present. Almost all INR/ENS fellowships (except 3 that I know of) are run by radiologists or neurosurgeons only. So unless you are one of 3 lucky fellows, you will have to convince a neuroradiologist or a neurosurgeon that you are as good or better as a neurologist to enter the field. This is obviously not very easy, and is only possible today because neuroradiology is very lucrative with many less hours without the interventions, and neurosurgeons simply don't want to tack on the extra 2 years of training. So often, a few extra spots every year are available (typically in radiology run programs) that will accept neurologists (typically those trained in vascular AND neurointensive care).
For us potential interventional neurologists, this poses a problem since getting a spot depends highly on whether neuroradiologists and neurosurgeons will continue to stay away from the field or not. The only way to provide some resilience against this is for neurologists to start their own programs (and a few will over the next several years, but probably not many).
If you are extremely interested in interventional neurology, I would recommend considering neurosurgery first. It essentially gaurantees you a fellowship in this field, provides sufficient radiological and neurointensive care training, and allows you to handle some of your cases surgically if necessary. However, if you don't want to spend 4/7 neurosurgery years doing spine cases while your wife (if you had time to get married) is threatening a divorce, spend 9 years as a resident, and are more interested in stroke than aneurysms, then do neurology. Most neuroradiologists have recommended to do neurology instead (!) to get the clinical training and avoid turf wars in the future. If you really want INR as a neurologist, you will be able to find a fellowship spot somewhere (though unlikely in or near a city of preference...) The best option is really to do neurology and radiology, and this might be the option that I will personally take (my wife politely asked me not to do neurosurgery...) But then be ready for a minimum of 10 years as a resident.
B
