Future of INR?

[Ischemia1032]

Hey guys! I am in med school( I know my profile saids pre-med, borrowing my sister's account) and I am highly interested in INR. I keep on reading about how interventional neurologists are taking over, or neurosurgeons are taking over, but given INR developed the field, I am confused why this is. I can understand NS taking some since they can handle their own complications(extreme ones), but given INR is probably one of the most technologically advanced fields in medicine, I can only guess it will become even more advanced by the time I apply for a fellowship in INR. Can anyone explain these turf wars and if these is an actual threat to INR.

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[Gadofosveset]

INR is now essentially a division of neurosurgery. There are a few fellowships that offer INR training (UVA and UW(?) spring to mind), but IRs don't usually mess with the head.

 

[deleted564680]

Cleveland Clinic offers INR/Endovascular NSG as a combined program. The NSGs spend the first year in the reading room and 2nd year with procedures and the Rads spend the first year managing patients on the wards/performing clinical duties then 2nd year with procedures. I imagine both then would be "equally" trained for the job market out there. I don't think many people have gone through this fellowship from the rads side however.

 

[shark2000]

Hey guys! I am in med school( I know my profile saids pre-med, borrowing my sister's account) and I am highly interested in INR. I keep on reading about how interventional neurologists are taking over, or neurosurgeons are taking over, but given INR developed the field, I am confused why this is. I can understand NS taking some since they can handle their own complications(extreme ones), but given INR is probably one of the most technologically advanced fields in medicine, I can only guess it will become even more advanced by the time I apply for a fellowship in INR. Can anyone explain these turf wars and if these is an actual threat to INR.

Whether the field will be more advanced by the time you apply is not clear. You never know. When I was in your shoes more than 10 years ago, people made all sorts of predictions and most of them turned out to be wrong.

Back to your question. INR is a niche market. In large academic centers, one or two INR guys do the job. Outside that, there is no enough cases to keep people busy even for 2 days a week. As I said, it may or may not change in the future but people have been talking about "advancements" in the field for the last 15 years and still we haven't seen any significant change.

More and more neurosurgery programs are integrating INR to their curriculum and in the next 5-10 years it will be a part of NS.

If you are sure that you want to do it, do a NS residency and expect to do 4-5 days of NS practice in the future with 1 day of NIR. Even if the technology booms and the volume goes up, since most NS will be trained to do it, there won't be enough volume to do all the time.

Right now, there are a huge number of NIR trained people without enough volume for them. Most don't do INR and have switched back to NS or Rads or Neurology. Your medical school may be different since it is a big referral center, but I am talking about how it works in pp.

 

[shark2000]

Hey guys! I am in med school( I know my profile saids pre-med, borrowing my sister's account) and I am highly interested in INR. I keep on reading about how interventional neurologists are taking over, or neurosurgeons are taking over, but given INR developed the field, I am confused why this is. I can understand NS taking some since they can handle their own complications(extreme ones), but given INR is probably one of the most technologically advanced fields in medicine, I can only guess it will become even more advanced by the time I apply for a fellowship in INR. Can anyone explain these turf wars and if these is an actual threat to INR.

As I said above, the only viable option will be doing NS. Whether you want to do a NS or not, is up to you. I personally wouldn't do it even if you paid me a salary of more than 1 mil a year.

You have to know what you are doing to your life. INR is a cool field when as an MS you read about it on a website or you show up at 9 am, just jump into a case and leave at 1 pm without understanding or knowing all the hassle that it comes with. Night calls, stroke call, complications, patients that don't get better, long hours of standing in cath lab with lead, late evening work, weekends, ....