Help with NCC fellowship ROL

[JeanGreyNCC]

Hello all,

I am having difficulty deciding between my #1 and #2 choice for NCC fellowship: MGH vs. Columbia. I’m hoping for any thoughts or advice.

Both are great programs. Maybe Columbia has an edge clinically but overall I think it would be splitting hairs to compare the caliber of training at these two programs. But please correct me if I’m wrong.

Most people that I’ve talked to said to go by gut feeling and location. I really enjoyed my interviews at MGH, so my gut feeling is that I would fit in more/be happier at MGH (not to say I didn’t have a great interview experience at Columbia). I want to end up in NYC after fellowship (family in NYC) so maybe training at Columbia would give me an advantage. Am I being ridiculous?

I know I might not even get into any of these places...so all of this might be pointless.

Any thoughts would be great. Thank you!

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[typhoonegator]

I'll stay out of the discussion between these two programs. Suffice to say they're both good. The "world" of NCC in the US is pretty small, so I wouldn't worry too much about training in Boston and getting a job in NYC. People scatter all over after fellowship, and as long as the caliber of faculty placements are up to par (and they certainly are at these two places) then you should feel good about your placement opportunities regardless.

 

[neglect]

Am I being ridiculous?

Yes. These are two world class institutions full of smart and devoted people, drawn to essentially the same patient population. The docs, adjuncts, staff, patients and families will also have various idiocies, quirks, grudges, pettiness and weirdnesses. You'll do fine. Relax. If you like NY, then go there. If you'd like to spend some time in Boston, then do that. Or go to California! Good luck.

 

[JeanGreyNCC]

I'll stay out of the discussion between these two programs. Suffice to say they're both good. The "world" of NCC in the US is pretty small, so I wouldn't worry too much about training in Boston and getting a job in NYC. People scatter all over after fellowship, and as long as the caliber of faculty placements are up to par (and they certainly are at these two places) then you should feel good about your placement opportunities regardless.

Yes. These are two world class institutions full of smart and devoted people, drawn to essentially the same patient population. The docs, adjuncts, staff, patients and families will also have various idiocies, quirks, grudges, pettiness and weirdnesses. You'll do fine. Relax. If you like NY, then go there. If you'd like to spend some time in Boston, then do that. Or go to California! Good luck.

Thanks for your replies. T minus 4 days and I'm still torn. I like both programs, for different reasons. Both offer great clinical training and a wealth of research opportunities/resources..so I am really stuck. I've even tried tossing a coin - please don't judge me . Program A kept coming up but somehow I couldn't make it #1. So by logic, one would think I want to rank program B first. But ranking program B first doesn't sit well with me either. Good grief. My gut clearly missed the memo and is out on vacation.

Can you offer some key questions I should ask myself in making this decision? Thanks!

 

[TUGM]

How much do you like acute stroke? If you do pick Boston. If you don't, pick NY
How much do you like trauma? If you do pick Boston. If you don't, pick NY

 

[TUGM]

Also just be ready for anything. Not to buzzkill you, but it is a match after all.

 

[JeanGreyNCC]

How much do you like acute stroke? If you do pick Boston. If you don't, pick NY
How much do you like trauma? If you do pick Boston. If you don't, pick NY

Thanks for your thoughts. I do want to see trauma but not so much acute stroke. During interviews, we were told stroke call time has been decreased. I guess they're aware that it's a relative weakness of the program.

Also just be ready for anything. Not to buzzkill you, but it is a match after all.

I hear ya but insofar as I have to make a ROL, I still need to pick one. Believe me, I'm well aware that I might not match at either.

 

[Hamhock]

Thanks for your thoughts. I do want to see trauma but not so much acute stroke. During interviews, we were told stroke call time has been decreased.

I am not a neurologist...but I am an intesivist, who trained at a pretty high-powered NCC program.

I'll admit that I have an anti-NCC bias (as NCC is currently structured; but I'm hoping NCC will be vanguard soon), but I would strongly suggest you ask yourself if you want to be the best NCC doc you can be...at this time...in this paradigm.

Or do you want to be a "super" stroke doc? A multi-disciplinary NCC doc for a big-time community program? A researcher working with the trauma surgeons (who still control - appropriately - TBI) docs? Or, honestly, a neuro-interventualist? A typical intensivist (back-door from NCC)?

Answer those questions honestly, and you will have your NNC fellowship answers.

HH

 

[CCM-MD]

There is no back door to practicing as a medical/surgical intensivist in academics or outside of it after a neurocrit fellowship. Great to lead neuro ICUs which remain in large academic hospitals. Few community hospitals have dedicated neuro ICUs - unless this changes in the future, NCC training is probably going lead to a consultant role. This goes along with the number of empty NCC fellowship positions left over each year.

 

[barbarossa12]

There is no back door to practicing as a medical/surgical intensivist in academics or outside of it after a neurocrit fellowship. Great to lead neuro ICUs which remain in large academic hospitals. Few community hospitals have dedicated neuro ICUs - unless this changes in the future, NCC training is probably going lead to a consultant role. This goes along with the number of empty NCC fellowship positions left over each year.

Are you speaking from first hand experience? I don't think anyone going into a neruocritical fellowship is trying to figure out a backdoor to be a medical/surgical intensivist. As I have seen all fellows have multiple job offers that are not just consultant roles. Neurologists are not avoiding NCC fellowships due to fear of not finding employment.

 

[CCM-MD]

Are you speaking from first hand experience? I don't think anyone going into a neruocritical fellowship is trying to figure out a backdoor to be a medical/surgical intensivist. As I have seen all fellows have multiple job offers that are not just consultant roles. Neurologists are not avoiding NCC fellowships due to fear of not finding employment.

Yeah. Just look around in whatever city you are in. Can probably count the number of real neuro ICUs in most with one hand. Sure no one is unemployed, but believe me when I say not every grad is working full time as a neurointensivist in the kind of role propagated on certain threads on this forum.

 

[neglect]

There is no back door to practicing as a medical/surgical intensivist in academics or outside of it after a neurocrit fellowship. Great to lead neuro ICUs which remain in large academic hospitals. Few community hospitals have dedicated neuro ICUs - unless this changes in the future, NCC training is probably going lead to a consultant role. This goes along with the number of empty NCC fellowship positions left over each year.

I also think there's a back door critical care board that doesn't require a fellowship.

 

[CCM-MD]

I also think there's a back door critical care board that doesn't require a fellowship.

I’m not aware of that. But I believe you. All kinds of things out there. It’s probably not an ABMS member board. Why waste money on that ? Not required to have CCM boards. I’m sure there’s a desperate enough hospital out there which will hire you without critical care boards. Just don’t expect it to be anywhere near a desirable location and it won’t be paying intensivist $. It would also be ill advised in our highly litigious society.

 

[Blackdogue]

I also think there's a back door critical care board that doesn't require a fellowship.

Just out of curiosity, is it possible for neurointensivists to complete another critical care fellowship in order to be employable in non-specialized community ICUs? If yes, why is it so uncommon?

 

[CCM-MD]

Just out of curiosity, is it possible for neurointensivists to complete another critical care fellowship in order to be employable in non-specialized community ICUs? If yes, why is it so uncommon?

Sure. If you are a Neurointensivist who has base training in Anesthesiology, IM, EM, or surgery then you can go and complete a critical care fellowship if you haven’t already done so.

I think your question is whether neurologist with neurocrit training can go and complete a IM-CCM or Anes-CCM or Surg-CC fellowship. Answer is no.

 

[Blackdogue]

Sure. If you are a Neurointensivist who has base training in Anesthesiology, IM, EM, or surgery then you can go and complete a critical care fellowship if you haven’t already done so.

I think your question is whether neurologist with neurocrit training can go and complete a IM-CCM or Anes-CCM or Surg-CC fellowship. Answer is no.

Yes, my question was referring to neurologists, thank you.