how does one become a neuroradiologist???

[neuropsych6]

i recently switched to medicine instead of finance and um, i have no clue how this whole medicine, healthcare, MD, etc crap works. like, how can i become a neuroradiologist??? is there like a special school for them or is it like in grey's anatomy where they all work in the hospital and gain experience?? idk, this is all confusing to me. my parents wont let me pursue a business career anymore and this besides psychiatry is the only thing that i can see myself doing for the next 30+ years.
thanx😎

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[MrBurns10]

Neurorads is 5 years of radiology residency (including the prelim year) + 1 year fellowship in neurorads...or 2 years if you want to do interventional neurorads. This is all after 4 years of med school.

I would take the advice of the others on the pre-allo boards and don't even think about this stuff until college.

 

[Docxter]

4 years college + 4 years medical school + 5 years radiology residency + 1 (or more often 2) years of neuroradiology fellowship

 

[Neuronix]

I'm going to poke my stick into the hornet's nest and ask... What about these guys?

http://www.asnweb.org/

Between the American Society of Neuroimaging and United Council of Neurologic Subspecialties, these guys will give neurologists one or two year fellowships so they can read CT/MR. To quote:

A one-year fellowship is offered by the Dent Neurologic Institute beginning July 1st of each year. This fellowship is based in a large outpatient neurology practice and includes, MRI and CT of the head and spine and neurosonology (carotid doppler and TCD). Emphasis is placed on basic science of neuroimaging, clinical interpretation of studies and neuroimaging research. Upon completion of the program the graduate will be eligible for clinical certification in MRI and neurosonology by the American Society for Neuroimaging."

So what's to stop any Neurologist from doing a fellowship with one of their sites and reading films? For that matter, what's to stop cardiologists and neurologists and orthopods from taking over all imaging in their areas? I ask because this is a hot topic among the FMGs in my lab who are very concerned about landing a spot in Radiology and are heavily investigating other ways to get into the field. Because Neurology in particular isn't very competitive, it would be easy for them to land a Neurology spot and work their way into Neuroradiology.

 

[pdz]

I'm going to poke my stick into the hornet's nest and ask... What about these guys?

http://www.asnweb.org/

Between the American Society of Neuroimaging and United Council of Neurologic Subspecialties, these guys will give neurologists one or two year fellowships so they can read CT/MR. To quote:



So what's to stop any Neurologist from doing a fellowship with one of their sites and reading films? For that matter, what's to stop cardiologists and neurologists and orthopods from taking over all imaging in their areas? I ask because this is a hot topic among the FMGs in my lab who are very concerned about landing a spot in Radiology and are heavily investigating other ways to get into the field. Because Neurology in particular isn't very competitive, it would be easy for them to land a Neurology spot and work their way into Neuroradiology.

I can't see from where you got that quote. The link you sent is for the ASN home page. Can you send the right link?

In any case, even without a neurorad fellowship, many neurologists feel very comfortable at reading brain MRIs... not to mention that most of brain imaging research is in fact carried out by neurologists. Just look at some big names in fMRI, most of them were trained in neurology.

Keep in mind that brain imaging is not only about interpreting an image. It entails understanding many aspects of brain physiology/pathology. And neurologists may have an edge on that.

 

[Neuronix]

I can't see from where you got that quote. The link you sent is for the ASN home page. Can you send the right link?

It's in here:
http://www.asnweb.org/clientuploads/Fellowshipupload2007.pdf

 

[Docxter]

The Dent institute has been training neurologists in neuroimaging for almost two decades now. The majority end up practicing in smaller or remote communities for the most part, places where there is no access to fellowships trained neuroradiologists. In bigger hospitals where there is an established radiology department and trained neuroradiologists, these people will have a very difficult time getting privileges. And just by the numbers, they are a small minority. I don't know how things will change in the future. On the one hand, nonradiologists are trying to do more imaging and on the other, there is beginning to be more efforts at curbing self-referral. For example, the Maryland supreme court just banned self-referral imaging for nonradiologists.

And using the fMRI example, just shows you are not familiar with clinical reality. fMRI is still more than 99% done as a research tool rather than a clinical tool, and psychologists and neuroscientists do way more more fMRI than either neurologists or radiologists. And while knowing the disease is certainly important, knowing about imaging physics and technique is just as important in image interpretation.

 

[Taurus]

Because neurologists have control of the patient, they can do to rads what the cardiologists did -- take over their imaging and interventional work. Even the neurosurgeons are getting into the game by having their own fellowships to do interventional work. I think the most important thing for anyone going into rads is to have a strong rads foundation so that you can fall back on reading films for any body region and modality.

 

[RoentgenRayz]

Where are these neurologist/neuroradiologists setting up shop? Since radiologist/neuroradiologists work at hospitals, do they join their group? Or buy MRIs/CTs and work in private settings? This pathway for neurologists to become neuroradiologists is something that seems new to me!

 

[RadFanatic]

Well, don't the Stark laws prohibit non-radiologists from self-referring and reading films if they own the MRI? Also, I don't think there are non-radiologist imaging billing codes...but I don't know if neuroradiologists who are also neurologists can bill for it. Anyone know???

 

[f_w]

Well, don't the Stark laws prohibit non-radiologists from self-referring and reading films if they own the MRI?

They don't (well, officially they do, but the stark and antikickback laws have more holes than substance and in reality don't create an obstacle to clinician self-dealing).

Also, I don't think there are non-radiologist imaging billing codes...

Any physician can bill any code. If you are an FP and you feel comfortable doing a transphenoidal anterior pituitary debulking, you can feel free to bill for it. Medicare at least will with few exceptions pay you for whatever you bill, regardless of your specialty.
Private insurers and HMOs can have their own policies restriciting imaging to either radiologists or respective specialists but most don't. OBs bill for US, ER docs bill for X-ray interpretation, orthos bill for x-ray interpretation and so on.

Now, most hospitals wont credential you for image interpretation and your malpractice carriers won't insure you, but that is on a different page.

 

[RadFanatic]

Thanks for the enlightenment, f_w. One last question, though - since board certification is probably used for malpractice coverage policies, I'm guessing those neurology-neuroradiologists are probably covered reading films, right?

 

[f_w]

Thanks for the enlightenment, f_w. One last question, though - since board certification is probably used for malpractice coverage policies, I'm guessing those neurology-neuroradiologists are probably covered reading films, right?

That is between them and their insurer. They will cover you if you can demonstrate that you can safely do what you want to do. Lets say you are a general surgeon and you want to venture into lap-bands, they won't cover you until you have done 3 or 5 cases with a preceptor.