In-house fellowships

[LieutenantKone]

If I am interested in stroke exposure, would I be at a disadvantage if the program has no stroke fellowship/stroke fellows? I have heard that sometimes residents get more experience without fellows bc the residents would get first hand exposure. But I’ve also heard fellows would teach residents. So should I be concerned if my fellowship of interest is not at a program I like? Thanks

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[CargoPants]

On the interview trail, ask the residents who is the first to respond to stroke activations and evaluate the patient. Most programs will give a good amount of stroke exposure in residency, though.

Is neurovascular your desired fellowship?

 

[Thama]

The last thing on earth you should be worried about in any neurology program is stroke exposure. Stroke management will be rote memory by week 3 of neurology residency at any program of even the most basic accreditable quality and you'll be begging to see something else by month 3. If a hospital doesn't have enough stroke exposure to totally saturate a neurology residency, they are either located somewhere with very different cardiovascular/cerebrovascular risk factors from the US, or are a tiny rural community hospital that primarily serves a small isolated town of Amish that don't use modern medicine.

In general though residents and fellows tend to have very different roles in care. You aren't going to get to run thrombectomies just because there aren't fellows there to do it, more likely that program will just have more rudimentary stroke capabilities and refer a lot of stuff to more qualified centers that you then won't get to see.

 

[Postictal Raiden]

Neurology residency is 50% stroke, 25% encephalopathy, 25% everything else.

 

[xenotype]

I wouldn't worry about fellowship choice at this point either. You are way too early. For stroke exposure just avoid smaller programs that don't do thrombectomies in house or have low volumes, and make sure as a PGY2 you'll be doing the majority of the initial stroke alerts yourself. The average program will intentionally try to drown you with stroke alerts, which is what you'll need to get comfortable.