INR questions

[NeuroKlitch]

How is the future of this field looking from the neurology stand point. I hear neurosurgery mainly controls the referral base. Does it make it very unlikely for someone to be able to practice pure INR with minimal call.


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[Hank Rearden]

What the heck is pure INR with minimal call? You mean you would like to electively coil aneurysms all day, but not do stroke thrombectomies or other emergent cases? I've never met any INR people that don't do both and frankly all have somewhat painful call schedules. Most large centers only have 2 people, so you're week on / week off 24/7. Having 3 in your group would be a luxury.

 

[Thama]

If you want "minimal call" you aren't destined for INR.

 

[TUGM]

Neurointervention remains multidisciplinary among neurorads, neurosurgeons and neurologists. It is still extremely competitive for neurologists to get fellowships, but not as hard as it was, say, 10 years ago. Certain programs have track records of sending people to NIR.

There is no such thing as NIR with minimal call. All NIR positions are actually maximal call. Typically Q2-Q3 call vs call 24/7 x 1 week every 2-3 weeks.

What is it with people wanting to do surgical fields without taking call? Get a derm spot dude.

 

[NeuroKlitch]

Maybe I should move this over to the psych forum lol. Sensing a lot of hostility . I don't think it's unreasonable to ask if this practice can be shaped in such a way that I could slow down to catch my Breath when I'm in my 50's. what i imagined was after completing the INR fellowship. I could take call at multiple major stroke centers and hospitals for 5-7 years in order to get my name out there, master the craft, and build a referral base , and then transition to something a little more scheduled in a private practice . Is this something that people generally do ? Although plenty surgeons practice until biology catches up with them , many also seem to retire and take academics or management positions in their 50's which is not something I want to do .


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[NeuroKlitch]

Also thanks for the responses


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[TUGM]

If you can't handle the hostility, then you aren't destined for NIR.

 

[BeTheBallDanny]

Neurointervention remains multidisciplinary among neurorads, neurosurgeons and neurologists. It is still extremely competitive for neurologists to get fellowships, but not as hard as it was, say, 10 years ago. Certain programs have track records of sending people to NIR.

There is no such thing as NIR with minimal call. All NIR positions are actually maximal call. Typically Q2-Q3 call vs call 24/7 x 1 week every 2-3 weeks.

What is it with people wanting to do surgical fields without taking call? Get a derm spot dude.

What are some of these programs?

 

[typhoonegator]

A three person group is actually a pretty good size to have. Enough to make the call "reasonable", but small enough that there isn't undue competition for suite time. While there are a few division chiefs who can sort of buy themselves out of the call pool (I've seen unofficial versions of this), this is by far the exception rather than the rule, and the rest of the group isn't necessarily going to like it. Also, referral bases and reputation are important, but the referral streams for elective cases are strongly reinforced by the referral streams for acute cases. You would take a hit if you dropped out of the acute call pool, and you'd lose cases to your former colleagues.

Remember, at the end of the day the group is responsible for covering the service 24/7/365. Angio suites are not free to build, maintain, or staff. What is the incentive for the group to support someone who only does elective cases and makes the rest of the partners/division faculty take the call burden? Especially when there is someone else who would gladly do both?