Inr?

[Aaargh]

can somebody give me some info on the lifestyle of an INR? Is this more like a surgeon? Heavy call? Are the opportunities after fellowship all in academia? Thanks

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[hans19]

can somebody give me some info on the lifestyle of an INR? Is this more like a surgeon? Heavy call? Are the opportunities after fellowship all in academia? Thanks

Lifestyle is basically equivalent to a surgical one. INR is a hardcore field. Many high risk procedures and less than ideal outcomes -- embolize the wrong vessel and you've caused a stroke. The call can be heavy. Compensation is very high due to limited supply. I would say there are more opportunities in Academia than PP simple because its such a highly specialized field and you need a fairly large patient population to get your cases. Academic centers tend to be tertiary referral centers as are large hospitals in large metro areas.
Expect to do your fellowship along side neurosurgeons and perhaps even neurologists in the future.

The radiology path to INR is 5 years of residency plus 2 of diagnostic neuro + 1 of INR = 8 years!
Its an awesome field. Good luck if you decide to pursue it.

 

[bigfrank]

This was very helpful. Thank you.

 

[hans19]

Check out http://www.asitn.org/live/Home/index.php

Its the closest thing to an accrediting body for interventional neuroradiology.
It will give you a very basic overview of conditions treated by and procedures performed by INRs.

Unfortunately, at most residencies (even large academic ones) there is very limited exposure to interventional neuroradiology as a resident. If you think you might be interested in INR you will really need to do your homework to get a feel for what its really like.

 

[samsoccer7]

I was interested in this field from the moment I even thought about radiology. In fact, it is part of the reason I gave up neurosurgery (yeah yeah, some of you will say I'm stupid, etc, but I'd rather read films exclusively when I'm older as opposed to doing spine surgeries over and over again).

I spent my 3rd yr spring break with a neuroIR guy in my hometown. It was a great experience. I also started a research project then and was able to attend the AANS/ASITN joint meeting a month ago in New Orleans to present a poster. The field is excellent, it just requires some persistence and drive b/c the neurosurgeons are hungry, and they see what's going on. BUT... they have too much other work to jump into NIR. There are neurosurgeons taking over in some areas, but it's still a radiology thing for the most part. What needs to happen is radiologists need to compromise their "consultant" tag and become clinicians, for the most part. They need to get referrals from primary care docs/neurologists, set up clinic time, talk with patients, and do the procedure and follow-up. The NIR I worked with had it setup exactly like that, and as a result, is extremely successful and without much competition at all from neurosurgeons.

That was long-winded, sorry. Feel free to discuss more.

 

[hans19]

That was long-winded, sorry. Feel free to discuss more.

Thanks for you insights, Sam. Right now I am torn between interventional (one more year of training, wide open fellowships) and INR (3 more years, ? competitive).

Do you happen to know of the stronger INR programs? Preferably one that gives exposure to a wide range of procedures including, including stenting and nonvascular spinal interventions? None of my fellow residents is interested in INR, so its hard to get the scoop.

I have heard MGH, Wash U are top notch.
I have heard great things about Iowa.
Perhaps Baylor in TX?
Any others?

 

[bente]

Yes Baylor, though tough crowd there per many reports.
OHSU has a nice set-up. Dotter and the VA and great amicability betw neuro/neuorsurg and INR.

 

[GMO2003]

Lifestyle is basically equivalent to a surgical one. INR is a hardcore field. Many high risk procedures and less than ideal outcomes -- embolize the wrong vessel and you've caused a stroke. The call can be heavy. Compensation is very high due to limited supply. I would say there are more opportunities in Academia than PP simple because its such a highly specialized field and you need a fairly large patient population to get your cases. Academic centers tend to be tertiary referral centers as are large hospitals in large metro areas.
Expect to do your fellowship along side neurosurgeons and perhaps even neurologists in the future.

The radiology path to INR is 5 years of residency plus 2 of diagnostic neuro + 1 of INR = 8 years!
Its an awesome field. Good luck if you decide to pursue it.

I was told by some of my rad buddies that comp is equal among partners regardless of subspecialty or being just a generalist?

however, I could see INR being more lucrative than general just from the reasoning of your post..you probably have more first hand info than I anyways

 

[f_w]

> I was told by some of my rad buddies that comp
> is equal among partners regardless of subspecialty
> or being just a generalist

Yes, most rads groups operate on the 'Kolchose' model. Some will offer a higher salary during the employee phase to people who have a 'high demand' specialty, but at the partnership level people tend to have pretty equal pay. Some practices have some sort of RVU based incentive model creating a perennial source of bickering amongst the partners.

Some INR's are in independent single practice, but most are with groups (In PP INR is often one of the specialties subsidized by the group. It has political advantages of offer it, even though the service is often not commercially viable.)

 

[fedor]

> I was told by some of my rad buddies that comp
> is equal among partners regardless of subspecialty
> or being just a generalist

Yes, most rads groups operate on the 'Kolchose' model. Some will offer a higher salary during the employee phase to people who have a 'high demand' specialty, but at the partnership level people tend to have pretty equal pay. Some practices have some sort of RVU based incentive model creating a perennial source of bickering amongst the partners.

Some INR's are in independent single practice, but most are with groups (In PP INR is often one of the specialties subsidized by the group. It has political advantages of offer it, even though the service is often not commercially viable.)

What would be these political advantages of INR? More leverage for the group when dealing with the hospital? Publicity?

 

[f_w]

> More leverage for the group when dealing with the hospital?

Keeping the cardiologists, neurosurgeons (and even neurologists) out of your angio-lab.

> Publicity?

Mainly for the hospital.
INR is high-tech, a 'brain attack team' and the like help in a competitive market to distinguish you from the smaller community hospitals.

 

[Koil Gugliemi]

The NS and neurologists generally like having INR capability around as well...