Interventional Neuroradiology hours vs fellowship

[NeuroKlitch]

A few questions about INR . When I'm not neurotically weighing the pros and cons of entering either psychiatry or neurology , I've been secretly drawn to this specialty due its potential of combining lesion localization, advanced Brian imaging (and possibly more importantly interpretation) , abnormal behavioral presentations secondary to the intravascular pathology , and a unique specialized skills of value to preform minimally invasive procedures. I find the neurologist pathway most appealing to me because it allows me to follow the patient throughout the entire process before during and after , in addition to being able to practice clinical neurology in between cases as opposed to neurosurg or rads.

So all this being said , I understand the pathways to getting to INR . Basically neurology , ncc or stroke then INR.

My main question or concern is about work hours with each route .

Because in my prior reasearch about NCC, I read that they tend to work a few months of the year and then dedicate the rest to research. How would this change once you became an INR ? Since you almost likely won't be able to practice INR 100% of the time. Hope this question makes sense .

If someone could break down what kind of life is to be expected if any at all, such as average hours per week and so on would be appreciated . Thanks


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[typhoonegator]

In the right practice model you could be able to be entirely neuroIR-based without any NCC or vascular responsibilities. Some neurologists don't want to give it up, so they stay in it. I'd say that happens more in NCC than vascular, because the RVU density is higher. My colleague who does NCC and neuroIR does q3 IR call, and ~12 weeks in the ICU per year. Plus IR clinic. He is on-call for one of the two more than half his weekends overall. He's busy. Calculating hours for acute call people is nonsensical, because how do you count an hour doing email on a tuesday afternoon vs. an hour on the phone at 3AM on Sunday morning? Or all those weekend days when you're on call and restricted in what you can and can't do but don't ever get called in for a case?

Almost all these people link their fellowships together, so they aren't practicing NCC before they "become" an interventionalist. They finish one 80+ hours/week fellowship and then start another 80+ hours/week fellowship, and then when they finish they find a job that suits their needs/wants. You definitely don't become an NCC or IR physician because you want to limit your training intensity or work encroachment into personal life.

And most NCC people aren't doing research for most of the year. Service weeks are usually spread out throughout the year, and then there are conferences, and then there are administrative responsibilities/initiatives, teaching things that you do, people to manage, some of us have clinic or stroke calls, etc. Some of us minimize all of that to focus on a research career and get paid for that time, but few of us are really that lucky. Working in the ICU 12 weeks a year won't get you near the average salary for NCC unless you've got a unique high-demand thing going on, so getting additional FTEs to run training programs, QA panels, manage clinical trials at your site, etc. are a very reasonable way to round-out your salary package. All those things take time, and lots of meetings. And outside of academics, people often work more weeks to make more money. Burnout is an issue.