Neurocritical Care after IM

[deleted1068599]

I applied for CCM 2yrs in a row and did not match. I am going for Neurocritical care.
Is it possible to get jobs as intensivist in non neuro ICU (Board certified ABIM, and UCNS Neurocritical care board certification after doing the fellowship) ??

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[SpacemanSpifff]

I applied for CCM 2yrs in a row and did not match. I am going for Neurocritical care.
Is it possible to get jobs as intensivist in non neuro ICU (Board certified ABIM, and UCNS Neurocritical care board certification after doing the fellowship) ??

I doubt you would be hired to attend in a MICU/SICU/CICU setting after a neurocritical care fellowship.

 

[grt398]

I think you would have a very hard time getting hired in a non-neuro ICU with just a neurocrit fellowship. If you're certain you want to do critical care, I would apply to every PCCM program in the country, as well as considering taking a nephrology or ID spot, and then applying to CCM after. The latter two are a longer road, but may provide you with better odds and when you interview for CCM, if you can sell yourself as wanting to staff clinic in your subspecialty in addition to working in the ICU, you'll be a more appealing candidate.

 

[deleted1068599]

So I applied to every PCCM, CCM and Pulm program last year, did not match, accepted Neph in SOAP, now finishing Neph in a big University program and applied to every CCM program, No offers (Season is over). I am on J1 visa. Now I am going for Neurocrit, I am out of options.

 

[blue.jay]

So I applied to every PCCM, CCM and Pulm program last year, did not match, accepted Neph in SOAP, now finishing Neph in a big University program and applied to every CCM program, No offers (Season is over). I am on J1 visa. Now I am going for Neurocrit, I am out of options.

Can you even apply for that fellowship without Neurology background or IM-CCM ? Like others said you won't get any job offers esp J1 waiver unless as a IM hospitalist covering a low acuity unit in a rural hospital (for which just IM residency would be enough). The fellowship is probably to use you as a cheap labor or you can try to apply for 1yr CCM fellowship third time. Your application might looks stronger with extra fellowships which shows yours determination.

 

[deleted1068599]

yes, they accept IM abnd EM residents without CCM training. Have 2 offers.

 

[blue.jay]

yes, they accept IM abnd EM residents without CCM training. Have 2 offers.

They can (because you will be a cheaper labor) but I doubt you will get any job without Neurology training or CCM board certification.

 

[deleted1068599]

Maybe will stay for 1 year CCM in the same place after Neurocrit then, since I will be a fellow there anyways and will have faculty support. Can’t imagine myself doing anything else but Critical Care!

 

[blue.jay]

Maybe will stay for 1 year CCM in the same place after Neurocrit then, since I will be a fellow there anyways and will have faculty support. Can’t imagine myself doing anything else but Critical Care!

Yes you can use it as a networking opportunity and also to buff up your CV showing your dedication. Gosh! I can see your dedication, I can not imagine myself doing nephrology and neuroicu fellowship (totally 3-4 yrs) to get into crit care.
Do you have any red flags in your application? I'm surprised you didn't match on J1 even after nephro fellowship. Most ppl I know who did nephro match in top tier CCM programs.

 

[deleted1068599]

No red flags tht I know of, my residency program was new, small community one, I understand tht, but fellowship is at big Uni (ranked no.1 in my state), did tons of SCCM, ATS, CHEST, NCS courses on bronch, vents, airway, neurocrit!!
0 publications though, 4 posters last yr, 7 this time

 

[blue.jay]

No red flags tht I know of, my residency program was new, small community one, I understand tht, but fellowship is at big Uni (ranked no.1 in my state), did tons of SCCM, ATS, CHEST, NCS courses on bronch, vents, airway, neurocrit!!
0 publications though, 4 posters last yr, 7 this time

Scores are good ? Probably you can take neuroICU fellowship if it's 1 year then CCM 1 yr (anyways you only have 2 years left in your J1 after IM+nephro)

This is a gamble as long as you understand you've been losing 150-200k worth salary since you finished IM. About 1 million if you end up without CCM and work as hospitalist after 3 yrs of nephro and neuroICU. Alternatively you can work as hospitalist get some publications and apply for fellowship after your waiver.

 

[deleted1068599]

240, 238, CS 1st attempt, 214
Passed IM Boards
Yeah I knw the time limit on J1, will have to get extension fr 8th year! But I have heard tht will affect Waiver application.
Neurocrit has to be 2yr if no Crit or Neurosurgery background

 

[CCM-MD]

You would need 2 years of CCM after your 2 years of neurocrit to be board eligible unless you are BC in nephro/ID/cards. In addition, ABMS member boards including ABIM will be taking over NCC boards over the next few years and you will not be board eligible for the ABIM boards - prerequisite for it is IM-CCM certification, you can look this up and correct me if I’m wrong. Only way you end up board eligible is if UCNS is still offering NCC boards by the time you finish. Neurocritical care fellowships go empty for a reason, there is a reason why you got 0 offers for anything else and 2 for NCC. My opinion: time is valuable, find an alternative career and don’t waste your time being cheap labor for someone.

Just read you’re J1. IM+NCC is almost unemployable without visa sponsorship. Good luck finding a J1 waiver job. Apologies if I am harsh, but these are the facts.

 

[blue.jay]

Neurocritical Care Policies | ABIM.org

Exam policy information for Neurocritical Care

www.abim.org

I got an email from ABIM today saying received approval from the American Board of Medical Specialties (ABMS) to offer certification in Neurocritical Care (NCC) as a co-sponsor. NCC becomes the 21st subspecialty available to ABIM Board Certified physicians.

@UHamdani I don't think it's worth pursuing NCC unless you consider it as a path to network and get into that institutions crit program (which is not a guarantee) plus a huge loss of potential $$$

Consider applying for ICU hospitalist jobs, UPenn has (or had) one where you work under the supervision of an intensivist but not for resident/fellow salary

 

[deleted1068599]

View attachment 323542

Neurocritical Care Policies | ABIM.org

Exam policy information for Neurocritical Care

www.abim.org

I got an email from ABIM today saying received approval from the American Board of Medical Specialties (ABMS) to offer certification in Neurocritical Care (NCC) as a co-sponsor. NCC becomes the 21st subspecialty available to ABIM Board Certified physicians.

@UHamdani I don't think it's worth pursuing NCC unless you consider it as a path to network and get into that institutions crit program (which is not a guarantee) plus a huge loss of potential $$$

Consider applying for ICU hospitalist jobs, UPenn has (or had) one where you work under the supervision of an intensivist but not for resident/fellow salary

Thank you. Yeah I saw that. Basically until 2025, they are offering a practice pathway through which I willbe eligible for this board as long as I pass my UCNS boards, so just an extra exam.
After 2025, they will take over the accreditation, and then you will require 1 yr CCM before 1 yr NCC.

 

[deleted171991]

I applied for CCM 2yrs in a row and did not match. I am going for Neurocritical care.
Is it possible to get jobs as intensivist in non neuro ICU (Board certified ABIM, and UCNS Neurocritical care board certification after doing the fellowship) ??

Go get a real hospitalist/nephrologist job on a waiver. Become a true doctor, not just a lifetime trainee (and possibly get a green card in the process). THEN you will have much better chances for a CCM fellowship (smart PDs will prefer somebody who doesn't need a lot of hand-holding).

No good intensivist will give a crap about your NeuroCCM fellowship. That fellowship shouldn't even exist, in the first place; it was invented only because neurologists and neurosurgeons wanted to protect their turf in the NeuroICU.

P.S. @UHamdani, to be even clearer: any board-certified intensivist worth her salt can take care of a neuroICU patient, except for specific procedures such as EVD placement (which are usually done by neurosurg-trained people anyway). Who do you think used to take care of these patients? Neurologist/neurosurgeon + general intensivist. A NeuroCCM fellowship is a royal waste of time for anybody outside the neuro fields.

 

[deleted1068599]

Go get a real hospitalist/nephrologist job on a waiver. Become a true doctor, not just a lifetime trainee (and possibly get a green card in the process). THEN you will have much better chances for a CCM fellowship (smart PDs will prefer somebody who doesn't need a lot of hand-holding).

No good intensivist will give a crap about your NeuroCCM fellowship. That fellowship shouldn't even exist, in the first place; it was invented only because neurologists and neurosurgeons wanted to protect their turf in the NeuroICU.

P.S. @UHamdani, to be even clearer: any board-certified intensivist worth her salt can take care of a neuroICU patient, except for specific procedures such as EVD placement (which are usually done by neurosurg-trained people anyway). Who do you think used to take care of these patients? Neurologist/neurosurgeon + general intensivist. A NeuroCCM fellowship is a royal waste of time for anybody outside the neuro fields.

Yeah, in my Residency, Our ICU was medsurg with neuro patients, we were just monitoring them most of the times after a stoke or bleed, or post op!!

 

[deleted171991]

Yeah, in my Residency, Our ICU was medsurg with neuro patients, we were just monitoring them most of the times after a stoke or bleed, or post op!!

You got my point.

Education-wise, MICU > Cardiothoracic SICU > General SICU >> NeuroICU, even in a big center.

Just my 2 cents. Go practice nephrology somewhere, get board-certified in it, get good at POCUS (e.g. fluid management, VExUS), and you'll become way more interesting than the average CCM applicant who needs her butt wiped as a first year fellow.

Some big universities are in areas that allow waivers. Look for such a job.

 

[CCM-MD]

You’ll be screwed if UCNS stops offering the exam after you finish, it’s going to happen anytime. I wouldn’t count on UCNS. Take a look at some of the other threads on this forum about neurocritical care. Agree with pretty much everything that’s been said. Don’t waste your time.

 

[deleted1068599]

You’ll be screwed if UCNS stops offering the exam after you finish, it’s going to happen anytime. I wouldn’t count on UCNS. Take a look at some of the other threads on this forum about neurocritical care. Agree with pretty much everything that’s been said. Don’t waste your time.

ABIM email said that until 2025, they will be offering practice pathway, which means if you are certified by UCNS, you are eligible.

 

[CCM-MD]

ABIM email said that until 2025, they will be offering practice pathway, which means if you are certified by UCNS, you are eligible.

Dude. You don’t get it. The UCNS can stop offering the NCC exam tomorrow if they wanted to. Good luck getting boards in that scenario. Have you ever spoken to them? I have. IMO it’s quite shady.

 

[grt398]

Consider applying for ICU hospitalist jobs, UPenn has (or had) one where you work under the supervision of an intensivist but not for resident/fellow salary

I would consider this option too if you can get a time extension on your J1, which I don't know much about but I'm guessing is difficult. I met a fellow at Cleveland Clinic on the interview trail who had been an ICU hospitalist at UPenn for 2-3 years prior to becoming a fellow and he was able to get a significant number of publications as well as be a Co-PI on some local studies which I'm sure helped a lot in securing a spot. Plus the faculty at a place like UPenn will have significant connections to other fellowships if they want to advocate for you.

 

[gro2001]

They can (because you will be a cheaper labor) but I doubt you will get any job without Neurology training or CCM board certification.

There are a number of EM trained faculty at various programs. There are even a couple of EM trained fellowship program directors. While there are very few EM trained neurointensivists (most do come from neurology), they don't seem to face any particular major difficulties finding work. There are some jobs that really want the neurointensivist to be a neurohospitalist as well, but those tend to be ones that the neuro trained neurointensivists don't want either.

 

[chocomorsel]

I applied for CCM 2yrs in a row and did not match. I am going for Neurocritical care.
Is it possible to get jobs as intensivist in non neuro ICU (Board certified ABIM, and UCNS Neurocritical care board certification after doing the fellowship) ??

Hey listen, there is a Pulm fellow where I am at who apparently threatened to walk out ther other day. Maybe I can help her pack her bags and get you in instead?

 

[deleted1068599]

Hey listen, there is a Pulm fellow where I am at who apparently threatened to walk out ther other day. Maybe I can help her pack her bags and get you in instead?

Lol, I have seen Pulm fellows struggling to match into critical care with me (although much easier than neph) Also, if I do 2yrs of Pulm, I max out my 7yr J1 training period. But thanks a lot for looking out !

 

[chocomorsel]

Lol, I have seen Pulm fellows struggling to match into critical care with me (although much easier then neph) Also, if I do 2yrs of Pulm, I max out my 7yr J1 training period. But thanks a lot for looking out !

I meant a Pulm/CCM. A little bit of a brat. I would be glad to see her go. haha

 

[deleted1068599]

I meant a Pulm/CCM. A little bit of a brat. I would be glad to see her go. haha

Here are people like me, desparate to get in, and then people who have it and r ungrateful

 

[chocomorsel]

Here are people like me, desparate to get in, and then people who have it and r ungrateful

I will see what I can do. You got decent stats? No red flags?

 

[deleted171991]

Here are people like me, desparate to get in, and then people who have it and r ungrateful

Nobody wants 2-3 years of Covid fellowship, if better choices are available.