Neurocritical Care Anxiety

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braintroubleshooting

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It's that time again: the yearly post about applying to NeuroICU.

Finishing my second year of Neurology, I've decided on critical care. I know 100% this is what I want. I have combed these forums and the websites for almost every program out there.

Needless to say, I'm pretty worried about my future and I'll explain why:
- I'm at a well-known program that is good, but not elite.
- Given the age of our critical care department, I have been told I have no well-established intensivists at my institution for a strong LOR.
- I plan on doing an away rotation for LOR, but cannot have one sooner than December.
- My year, as everyone's, has been very busy, but to the point that my need to focus on academics has pushed research into the periphery. I do plan on publishing some work, but have nothing yet.
- Reading these forums makes the application process seem significantly more competitive every year.
- The strong, well-sought programs have fellows that seem to have excellent academic pedigrees that I don't think I can match.
- My spouse will be applying for a very competitive specialty after I match so I need to aim for large cities in hopes we stay together.

I know what the key parts of a strong candidate are: connections, LOR, research. Hence, I feel like I'm facing an uphill struggle. I have a strong passion in working hard and want to lead the field one day but I don't want to be stifled by ending up at a place with not the strongest academic background or a brand spankin' new program without any experience.

Folks, what else can I do? This young field is ever-changing. I think addition of some of the newer programs fueled by some of the recent top leaders has accommodated for a growing applicant pool. But I worry that I will lose out.

Am I appropriate for being so worried? Seeing how I just recently put in time to review all these programs, I feel like I am already starting late in the race.

Please help! Thank you for your time.
 
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I think in general it will be possible to match well, given that you are able to overcome some of your aforementioned obstacles. Neurocritical care is still a relatively new field, and there are not that many well-established neuroICUs. The ones that are established are obviously the large-name academic powerhouses that always get the recognition.

You probably need to get some research of some sort done, to display your commitment to academics. Away rotations that I have seen are typically observerships, so they will really only be good for showing your face to programs, I think, but it can't hurt if you make a good impression.

Please keep in mind that the information I give you is very general, and coming from a PGY-2 with a strong interest in a similar career, and this is what I've gathered from scouring forums, talking to attendings, etc.

Some senior members on this forum would be able to provide more solid advice. Good luck!
 
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