Neurocritical care fellowship

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EMhawkeye

EMhawkeye

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Is it common for a neurocritical care trained intensivist to work a general intensivist if their background is IM or EM?
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EMhawkeye said:
Is it common for a neurocritical care trained intensivist to work a general intensivist if their background is IM or EM?
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Neurocrit training is great for running a Neuro ICUs. It will not give you adequate training to manage non-neurological patients. If you are interested in both, I recommend pursuing a CCM fellowship first. You can add a 1 year neurocrit fellowship afterwards if you really really want to. Doing neurocrit first followed by a CCM fellowship will require 2 years in each fellowship- this is assuming you have base training in IM or EM.

Looking at your post history, it looks like you have bigger fish to fry... have you found a residency?
 
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Wait......people actually do extra training to voluntarily get stuck with all the hypoxic brain injuries, traumatic subdurals and post TPA head bleeds that I gladly ship the hell out of here?
 
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Bostonredsox said:
Wait......people actually do extra training to voluntarily get stuck with all the hypoxic brain injuries, traumatic subdurals and post TPA head bleeds that I gladly ship the hell out of here?
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Of course. You don't think just anyone can legally drown humans in salt water, learn just enough critical care to really hurt patients, or mis-interpret research with the blind optimism of Candide, do you? Specialized training is needed, at the very least, to convince hospitals, medical societies, and the ignorant generalists that NCC is needed to (not) change outcomes and develop the "neurosciences" that sells so well.

Of course, I am being a bit facetious and hyperbolic here. It makes me feel better.

OTOH, neurocritical care training (with some good research training) has the potential to move a sub-field of critical care in a most wonderful and helpful direction.

HH
 
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EMhawkeye said:
Is it common for a neurocritical care trained intensivist to work a general intensivist if their background is IM or EM?
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No, I haven’t seen it before. I do know of some ccm fellows that do the extra year of Neuro cc for boards. The job market is supposed to be decent.
 
From my experience - there’s not many Neuro ICUs outside academia. Job opportunities wise best to worst:

IM/Anes/EM/Pulm + CCM + neurocrit > neurology + neurocrit > neurocrit without neurology and without CCM

I know of only one person who did IM followed by neurocrit. Couldn’t find a job. Worked as a Hospitalist and eventually ended up doing a 2 year CCM fellowship. Now works as an intensivist at a hospital that doesn’t even have a Neuro ICU.
 
Hamhock said:
Of course. You don't think just anyone can legally drown humans in salt water, learn just enough critical care to really hurt patients, or mis-interpret research with the blind optimism of Candide, do you? Specialized training is needed, at the very least, to convince hospitals, medical societies, and the ignorant generalists that NCC is needed to (not) change outcomes and develop the "neurosciences" that sells so well.

Of course, I am being a bit facetious and hyperbolic here. It makes me feel better.

OTOH, neurocritical care training (with some good research training) has the potential to move a sub-field of critical care in a most wonderful and helpful direction.

HH
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Are you?
 
Bostonredsox said:
Wait......people actually do extra training to voluntarily get stuck with all the hypoxic brain injuries, traumatic subdurals and post TPA head bleeds that I gladly ship the hell out of here?
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Yup. I know someone who's doing it. Because then they can teach IM residents as an EM attending.

And then there are all these stroke centers needing these type of folks. Of course I thing a CCM would do, but the neurocrit neurologist would beat someone like me out I bet.

I actually like neuro. But not gonna do an extra year though.
 
chocomorsel said:
Yup. I know someone who's doing it. Because then they can teach IM residents as an EM attending.

And then there are all these stroke centers needing these type of folks. Of course I thing a CCM would do, but the neurocrit neurologist would beat someone like me out I bet.

I actually like neuro. But not gonna do an extra year though.
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You don’t need to do neuro critical care to supervise medicine residents. Besides, where do medicine residents spend a lot of time in the neuro icu???
 
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TimesNewRoman said:
You don’t need to do neuro critical care to supervise medicine residents. Besides, where do medicine residents spend a lot of time in the neuro icu???
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Well, apparently there are rules on who can teach IM residents. And by some kind of way this works out for him. I don’t know details.
 
TimesNewRoman said:
I’m EM and accepted a job teaching medicine residents.
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Well, not everything is the same across the board I guess. Look, I am not EM, I could give a flying f.... Nothing in it for me. This is what my friend told me and he's got no reason to lie because he is doing an extra year he didn't originally plan on.
No point in debating this s hit. I don't care. Just sharing some second hand info. Maybe you lucked out and he didn't.
 
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CCM2017 said:
Neurocritic isn't an ABMS specialty and the training is not ACGME. Doesn't make one more qualified to teach IM residents.
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Hot off the presses! Neurocritical care is now an ABMS recognized specialty and will have a separate board exam.

The American Board of Anesthesiology - ABA Announces New Subspecialty Certificate in Neurocritical Care

https://www.abpn.com/wp-content/upl...ounces-New-Neurocritical-Care-Certificate.pdf

Anyone from the gallery have any thoughts on this?
 
AdmiralChz said:
Hot off the presses! Neurocritical care is now an ABMS recognized specialty and will have a separate board exam.

The American Board of Anesthesiology - ABA Announces New Subspecialty Certificate in Neurocritical Care

https://www.abpn.com/wp-content/upl...ounces-New-Neurocritical-Care-Certificate.pdf

Anyone from the gallery have any thoughts on this?
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My friend is doing it. He loves it. He keeps suggesting I do it. I am like, I highly doubt I will do two fellowships.
 
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chocomorsel said:
My friend is doing it. He loves it. He keeps suggesting I do it. I am like, I highly doubt I will do two fellowships.
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2 fellowships for the ability to work in the Neuro ICU is going to be a hard sell for many. Interested anesthesiologists coming through will be few in number - easy to argue time is better spent doing CCM among with a cardiac fellowship instead.
 
One can count the number of real neuro ICUs in most cities with one hand - and most of them are in large academic institutions. Academic Neuro ICUs will probably be run by neurology trained physicians. True neurointensivist jobs outside academics are already scarce for neurology trained neurocrit physicians. Unless the number of real Neuro ICUs changes substantially, ACGME accreditation isn’t going to improve the popularity of this fellowship.
 
TimesNewRoman said:
Silly.
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Have to say I wouldn’t eat another year of fellowship for it but if I’m eligible via the practice pathway given the sheer volume of annoying neurological conditions that roll through my combined med-surg ICU then I’ll probably sit for the board. Outside of the initial testing fee and some time in front of a book on an island off my CME budget I don’t see a downside.
 
inspirationmd said:
Have to say I wouldn’t eat another year of fellowship for it but if I’m eligible via the practice pathway given the sheer volume of annoying neurological conditions that roll through my combined med-surg ICU then I’ll probably sit for the board. Outside of the initial testing fee and some time in front of a book on an island off my CME budget I don’t see a downside.
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"The practice pathway represents a means to enter the rigorous NCC examination system... The practice pathway will not confer NCC certification."

Source: https://www.abms.org/media/176505/neurocritical-care-application-20170208.pdf
 
CCM2017 said:
"The practice pathway represents a means to enter the rigorous NCC examination system... The practice pathway will not confer NCC certification."

Source: https://www.abms.org/media/176505/neurocritical-care-application-20170208.pdf
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Page 16/Section 8d of that document lists pretty explicit breakdown of the criteria required to enter the exam system. I am reading that to say one should not expect the practice pathway alone to confer NCC certification but rather a means to be eligible to take the exam to get the certification. This is consistent with the other ABEM practice pathway for critical care including IM-CCM and ACCM where the practice pathway allowed you the means to take the exam and then be certified.

Does that seem like a reasonable interpretation? Just want to make sure I’m not off.

Appreciate the link.
 
inspirationmd said:
Page 16/Section 8d of that document lists pretty explicit breakdown of the criteria required to enter the exam system. I am reading that to say one should not expect the practice pathway alone to confer NCC certification but rather a means to be eligible to take the exam to get the certification. This is consistent with the other ABEM practice pathway for critical care including IM-CCM and ACCM where the practice pathway allowed you the means to take the exam and then be certified.

Does that seem like a reasonable interpretation? Just want to make sure I’m not off.

Appreciate the link.
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I think that makes sense. I wonder how many years the practice pathway will be available for.
 
What would be the incentive for an anesthesiologist to invest 2 years for this fellowship and then eventually take a pay cut anyway?
 
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Well I just registered for the Neurocritical care boards and got my attestation verifying my eligibility for the practice pathway done by my section chair. $2,995 for this test (yay CME funds). 10/2021 is the first admin of the test and I guess I’ll see how it goes.

Anyone else planning to take it?
 
inspirationmd said:
Well I just registered for the Neurocritical care boards and got my attestation verifying my eligibility for the practice pathway done by my section chair. $2,995 for this test (yay CME funds). 10/2021 is the first admin of the test and I guess I’ll see how it goes.

Anyone else planning to take it?
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Jesus Christ that is highway robbery if I ever seen one.
And I thought the CCM boards were pricey.
 
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chocomorsel said:
Jesus Christ that is highway robbery if I ever seen one.
And I thought the CCM boards were pricey.
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I have to agree it’s kind of a rip off. Especially since it looks like if I had been able to go through ABPN it would have only been $1900 ($700 app fee and $1200 exam fee). Not sure how that is justifiable to charge different fees for the same test depending on which board you go through.

Neurocritical Care - American Board of Psychiatry and Neurology

Neurocritical Care Deadlines, Fees and Content for Initial Certification in Neurocritical Care *Application deadlines are at 11:59 p.m. CST. Certification Requirements Applicants for certification in neurocritical care must be certified in neurology or neurology with special qualification in...
www.abpn.com www.abpn.com
 
I just registered for the test. Any book or course recommendations to prepare?
 
inspirationmd said:
Well I just registered for the Neurocritical care boards and got my attestation verifying my eligibility for the practice pathway done by my section chair. $2,995 for this test (yay CME funds). 10/2021 is the first admin of the test and I guess I’ll see how it goes.

Anyone else planning to take it?
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Think I will just practice w my CCM boards alone. I don’t see any added benefit of having it especially since it costs so much. I am over all this testing. I am getting old.
 
chocomorsel said:
Think I will just practice w my CCM boards alone. I don’t see any added benefit of having it especially since it costs so much. I am over all this testing. I am getting old.
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Agree. Unnecessary certification. Are we gonna have separate exams for every critically ill organ system? Doesn’t make any sense.
 
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CCM-MD said:
Agree. Unnecessary certification. Are we gonna have separate exams for every critically ill organ system? Doesn’t make any sense.
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Don't give them ideas... Post-op CCM boarded, Decompensated cirrhotic CCM boarded, ARDS CCM boarded we can be like nurses with so many certifications!
 
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