Neuroimaging via Neurology or Radiology

[medsRus]

I've seen that the United Council for Neurologic Subspecialties created a subspecialty in neurology called neuroimaging. They say,

The purpose of the training program is to prepare the physician for the independent practice of neuroimaging.

Also,

The objectives of the Neuroimaging Fellowship are:
1. To understand the technical aspects of imaging and be able to apply this knowledge in the clinicalsetting
2. To gain the ability to independently interpret neuroimages and express that
3. interpretation in a complete, clear, organized, and accurate report

Discussion

Does it seem realistic that such neuroimaging fellowships will pop-up shortly?

Will they be able to read neuro studies?

Will radiology shut this down?

Is there a general movement towards organ system specialty imaging?

Thank you!

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[USIMGgrad]

I've seen that the United Council for Neurologic Subspecialties created a subspecialty in neurology called neuroimaging. They say, Also, Discussion

Does it seem realistic that such neuroimaging fellowships will pop-up shortly?

Will they be able to read neuro studies?

Will radiology shut this down?

Is there a general movement towards organ system specialty imaging?

Thank you!

yes, yes, no, dont' know

 

[doxtyp]

NEUROIMAGING TURF BATTLES FLARE

 

[pep45]

NEUROIMAGING TURF BATTLES FLARE

Gotta love those Radiologists. I can understand how they feel. Interventional Radiology has or seems to be slipping from the hands of Rads. Seems like Radiologists may be realizing that they aren't as "necessary as they used to be..." I feel like in the future specialties should be able to read radiological studies if they are certified and willing to fork out the Insurance. Just depends on how much you are willing to do I guess and how much money you have to influence the laws as a group..

 

[typhoonegator]

Neuroimaging fellowship theoretically qualifies you to read neuro MRIs and CTs. I know a bunch of people who have done this, usually in conjunction with another fellowship, like MS. However, I don't know anyone around my institutions who is using this fellowship experience to actually read scans. You would have to be working in the right environment to have a neurorads department that would be welcoming to you, and I think a lot of people still don't feel comfortable enough even after this fellowship to sign-out scans independently. However, the neuroimaging fellowship can be very useful for research endeavors.

Neuroradiology fellowship is a lot more rigorous than neuroimaging fellowship, and the two are most certainly not interchangeable.

 

[medsRus]

I like neuroimager Carl Ellenberger's response:

We have no reason to believe that the level of intelligence in any specialty is higher than in any other. A neurologist, cardiologist, neurosurgeon, or orthopedist with appropriate training can be capable of interpreting images in his or her respective discipline. The ability to perform procedures or interpret tests depends upon the training and the experience of the individual, not his or her specialty. The AMA House of Delegates has repeatedly affirmed this in principle and thousands of non-radiologist physicians have validated it in practice.

 

[HarveyCushing]

I like neuroimager Carl Ellenberger's response:

I like that response as well.

 

[typhoonegator]

I totally agree with Ellenberger's stance as well. But there is a big difference between interpreting scans on your own, and even disagreeing with the formal read, and formally reading scans on your own. There are liability issues in addition to experience and training.

I feel very adept at reading scans at this point in my training, but I still routinely miss mucus retention cysts in the maxillary sinus, or dental disease, until I look at the formal read. Formal radiologic training just trains you differently.

I personally think there should be a formal track from neurology --> neuroradiology. If radiologists don't think the neuroimaging fellowship is enough to read scans professionally, then let those of us who want to get formal training with radiology.

 

[drjaymehta]

i think its still unfair to allow the neurologists to read the radiological stuff..

it takes years of training, to learn and interpret the scans properly..

and its not just about knowing the anatomy or physiology of an organ better...anyone can study the necessary anatomy in 4 years of training...

 

[Amos]

i think its still unfair to allow the neurologists to read the radiological stuff..

it takes years of training, to learn and interpret the scans properly..

and its not just about knowing the anatomy or physiology of an organ better...anyone can study the necessary anatomy in 4 years of training...

I agree that there is a TON that goes into training in radiology, including some pretty advanced physics. It's a full 4 year residency with light hours in terms of inpatient care but a heavy didactic load and pretty tough boards.

However your statement "anyone can study the necessary anatomy in 4 years of training..." seems off base to me. I'm sure that different potential diagnoses and interpretations pop into the head of a neurologist vs. "just" a radiologist when looking at an MR. Heck, if you are reading brain and spine images only, I ideally I would want someone that extensive experience in radiology and clinical neuro. I do agree with the poster above that pointed out that economically its not feasible to do read only head images at the moment.

In addition, if I had just had a stent placed in my MCA or a clot busted with local TPA I would sure as heck want the fellow who did the procedure to have extensive neurologic training so that he could closely monitor me after the procedure and be ready to intervene in case of complications. It wouldn't matter to me at all if he was trained in reading lung x-rays or pelvic CTs during residency, but I would want him/her to have managed hundreds of stroke patients before she/he starts doing IR stuff in my brain.