Neurology trained Interventional pain vs interventional neuroradiology outlook?

[Neuroelectrobuzz]

I am an IMG applying to neurology. Yes, I know those are two completely different specialties. But I want a practice where I can do some general neurology (maybe 20%) but also a lot of procedures, atleast early on in my career. These are two most procedure heavy neuro fellowships so I would like to go into this.

I have a few specific doubts:
1)I know that NIR has terrible lifestyle and call, which I am okay with now, but maybe not in my 50s. Can I switch to a more relaxed lifestyle down the road? Perhaps something like telestroke 10 12hour shifts a month. Also, how is the lifestyle of an academic NIR specialist like?
2) What’s the catch with pain? Great money, lifestyle. Patients aren’t great but I can handle it, especially if I join a needles only practice.
3) Which specialty is likely to have a better outlook in the future? How’s the research looking like?

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[Thama]

Someone looking to go into neurology for access to NIR and interventional pain just screams "I'm trying to backdoor into a procedural specialty". If your goal in life is to crank out procedures 8 to 5, neurology is not a good specialty fit and you'll spend almost all of your time in training wasting everyone's time including your own.

 

[Neuroelectrobuzz]

Someone looking to go into neurology for access to NIR and interventional pain just screams "I'm trying to backdoor into a procedural specialty". If your goal in life is to crank out procedures 8 to 5, neurology is not a good specialty fit and you'll spend almost all of your time in training wasting everyone's time including your own.

I agree, but I am an international medical graduate with not the best profile, not good enough for anesthesia or radio or neurosurgery. Neurology, IM and pediatrics are more viable for us. And I am open to other fields too, especially movement because of Botox+DBS, however I’m most interested in these two currently.

I would be very grateful if you could provide an input to my questions.

 

[Postictal Raiden]

PMR is your path of least resistance. Anaesthesiology maybe

 

[Thama]

PMR is your path of least resistance. Anaesthesiology maybe

This is the way

 

[sloh]

Don't think a "needles only practice" exists.

 

[Neuroelectrobuzz]

PMR is your path of least resistance. Anaesthesiology maybe

They’re difficult to get for IMGs unfortunately. Plus interventional neuro isn’t possible through that route

 

[Dr Meow]

How hard/competitive is it to get a Neurointerventional radiology fellowship?? What does it take to get it?

I'm OMS1 but I've always been interested in ALS/MS/Alzheimer's but I heard there's high burnout rates. So I want to a backup route to procedural if I burn out in the future.

 

[xenotype]

How hard/competitive is it to get a Neurointerventional radiology fellowship?? What does it take to get it?

I'm OMS1 but I've always been interested in ALS/MS/Alzheimer's but I heard there's high burnout rates. So I want to a backup route to procedural if I burn out in the future.

Quite doable for DO or IMG in the right residency with the right connections. But cognitive neurology and NIR are literally on complete opposite ends of the spectrum and I highly doubt your personality is compatible with both.

I think for some people neurology can be an OK choice if you are thinking procedurally about pain or NIR in the future. But you absolutely need to match into a residency program that routinely places people in these fellowships and has the right connections to make it happen for you, and you also need to understand that neurology is a lot of non-procedural stroke alerts, consults for AMS, and in the real world 90% outpatient consults for neuropathy, dementia, or weird symptoms that are psychogenic etc. Pain and NIR in the real world may still involve doing a lot of neurology when it comes time to find a job. Example- a neuro trained pain doc signing with a hospital they may want you to cover neurology call etc, and NIR 50% of the time or more you'll be doing stroke/neuroICU/inpatient neuro.

PMR, anesthesia, rads are certainly paths of less resistance for proceduralists and these spots are not as hard for DO/IMG to get as they were 10 years ago while neurology has gotten slightly more competitive than it used to be.