Neurology vs. Neurology ICU

[Aloha Kid]

Maybe someone could help. I wanted to fulfill my 4th year core Neuro requirement by doing Neuro ICU. The chair of IM at my school said "No." His reasoning was that Neuro ICU will not teach you what you the fundamentals of regular Neurology. Is this true? I always kind of thought of Neuro ICU was a more intensive type of Neurology, just like Medical ICU is a more intensive type of internal medicine.

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[GopherBrain]

Your chair's assessment is fair enough. You aren't going to learn a good neuro history or physical exam, or see much variety, taking care of gorked out stoke patients and induced comas for status. It really is a different experience.

 

[swedcrip]

He's right. It's full of patients nearly or completely out of it. It's only a small part of neurology and isn't really a continuation of the field (sever cases of everything doesn't make it there). In some ways it's more of a place to learn about neurosurgical cases and at some places it's a place to scut neurologists into managing surgery cases (this I didn't see as common, but I often heard it's something neurology residents keep an eye on - actually most places had an excellent relationship between the 2 fields).

 

[scared sh*tless]

He's right. It's full of patients nearly or completely out of it. It's only a small part of neurology and isn't really a continuation of the field (sever cases of everything doesn't make it there). In some ways it's more of a place to learn about neurosurgical cases and at some places it's a place to scut neurologists into managing surgery cases (this I didn't see as common, but I often heard it's something neurology residents keep an eye on - actually most places had an excellent relationship between the 2 fields).

Point well taken about Neuro ICU being a dumping ground for neurosurgical cases.

I'm on MICU right now and I am wondering: what point would there be to a neuro ICU experience? And some residency programs proudly tout their neuro ICU strengths, and neuro ICU rotations...

Seems to me like the cool stuff in ICU is all respirators, putting in lines, and cardiology findings... cool enough, but why would you go into neurology if you wanted to do that? It seems like for most of our patients -- their neurological problems are the LEAST of their worries.

There must be a reason for this emerging field of neuro-icu... Is it just kind of a combined thing, like 'med neuro'?

 

[GopherBrain]

I'm on MICU right now and I am wondering: what point would there be to a neuro ICU experience? And some residency programs proudly tout their neuro ICU strengths, and neuro ICU rotations...

I think that neuro ICUs can provide greater continuity to patients, as well as more focused expertise. As a resident in the neuro ICU you learn to manage the sickest possible patients in your chosen field, so later you can serve them from the clinic room to the ICU by yourself. Personally, I have no interest in becoming a neuro-intensivist, but I wanted a residency program that was strong in that area.

Plus, perhaps it is an appealing field for those people deciding between neurology and medicine. This is certainly a common situation.