Neurosurgery Vs Interventional Radiology

[libertyyne]

Alright guys. I saw the light, or in this case the dark. I will be only applying to DR, and if i still have the interventional bug I will apply DR->Neuro Rad->NIR.

---

Members don't see this ad.

 

[Chlorini]

Alright guys. I saw the light, or in this case the dark. I will be only applying to DR, and if i still have the interventional bug I will apply DR->Neuro Rad->NIR.

What made you change your mind??

 

[libertyyne]

What made you change your mind??

I looked at the primary literature for spine. I had a hard time thinking i would have to do 80% spine in my career going forward with that in mind.
I dont like that i would essentially be incentivized to do as much spine as i possibly could.

I have financial responsibilities towards my parents and a family, rads programs tend to allow a good amount of moonlighting which would help me fulfill those obligations a lot sooner than Neuro.

NIR would be a shorter pathway from rads 5+2 vs the 7+1 for neurosurgery.

Rads flexibility allows me to have some side gigs i have been interested in pursuing and obviously spending more time with family.

I also think , Rads is inherently undervalued at this time due to overblown fears of AI.


I am kinda over medicine. i know that sounds crazy, and maybe that is just a temporary depression associated with the loss of something that i wanted for a few years. Or maybe just burn out.

 

[Chlorini]

I looked at the primary literature for spine. I had a hard time thinking i would have to do 80% spine in my career going forward with that in mind.
I dont like that i would essentially be incentivized to do as much spine as i possibly could.

I have financial responsibilities towards my parents and a family, rads programs tend to allow a good amount of moonlighting which would help me fulfill those obligations a lot sooner than Neuro.

NIR would be a shorter pathway from rads 5+2 vs the 7+1 for neurosurgery.

Rads flexibility allows me to have some side gigs i have been interested in pursuing and obviously spending more time with family.

I also think , Rads is inherently undervalued at this time due to overblown fears of AI.


I am kinda over medicine. i know that sounds crazy, and maybe that is just a temporary depression associated with the loss of something that i wanted for a few years. Or maybe just burn out.

I relate to that haha. I just finished an inpatient medicine rotation (I'm in my transitional year) and let me tell you--there have been exactly 0 times that I wished I pursued internal medicine or any of its subspecialties.

 

[aaronrodgers]

I looked at the primary literature for spine. I had a hard time thinking i would have to do 80% spine in my career going forward with that in mind.
I dont like that i would essentially be incentivized to do as much spine as i possibly could.

I have financial responsibilities towards my parents and a family, rads programs tend to allow a good amount of moonlighting which would help me fulfill those obligations a lot sooner than Neuro.

NIR would be a shorter pathway from rads 5+2 vs the 7+1 for neurosurgery.

Rads flexibility allows me to have some side gigs i have been interested in pursuing and obviously spending more time with family.

I also think , Rads is inherently undervalued at this time due to overblown fears of AI.


I am kinda over medicine. i know that sounds crazy, and maybe that is just a temporary depression associated with the loss of something that i wanted for a few years. Or maybe just burn out.

What gaming chair are you going to buy when you do telerads from your vacation home

 

[CyrusHabs7695]

Alright guys. I saw the light, or in this case the dark. I will be only applying to DR, and if i still have the interventional bug I will apply DR->Neuro Rad->NIR.

Love it bro. Hopefully see you on the dark side someday

 

[libertyyne]

What gaming chair are you going to buy when you do telerads from your vacation home

There can be only one.

 

[You shall know the Truth]

Alright guys. I saw the light, or in this case the dark. I will be only applying to DR, and if i still have the interventional bug I will apply DR->Neuro Rad->NIR.

Congrats

 

[Cognovi]

I looked at the primary literature for spine. I had a hard time thinking i would have to do 80% spine in my career going forward with that in mind.
I dont like that i would essentially be incentivized to do as much spine as i possibly could.

I have financial responsibilities towards my parents and a family, rads programs tend to allow a good amount of moonlighting which would help me fulfill those obligations a lot sooner than Neuro.

NIR would be a shorter pathway from rads 5+2 vs the 7+1 for neurosurgery.

Rads flexibility allows me to have some side gigs i have been interested in pursuing and obviously spending more time with family.

I also think , Rads is inherently undervalued at this time due to overblown fears of AI.


I am kinda over medicine. i know that sounds crazy, and maybe that is just a temporary depression associated with the loss of something that i wanted for a few years. Or maybe just burn out.

Rads to NIR will be 1 (internship) + 4 (DR) + 1 (diag neurorad) + 2 (NIR; 1 nonaccredited year, 1 accredited year) = 8

 

[libertyyne]

Rads to NIR will be 1 (internship) + 4 (DR) + 1 (diag neurorad) + 2 (NIR; 1 nonaccredited year, 1 accredited year) = 8

I am not well versed on this but there are some programs that will only be 1 year post neurorads training .or that have combined 2 years of neuro rads and nir. Also would love to hear some recs from you in the wamc thread in radiology with my interest in nir in mind .

 

[Giovanotto]

Best of luck in whatever you end up doing libertyyne, been following your predicament in the last few months. Hope you find what you're looking for out there, medicine is one hell of a beast.

 

[TheVagüs]

I am kinda over medicine. i know that sounds crazy, and maybe that is just a temporary depression associated with the loss of something that i wanted for a few years. Or maybe just burn out.

It's funny you mentioned this, because I felt the same way when I pivoted to ophtho. I could have written this exact line myself. I am still super excited for my chosen career, but I'm a bit tired at the moment and there is a feeling of loss associated with letting something go that you held onto for a long time.

I think we will feel better and more of the fire will come back once we have some off time in 4th year and settle in to our new paths.

Edit: If any PDs happen to find this... just kidding about the above. Medicine is life. My passion for eyes never waivers. I will work 16 hour days 7 days a week until I die. Please interview me.

 

[yungspleen]

Loving all the discussion about NIR in this thread. Def a pathway I'm considering which doesn't get discussed enough on here. Wish there were some NIR attendings active on the forum

 

[NDcienporciento100]

Rads to NIR will be 1 (internship) + 4 (DR) + 1 (diag neurorad) + 2 (NIR; 1 nonaccredited year, 1 accredited year) = 8

Not necessarily true. Depends on how much NIR exposure he gets in residency. Might only be one year NIR. You need 200 cerebral procedures, I will have well over that when I graduate.

 

[libertyyne]

Not necessarily true. Depends on how much NIR exposure he gets in residency. Might only be one year NIR. You need 200 cerebral procedures, I will have well over that when I graduate.

Some programs have a lot of elective time. hoping i can squeeze in some of the requirements.
I would be ecstatic if i could squeeze training in 7 vs 8.

 

[NDcienporciento100]

Crazy, this thread is 6 pages long!!!!!

Neurosurgery is great field and so is IR or NIR. I would never switch out of IR but that said if someone told me I had to and I could pick any field it would probably be neurosurgery. Both fields on the cutting edge. When it comes to those people writing posts about the bad parts of each specialty. All fields!!! And I do mean all fields, have things that are not glamorous and not fun. For me it’s putting drains in surgical nightmares or doing a picc no one else can. You have to decide if you can live with that. I personally think drains and picks are kinda fun and don’t mind them and if somehow I could find a way to do them without having to talk to the general surgery team I’d actually look forward to them lol. For those that have there mind set on NIR really look at the three specialty’s that do it Neurosurgery, neurology, and radiology a whole and decide what things you can live with from each specialty that have nothing to do with NIR.

 

[NDcienporciento100]

Some programs have a lot of elective time. hoping i can squeeze in some of the requirements.
I would be ecstatic if i could squeeze training in 7 vs 8.

Go to a program with no NIR fellows that is comprehensive stroke center.

 

[yungspleen]

Go to a program with no NIR fellows that is comprehensive stroke center.

Are you an NIR fellow?

 

[Cognovi]

Can you list programs that are comprehensive stroke centers that do not have NIR fellows?

 

[NDcienporciento100]

Can you list programs that are comprehensive stroke centers that do not have NIR fellows?

Lots of them! Actually most of them....

 

[NDcienporciento100]

Are you an NIR fellow?

Nope

 

[NDcienporciento100]

Can you list programs that are comprehensive stroke centers that do not have NIR fellows?

165 comprehensive stroke centers in US and 30 something NIR fellowships I’ll leave the rest in your competent hands.

 

[Cognovi]

165 comprehensive stroke centers in US and 30 something NIR fellowships I’ll leave the rest in your competent hands.

Here's what I got

Duke
Mayo Rochester
Cornell
Mount Sinai
UCLA
Cleveland Clinic
UAB
Northwestern
Yale
Colorado
Georgetown
UChicago
Tufts
Boston Medical Center
U Maryland
UNC
Brown

 

[NDcienporciento100]

Here's what I got

Duke
Mayo Rochester
Cornell
Mount Sinai
UCLA
Cleveland Clinic
UAB
Northwestern
Yale
Colorado
Georgetown
UChicago
Tufts
Boston Medical Center
U Maryland
UNC
Brown

Would not go to Brown . IR does all there Strokes.

 

[dr_kateb]

View attachment 320497
There can be only one.

Amatuer

 

[NDcienporciento100]

Here's what I got

Duke
Mayo Rochester
Cornell
Mount Sinai
UCLA
Cleveland Clinic
UAB
Northwestern
Yale
Colorado
Georgetown
UChicago
Tufts
Boston Medical Center
U Maryland
UNC
Brown

Northwestern has a great NIR program....

 

[libertyyne]

Go to a program with no NIR fellows that is comprehensive stroke center.

oh wow. I was thinking of going to a program based on them having fellowship. Because i reasoned that i would be able to network internally and get the appropriate research exposure for fellowship. This thinking throws that out of the window.

 

[NDcienporciento100]

oh wow. I was thinking of going to a program based on them having fellowship. Because i reasoned that i would be able to network internally and get the appropriate research exposure for fellowship. This thinking throws that out of the window.

You can do that but you won’t get to do any of the procedures, the fellow will be doing them. You need at least 200 cerebral cases to shave a year off training.

 

[libertyyne]

You can do that but you won’t get to do any of the procedures, the fellow will be doing them. You need at least 200 cerebral cases to shave a year off training.

this is some 4D chess. Thanks , i will go to a smaller university program then. i was getting excited about duke,emory but i guess not then.

 

[Cognovi]

Northwestern has a great NIR program....

My bad, they were listed under McGaw rather than Northwestern and I overlooked it.

 

[Cognovi]

You can do that but you won’t get to do any of the procedures, the fellow will be doing them. You need at least 200 cerebral cases to shave a year off training.

You also need to spend at least 6 months clinical time on neurosurgery, vascular neurology, or neuro ICU.

 

[NDcienporciento100]

You also need to spend at least 6 months clinical time on neurosurgery, vascular neurology, or neuro ICU.

I would try and do some intern year if you can.

 

[Giovanotto]

I thought MCW had a NIR fellowship program.

 

[aaronrodgers]

Amatuer

View attachment 320577

Where are the cup holders

 

[dr_kateb]

Where are the cup holders

Damn I thought something looked off about that photo. This is the one I meant to post lol.

Pssst it's only 10k.

 

[aaronrodgers]

Damn I thought something looked off about that photo. This is the one I meant to post lol.

Pssst it's only 10k.

this needs to be in every reading room

 

[NDcienporciento100]

I thought MCW had a NIR fellowship program.

Lots of programs on that list have NIR fellowships....

 

[libertyyne]

Damn I thought something looked off about that photo. This is the one I meant to post lol.

Pssst it's only 10k.

i heard the computer was worth 6 by itself . So not a bad deal.
Edit :that was the 20k model. This pc is just kinda meh.

 

[libertyyne]

I would try and do some intern year if you can.

You also need to spend at least 6 months clinical time on neurosurgery, vascular neurology, or neuro ICU.

Based on this , do you think a surgical intern year would be beneficial for meeting some of these requirements ? I think I am leaning ty or surg intern considering it would allow me to get some of these requirements in.

 

[NeuResurgens]

Based on this , do you think a surgical intern year would be beneficial for meeting some of these requirements ? I think I am leaning ty or surg intern considering it would allow me to get some of these requirements in.

I did an IR rotation here and some of the residents seemed to appreciate having done a surgical prelim year, not just for things like this but in general having better procedural skills

 

[efle]

^ I got a different take from my IR department when I asked them about medicine vs surgery vs TY for PGY-1. Unanimously told me that it doesn't matter at all, you don't get to operate much as a surg intern anyways, so go for the TY or a chill medicine prelim instead.

 

[libertyyne]

^ I got a different take from my IR department when I asked them about medicine vs surgery vs TY for PGY-1. Unanimously told me that it doesn't matter at all, you don't get to operate much as a surg intern anyways, so go for the TY or a chill medicine prelim instead.

My IR PD said that a surgical intern year would look favorable come fellowship match time. I guess in my instance it would help me get to the 6 months of vascular/nsx rotations required for NIR fellowship, but im not sure if they would take it into consideration when the time for fellowship arrives.

 

[NDcienporciento100]

My IR PD said that a surgical intern year would look favorable come fellowship match time. I guess in my instance it would help me get to the 6 months of vascular/nsx rotations required for NIR fellowship, but im not sure if they would take it into consideration when the time for fellowship arrives.

So never thought about it from this standpoint. That is someone only interested in NIR.... I would say medicine or whatever internship will get you the most Neurology time. Neuro critical care , vascular neurology those would be the money shots. General surgery is necessary. for body IR it is but not for NIR. Actually think it would be detrimental.

 

[libertyyne]

So never thought about it from this standpoint. That is someone only interested in NIR.... I would say medicine or whatever internship will get you the most Neurology time. Neuro critical care , vascular neurology those would be the money shots. General surgery is necessary. for body IR it is but not for NIR. Actually think it would be detrimental.

the fellowships however require 6 months of nsx or vascular surgery not general neurology or neuro critical care, to essentially shave time off.

 

[NDcienporciento100]

the fellowships however require 6 months of nsx or vascular surgery not general neurology or neuro critical care, to essentially shave time off.

Where does it say vascular surgery?

 

[NDcienporciento100]

Where does it say vascular surgery?

You will likely not do any neurosurgery as an intern. At most 1 month.

 

[FalconSlice]

Just wanted to say great thread and great read. Keep us updated @libertyyne as you go through your process. Will be extremely helpful for those in similar situations in the future.

 

[libertyyne]

You will likely not do any neurosurgery as an intern. At most 1 month.

I guess, i was thinking about TY years and 4 months of electives. I mean would they really say no to vascular surgery or NSX?
It is not clear from the the surgical intern year curricula what duration of electives is allowed.

here is an example

The t"these rotations may be changed piece is what is what i am trying to get. And at my home program the NSX interns rotate on NSX for 4 months.

 

[NDcienporciento100]

You will likely not do any neurosurgery as an intern. At most 1 month.

I guess, i was thinking about TY years and 4 months of electives. I mean would they really say no to vascular surgery or NSX?
It is not clear from the the surgical intern year curricula what duration of electives is allowed.

here is an example
View attachment 321008

The t"these rotations may be changed piece is what is what i am trying to get. And at my home program the NSX interns rotate on NSX for 4 months.

No what I’m saying is vascular surgery does not qualify as part of the 6 months required.

 

[bobjonesbob]

the fellowships however require 6 months of nsx or vascular surgery not general neurology or neuro critical care, to essentially shave time off.

These are the current requirements for radiologists entering the CAST accredited NIR programs:

"Satisfactory completion of an ACGME-accredited neuroradiology fellowship including, or in addition to, at least 6 months of clinical service in a neurological surgery, vascular neurology, or neurocritical care program before entering the advanced year of NES fellowship."

Your best chance to get rotations in those fields will be a prelim medicine year or a TY.