Neurosurgery Vs Interventional Radiology

[Dr. USMLE]

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.

I did a cush transitional year. During the TY, I did DR, IR and vascular surgery electives.

I think that was the ideal approach. Having said that, I am not in NIR. I do diagnostics and interventional now.

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[NDcienporciento100]

I did a cush transitional year. During the TY, I did DR, IR and vascular surgery electives.

I think that was the ideal approach. Having said that, I am not in NIR. I do diagnostics and interventional now.

Yeah this seems smart. Many of these programs have 4 months of electives. So you could easily do those in neurology.

 

[NDcienporciento100]

Many programs will train you in NIR that aren't on that list, they just don't necessarily advertise it. This is something you can probably ask about at interviews.

I notice a lot of ppl talking about DR/IR/NIR, but not a lot of talk about nsgy in general. Just a couple things:

- Your b&b in DR/IR will be abscesses, drains, CXRs, and CTs. Your b&b in nsgy will be emergent cases and spine (hemicranis, washouts, strokes, SAHs, trauma). If you like the excitement of emergent cases, nsgy has more of that than almost any other service.
- Its important to be skeptical of the spine primary literature but if you have a patient with a metastatic lesion or compression that's preventing them from walking, there's only one way to fix it. The trick to being a good spine surgeon is knowing when surgery is necessary. There are indications for spine surgery that no one else can treat.
- Nsgy is a service with its own patients. You will have to round on them. You will take care of them for their whole hospital stay. They will know you, appreciate you, and you will have continuity with them. You won't get that with DR/IR/NIR. This could be a pro or con
- Nsgy patients are the sickest in the hospital. This could be a pro or con
- Many nsgy residencies allow for moonlighting, although not as common as in DR/IR. Moonlighting as a nsgy attending is extremely lucrative and very common where I am.
- Neurosurgeons are the experts in their respective diseases. Other services will come to you for help. This means a lot more work and consults, but you are seen as the expert and source of knowledge (could be a pro or con). DR/IR/NIR are more of technicians and are experts on the imaging itself.

I think you'll find that most neurosurgeons never considered DR/IR, and its not due to lack of exposure. Its a very different service with a very different feel and different people. You have to decide what kind of person you are what you want from your practice. If there's something that draws you as much or more than nsgy, pursue that field. If nsgy is the only thing you think about during the day and you can't imagine living your life and not trying to break into it, do nsgy.

Agree with what you said. It really comes down to do you like surgery. Or do you just like endovascular. Yes b&b IR is lines and drains but we also do awesome endo cases TIPS, Y90, venous occlusive disease, GI bleeds, ct guided ablations, etc. IR are the experts in image guided procedures that other specialty’s will come to you asking for help.

 

[7331poas]

snip

The b&b of IR depends on the hospital I think. At my institution IR/NIR does some pretty crazy cases regularly.

 

[cybermed2424]

Just wanted to check in to see if you are still happy with your decision of pursuing DR? Have you reconciled giving up your pursuit of neurosurg? In a similar position as you were.