Path vs Rads

[Neurointerventionalist]

You’re right, I went too far with the current accepted name towards the neurosurgery side of things. The turf battle in the US is indeed bad, and while I agree the name should remain interventional neuroradiology, it’s trending away from that.

The neurosurgeons don’t want to repeat the mistake of the cardiothoracic surgeons, so they’ve marked their territory (at least in the US).

Agree.
IMO solution to the turf war is to transform the residencies into "modular pathways".

Neurologists, neurosurgeons, neuroradiologists and neurointensivists should all start with a "clinical neuroscience module" and then add the "modules" they want to (clinical neurovascular, general neurosurgery and then vascular neurosurgery, neurovascular imaging and then neurointerventional, etc).

Then you a have real neurointerventionalists (and not neuroIR vs endovascular nsg doing the same business). Convergence instead of turf war.

Same goes for gamma-knife (instead of turf war between neurosurgeons and radonc).
Same goes for neurocritical care (instead of turf war between neurologists and intensivists).
Same goes for stroke units etc etc

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[Neurointerventionalist]

I think what did it for me was the flexibility of Rads. In terms of work (procedures, seeing patients, just reading), work setting (private, academics, telerads, and VA) and job market (has ups and downs but always better than path). After doing rotations and talking to people, I realized path is too academic for me. Something I'm not super interested in. I also like the faster pace of Rads and the possibility of finding lifestyle groups working 3-4 days a week (something you can't find in Path). Hopefully I made the right decision.

Great decision. Same was for me.

Look at all the "subfields" in radiology and find the one best suits for you. So many possibilities.

AI, molecular imaging and interventional are the future anyway.

 

[WedgeDawg]

Agree.
IMO solution to the turf war is to transform the residencies into "modular pathways".

Neurologists, neurosurgeons, neuroradiologists and neurointensivists should all start with a "clinical neuroscience module" and then add the "modules" they want to (clinical neurovascular, general neurosurgery and then vascular neurosurgery, neurovascular imaging and then neurointerventional, etc).

Then you a have real neurointerventionalists (and not neuroIR vs endovascular nsg doing the same business). Convergence instead of turf war.

Same goes for gamma-knife (instead of turf war between neurosurgeons and radonc).
Same goes for neurocritical care (instead of turf war between neurologists and intensivists).
Same goes for stroke units etc etc

I don’t think a surgical residency would work well like this. For neurosurgery at least, you get ~6 months (depending on the program can be a lot more) of endovascular time and then can either do an enfolded or post residency endovascular fellowship if you want to make it a big part of your practice (which is the trend for the newest generation of vascular neurosurgeons). But you still need to start to develop the surgical technical and management skills to become an excellent operator, which takes a lot of time and volume. A different modular system may not be conducive to this if it cuts down on the OR time.

Honestly if you want you can probably think of the current paradigm as “modular” if you want.

Neurosurgery has a “base” module of general neurosurgery with further “modules” where you can expand your ability to do neurocritical care, endovascular neurosurgery, GK, whatever via additional case volume or even a fellowship.

Neurology has a “base” module in the clinical non-operative neurosciences and can expand with “modules” in neurocritical care or neurointerventional radiology.

Starting neurology and neurosurgery from a base pathway and then diverging IMO would provide no real benefit over the current system and may even dilute the specialized skills that each group has in favor of more generalized practice (which would be functionally useless and again not an improvement).