Pathway from integrated IR to NIR

[cybermed2424]

Hey everyone,

Just curious if anyone has experience with this? SIR had a blog post from 2018 that going from IR to NIR was only on a case by case basis as the traditional radiology pathway is DR-> neurorad -> NIR.

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[NDcienporciento100]

Hey everyone,

Just curious if anyone has experience with this? SIR had a blog post from 2018 that going from IR to NIR was only on a case by case basis as the traditional radiology pathway is DR-> neurorad -> NIR.

Yep still case by case bases. Try to go to a program where you will get lots of NIR experience.

 

[NDcienporciento100]

Very few people can say they have both skill sets. Downside is you will have not just a few but many sleepless nights.

 

[cybermed2424]

Great thanks for the response! Are you in the field?

 

[NDcienporciento100]

Training now.

 

[irwarrior]

More and more groups have a bunch of peripheral VIR and a couple of NIR in the interventional practice. The stroke call is split between the peripheral and neuro IR docs. This allows for a more reasonable call existence.

Here is a link to programs in integrated VIR that offer some INR experience.

 

[cybermed2424]

Thanks for your responses everyone! I was also curious as to your perceptions on neurosurgery in the field. Is it difficult acquiring patients if neurosurgery is also involved (as I assume they are getting a lot of the referrals)? Do they try to bully NIR folks out of the more interesting cases?

 

[NDcienporciento100]

Thanks for your responses everyone! I was also curious as to your perceptions on neurosurgery in the field. Is it difficult acquiring patients if neurosurgery is also involved (as I assume they are getting a lot of the referrals)? Do they try to bully NIR folks out of the more interesting cases?

No.

 

[NDcienporciento100]

Thanks for your responses everyone! I was also curious as to your perceptions on neurosurgery in the field. Is it difficult acquiring patients if neurosurgery is also involved (as I assume they are getting a lot of the referrals)? Do they try to bully NIR folks out of the more interesting cases?

In general

More and more groups have a bunch of peripheral VIR and a couple of NIR in the interventional practice. The stroke call is split between the peripheral and neuro IR docs. This allows for a more reasonable call existence.

Here is a link to programs in integrated VIR that offer some INR experience.

Don’t just look at this list (Which is not comprehensive, there are IR programs that receive NIR training not in thIs list) as I’ll get Neuro IR at any of them. Really research them all to see what kind of experience you will get. If you go to university of Iowa who has several fellows every year you will not get to do as much as University of Arkansas who has no fellows.

 

[irwarrior]

Do you know which other programs formally offer NeuroIR. This was a pretty recently updated list.

 

[NDcienporciento100]

Do you know which other programs formally offer NeuroIR. This was a pretty recently updated list.

I won’t go through every program.

 

[qxrt]

Would not confuse true neuroIR training (which includes cerebral aneurysm coiling/repair, intracranial AVM embolization, etc. by calling the few weeks/months of neuroIR rotation that some IR programs offer "neuroIR training."

If you want to learn how to do the above procedures and more, do a proper neuroIR fellowship +/- neuroradiology fellowship. If all you're interested in is stroke, then it's easy enough to pick up stroke skills on-the-job even out of IR training after some mentoring from an experienced stroke interventionalist. Most IR fellowships (aside from a few exceptions in the single digits), even ones listed above, are not going to train you sufficiently to be taking independent stroke call right out of fellowship, let alone more complex neuroIR procedures.

 

[NDcienporciento100]

Would not confuse true neuroIR training (which includes cerebral aneurysm coiling/repair, intracranial AVM embolization, etc. by calling the few weeks/months of neuroIR rotation that some IR programs offer "neuroIR training."

If you want to learn how to do the above procedures and more, do a proper neuroIR fellowship +/- neuroradiology fellowship. If all you're interested in is stroke, then it's easy enough to pick up stroke skills on-the-job even out of IR training after some mentoring from an experienced stroke interventionalist. Most IR fellowships (aside from a few exceptions in the single digits), even ones listed above, are not going to train you sufficiently to be taking independent stroke call right out of fellowship, let alone more complex neuroIR procedures.

All true.

 

[irwarrior]

If you get 3 to 4 months of primary operator experience doing cerebral angiography and stroke interventions and aneurysm coiling you will have a good handle on stroke thrombectomy. Brown graduates have historically had a great deal of cerebral vascular interventions and have come out quite competent as just one example.

 

[irwarrior]

I would reach out to the likes of PIH , INOVA and countless others in practice who are providing this service as peripheral vascular interventionalists.