Question regarding fellowships from a MS4

[Dr. Bruce Banner]

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I have a question for residents, fellows, attendings, and program directors. What are the most important factors that fellowship directors look for in applicants when they apply for fellowships? is it prestige of the residency institution? is it publications?

 

[AlbinoHawk DO]

I have a question for residents, fellows, attendings, and program directors. What are the most important factors that fellowship directors look for in applicants when they apply for fellowships? is it prestige of the residency institution? is it publications?

Except for pain and some of the top stroke or neurophysiology/epilepsy, "does he have a pulse?"

 

[Dr. Bruce Banner]

lol so which ones are the top stroke or neurophys/epilepsy fellowship in the country?

 

[Thama]

I don't know why he singled out neurophysiology and stroke as being competitive. Even the best neurology departments don't always fill all of their stroke and epilepsy spots. Neurophysiology (EEG/EMG hybrid) is on its way out as a viable fellowship option altogether.

Interventional is competitive. ICU is kind of competitive depending on location. Everything else is a crapshoot and you'll see fellowships within elite neurology departments advertising open positions after the match on a very regular basis.

 

[aye_emm_gee]

Neurophysiology (EEG/EMG hybrid) is on its way out as a viable fellowship option altogether.

This is surprising to me. What makes you say this?

 

[Thama]

This is surprising to me. What makes you say this?

Short answer: hospitals want epilepsy trained people to read the EEGs and neuromuscle people to read the EMGs. Most large academic centers are already this way, and higher level private hospitals and large affiliated practices are close behind.

Longer answer: Why is the above the case? Because both EEG and EMG are highly dependent on the clinical questions being asked and are generally useless outside of that context. The standard routine EEG ordered by a hospitalist as part of an altered mental status workup is on the short list for most useless tests available at any hospital. The training for how to perform electrophysiology tests well is intimately tied to the overall context of how to diagnose and treat these patients which is why fellowship training in the disease type is increasingly seen as strongly preferable.

 

[Telamir]

I would agree with the above:

I did an EEG only fellowship and I saw the writing on the wall. I think CNP only fellowships may be on their way out for what Thama said. EEG and EMG are both very highly "operator dependent", and you can get into trouble if the person doing/interpreting the study is not well versed in the technique. While I think that a CNP fellowship prepares you adequately to interpret or perform these studies the advantage lies in the context/interpretation.

I'm pretty lucky that I was able to take the Epilepsy board with my CNP-EEG fellowship, though and to be fair my fellowship was more geared towards epilepsy rather than purely CNP.

 

[Dr. Bruce Banner]

I would agree with the above:

I did an EEG only fellowship and I saw the writing on the wall. I think CNP only fellowships may be on their way out for what Thama said. EEG and EMG are both very highly "operator dependent", and you can get into trouble if the person doing/interpreting the study is not well versed in the technique. While I think that a CNP fellowship prepares you adequately to interpret or perform these studies the advantage lies in the context/interpretation.

I'm pretty lucky that I was able to take the Epilepsy board with my CNP-EEG fellowship, though and to be fair my fellowship was more geared towards epilepsy rather than purely CNP.

What are the best CNP-EEG fellowships in the country in your opinion if I would like to work in an academic / university setting when I graduate?

 

[Thama]

What are the best CNP-EEG fellowships in the country in your opinion if I would like to work in an academic / university setting when I graduate?

Given what multiple people are telling you above, what on earth would possess you to apply to CNP rather than epilepsy programs if you want to read EEG at an academic center?

 

[Hank_Hill_MD]

Another question related to fellowships: during my away rotations, I spent a lot of time with neuro-ophthalmologists (ophtho-trained) and will likely look to neuro-ophtho fellowship after residency. My experience is that most ophtho-trained neuro-ophthos will do multiple fellowships (say, plastics + neuro), as neuro-ophtho is not known to generate a lot of income. Are there any fellowships that neuro-ophtho would synergize well with coming from the neuro side of things? I'm thinking of a future outpatient setup of like 3-4 days/wk of MS or headache clinic + a day or so of neuro-ophtho, but I honestly don't know if this is viable or commonly done.

 

[Telamir]

The few neuro-ophthalmologists that I know that went the Neuro-->Neuro-ophthalmology route tend to be in academics. They also tend to do a lot of MS and pseudotumor, so it's rarely 100% neuro-ophtho unless you have a big referral base. That being said they're rare enough that if they are in the community they tend to have huge waiting lists. I don't know much about their compensation, though. It's a pretty small, tight knit community however.