Questions on Vascular/Stroke

[Groy]

I'm a medical student thinking about potentially going into neurology. I have a deep interest in cerebrovascular disease and its nonsurgical care, particularly stroke and aneurysm (have done clinical research in both, have shadowed in neuro, loved learning neuro phys and anatomy, etc.) I like cerebrovascular topics much more than general neurological stuff, although I like that too.

For these reasons, vascular neurology (at least by its name) jumps out to me as something I would potentially want to do. If I could shape my own career, I'd love to manage both acute ischemic stroke patients as part of a stroke team, see stroke patients in an outpatient setting to council them long-term, and also see patients with other neurovascular (exclusively vascular) problems.

From what I am reading on this site and others is that a stroke/vascular fellowship is not needed to accomplish this, and that general neurologists interested in stroke/vascular can tailor their work to focus on those. Is that true? If it is, what is there benefit of completing a stroke fellowship (besides as a path to NIR)? What is the scope of practice of vascular neurologists, in addition to stroke, do they provide medical care for patients who have other cerebrovascular diseases (AVF, aneurysms, CASADIL, leukoencephalopathy, etc), or is that strictly for nsurg/NIR? Is it more common for these specialists to work at academic centers or in private hospitals?

TL;DR: Can't really seem to pinpoint all that distinguishes a vascular neurologist from a general neurologist interested in stroke/vascular stuff. Everything I'm reading kinda says both do both.

Sorry for any dumb questions, Thanks in advance!

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[deathmerchant]

You Can practice Vascular neuro(sans NIR) without a fellowship, but that trend is going to become less and less as stroke management becomes more complex every year. Also it would be highly unlikely even today to get into an academic program or a good non-academic(as a vascular neurologist) without a fellowship and esp if you want to climb the ladder.
You can probably only do that in small community hospitals/programs. Stroke fellowship is just 1 year and if that is what u want, I would highly recommend doing it.

 

[typhoonegator]

If you want to practice vascular neurology exclusively in both inpatient and outpatient settings, you should do a fellowship. It will give you the most options moving forward.

 

[Groy]

Thanks for these answers, my first thought is to definitely explore vascular fellowships in the future since that training seems to align with my interests. I know that in some neuro subspecialties, there isnt enough clinical volume to practice the subspecialty alone, and some specialists will split their time between specialty practice and general neuro. Is this the case in vascular (generally speaking)? I understand there are various factors like institution type/location, etc may impact this.

 

[deathmerchant]

Thanks for these answers, my first thought is to definitely explore vascular fellowships in the future since that training seems to align with my interests. I know that in some neuro subspecialties, there isnt enough clinical volume to practice the subspecialty alone, and some specialists will split their time between specialty practice and general neuro. Is this the case in vascular (generally speaking)? I understand there are various factors like institution type/location, etc may impact this.

Yes you can develop your practice to be be pure vascular(with some outliers) in general.