Radiology vs. Neurology please give me information

[DocToBe]

I was wondering if anyone knows of there is a radiology subspecialty that only deals with the nervous system? Like maybe neuroradiology or something like that? If such a thing exists, how difficult is it to obtain such residencies? What are the main differences between such a radiological subspecialty and a plain old neurologist besides the fact that the neurologist may administer more treatments and may play more of a role in doc-patient communication? Thanks for the info.

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[Socceroo4ever]

Yes, there is a subspecialty in neuroradiology. It's part of your neurosurgery residency. Not really sure about how competitive neurosurgery residencies are, but from reading around on here... it's anal. Don't let that discourage you, though! I'd suggest checking out Frieda's web page to get a basic idea about it. Sorry, but I can't remember Frieda's long page URL! If I find it I'll post it.

Best of luck!

 

[P.R.BrainDrainOK]

Neuroradiology is a subspecialty of Diagnostic Radiology. "Interventional" Neuroradiology is part of the training in Neuroradiology and is a separate fellowship for Neurosurgeons (who, like Radiologist-Neurorads, perform endovascular interventions, but not imaging diagnosis)
Neurologists do not do Neuroradiology. They do the "Medicine" part while the Neurosurgeons do the "Surgery" part. Only Diagnostic Radiologists do the totality of Imaging based diagnosis and treatment through neuroradiology. Now, there are a handful of neurologists and neurosurgeons who fancy they can do neuroradiology as good as a Radiologist, which is a source of endless mirth to the Rad-neurorads. Just like family physicians are just as competent and qualified to make deliveries as OB/GYN people. Of course, we know that is not the case, and the minority of FP's who include OB/GYN in their practices are very careful not to mettle in complicated cases. In the case of imaging, you never know when a complicated case is going to show up. Even the simplest case may show subtle signs of a disease that no one had thought off.
So, to the point: if you want to do the interventional aspects of neuroradiology you can get there by the diagnostic radiology or neurosurgery route. If you want to do neuroradiology in all its aspects (diagnosis and intervention), you do the diagnostic radiology route.
Neurology is a very important specialty dealing with the clinical-medical diagnosis and treatment of neurological disorders.

P.S. There is a ridiculosly long residency at NYU that trains in neurology/radiology/neuroradiology. Like the MD/PhD, it looks pretty - but are you going to use all that in your practice often enough to remain competent? Remember, that if you don't use it, you lose it.

 

[scully]

I am interested in this too! It seems like a fascinating specialty, but be warned: I was told you have to have a very strong math and physics background to do well on the boards. And you have to do very well on the boards because it is a very competitive residency.
Good luck to us both!

 

[Socceroo4ever]

Eesh! Perchance I should beef up on the research next time I suggest an answer... thanks to the poster who corrected me on neuroradiology. Interesting it is still that one subspecialty can come from two different fields! Does that say anything for the ambiguity of words sometimes?

Even though I'm not considering neuroradiology as a career, I'm still interested in knowing how this specialty would be taught, given there's two different ways to interpret the subspecialty (i.e., as a surgical or diagnostic emphasis). Any input?

 

[DocToBe]

I looked on Frieda's Website and saw that 7 year combined residency. NYU, Emory, UCLA (I think), U of Wisconson, and one other school has it. Since I am only a first-year I am not sure if I'd enjoy Diagnostic or Interventional radiology better. I know I want to do something that specializes in the nervous system... so I have been thinking about Psychiatry, Neurology, Neuroradiology, and Neurosurgery. Maybe you guys could give me some advice because I need to pick an advisor at my school. There are advisors available from all the specialties I mentioned but because I'm not sure which one I'd really like to do, how should I choose?

Thanks for the information.

DocToBe

 

[P.R.BrainDrainOK]

Allright. I think it is way too early for people to talk about SUB-specialties that are over 8 years away.
Medical school offers great opportunities to discover yourself and your aptitudes and weaknesses. This whole thing about entering medical school with a subspecialty in mind is overkill that railroads you into unconsciously shutting off other specialties in which you would do better at. A handful of people do well going into med school with the mentality of competing for neurosurgery or dermatology. These people have often been exposed to these areas because of family or personal experience. As you can see, that excludes most of us.
Better to think of it this way: try to learn as much as you can of everything. If you really do enjoy the neurosciences and do well in it, then half of your work is done. The next is to simply shadow a specialist in this area for a while. Everyone has made their personal opinions about one specialty over another. You should make your own. (Just don't fall prey to over-romantizising any given one, specially in an academic medical center.)
You will be surprised at how many procedures, and how much patient interaction radiologists really have. Or how little or how much contact a neurosurgeon might have. Hell, you might end up doing benchlab scientific work in neuroscience, without any patient contact!
Also look into combined Psych/Neurology, that sounds like a prettu good deal.
Heck, go visit medschool.com and search it carefully. You'll save yourself from looking for anecdotal answers in a public forum.

 

[P.R.BrainDrainOK]

Sorry, forgot about Socceroos question.

That happens in MANY specialties. Specially when it means that another specialty comes with a much better way to diagnose and treat a disease better than the specialty that has traditionally managed that problem. That means that the bucks will move to the new or different specialty, and abandon the older "traditional" one. As I said this happens in many specialties, but since I'm more hip to those that deal with mine, I'll be limiting myself to those.

Example one:
Angiographers (the precursor of Interventional Radiology) came up with endovascular (and extravascular) techniques that were cheaper, faster, with far less risk and morbidity in treating a problem than were the Vascular Surgical techniques. In order to keep a hold on the available cash, several general and vascular surgeons started doing these techniques (I've witnessed the horrors that result). Some vascular surgeons get good at it and include it in their training. Like I said before, if you don't use it, you lose it. There is a host of endovascular procedures, and another host of vascular surgical procedures. Obviously, the vascular surgeon will never be able to catch up with the skill of an IR who does them several times a day, day in day out - while the surgeon does other procedures. The complication rates will be much higher than those of an IR - and nevermind about liability issues . . .
But the bottom line lies in where the cash and the future of practice will be. Thus, it will be no surprise to me if in the future (or today) vascular surgeons establish their own "endovasular surgery" fellowships to follow up on the techniques developed by radiologists. The result: two paths to the same fellowship. (But remember, if you don't use it as often . . . )
The similar thing happened with Neurosurgeons and Neuroradiologists. These two groups, on the other hand, have wisened up and have banded together to stop creating "parallel" programs. Between the two, they are developing standards for fellowship training in interventional neuroradiology. Both neuroradiologists and neurosurgeons will be training shoulder to shoulder in the same program in the same techniques.
But again, whoever does the interventional procedures the most will be the better one at it. If you keep busy on call to drain epidural hematomas, while another only comes to coil an aneurysm . . . and then, for one you need 8 years of postgraduate training, for the other it's 7.
Nuclear Imaging:
2 routes as well. One of them called Nuclear Medicine, the other Nuclear Radiology. They are EXACTLY THE SAME THING. For NM you train for 2 years after internship (if you want a job and a bright gainful future, you better have finished an Internal Medicine residency, and do NM as a "fellowship" - otherwise you'll be pushing carts and mumbling under your breath). For NR it's a 1 year fellowship after diagnostic radiology.
One does only NM. The other does NM AND MRI, CT, ultrasound . . .
Did I already mention "if you don't use it . . ."

NM is still justified because, honestly, it requires fully dedicated people to maintain a sizeable division of Nukes. There will always be a need for full time Nukes people.