Stroke fellowship

[jimbo21]

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I'm currently a MS3, leaning to neurology. I'm really interested in stroke and want to choose something that will allow me to diagnose and treat strokes acutely, preferably with procedures as well as meds. And some patient follow-up would be nice (as opposed to an ER doc). Would a stroke fellowship allow me to do this, or does this sound more like a neuroradiologist? Also, does anyone know what kind of outlook/pay/hours a doc like this would work?

Sorry if these seem like dumb questions, I appreciate any help I can get.

 

[bustbones26]

Stroke fellowship will allow you to see and treat acute strokes and do follow up. It will be in an academic university hospital setting of course. What you learn depends on the place you do the fellowship as there is no American Board of Stroke Medicine, etc. etc. What to expect would be-------

Using the neurologic exam to determine the lesions caused by stroke
Becoming proficient at reading CT/MRI's more than the average neurologist
Perform and or read carotid or transcranial dopplers
Run the stroke protocol in the ER and decide if a person needs tPA or further intervention, then manage the patient in a neuro-ICU setting.
And yes, follow up of these patients at the University academic stroke clinic

Length of fellowship varies, could be one year to two years.

If you want to do neurointervention, cerebral angiograms, intra-arterial tPA, clot retrieval, etc. this requires an extra fellowship in neuro intervention after stroke fellowship that is usually one year in length. These particular fellowships are shared amonst neuroradiologist, neurosurgeon, and neurologist. The difference between you and the surgeon/rads guys is that you have to do the basic stroke fellowship to become more proficient in gross neuroanatomy, reading CT/MRI, and management of patients in the ICU setting before you can apply for neurointervention fellowship. Not to mention that it will be highly competitive.

 

[Bonobo]

I am becoming a believer that getting to do neuro-interventions following a stroke fellowship *will not* be that competitive. It is growing at a rapid speed already, and given that you are an MS3 currently, you won't have to worry about these fellowship for another 5-6 years. I think already a model is developing where stroke interventionalists will specialize in carotid stents and intraarterial injection of tPA and soon neurotrophic factors (in addition to diagnostic angios). This appears to be the model at Cleveland Clinic for example. The more complex neurointerventions such as aneurysm coiling and embolizations will probably still be left to radiology/neurosurgery trained folks instead. But I would interested to hear what others think.

B