Stroke intervention as a neurologist

[Groy]

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If a neurologist with vascular training decides to also go the IR route, do they have the ability to act as a comprehensive stroke doctor (ex: see a stroke call in the ER, do a neuro exam, imaging, diagnose, then either medically treat and/or have the ability to perform the intervention if the pt is a candidate)?

In other words, could you serve as a stroke neurologist who is able to perform the intervention and provide comprehensive care from start to finish (including long-term counseling) or is this totally unheard of?

 

[barzan]

Yes.

 

[Groy]

Yes.

Thanks

Any further elaboration would be appreciated, thanks in advance!

 

[neurochica]

I have a friend who spends 1 week as a neurohospitakist. When there is an intervention, he admits and performs the procedure. He handles all of the inpatient too. The remaining 3 weeks, he sticky dies interventions/ on call. 1 day a week clinic.

 

[premed1234567891011]

I have a friend who spends 1 week as a neurohospitakist. When there is an intervention, he admits and performs the procedure. He handles all of the inpatient too. The remaining 3 weeks, he sticky dies interventions/ on call. 1 day a week clinic.

What combination of residency/fellowships did he do?

 

[neurochica]

What combination of residency/fellowships did he do?

Stroke followed by NIR

 

[oopsy]

You can do neuroendovascular as a neurologist via one of two pathways, stroke or ICU fellowship training.

If you're going to be performing these interventions, it's either going to be in one of two scenarios

1) You're in a major center (large enough to support thrombectomy, so big cachment area).You'll have 1-2 other people in your group, and take q2-q3 call. In that kind of center, you will have dedicated stroke, dedicated neuroICU teams, and so the stroke team will not be the same person as the endovascular team. You can do stroke weeks and endovascular weeks [plenty of folks do it], but you are unlikely to do both for the same patient.

2) You're the guy for the center. Smaller center. You'll be on call all the time unless you're on vacation, but your volume will be low. You can be the big fish in the pond if you're the only fish.

I think it's very unlikely that you find a lot of folks who run stroke codes and do interventions on the stroke they ran.

 

[kchan99]

In the old days, there was a neurology+radiology+neuroradiology residency track that prepared for endovascular fellowships, but these days, stroke and neurocritical care fellowships can satisfy requirements for endovascular training. Based on what I hear from my neurology-trained endovascular colleagues, it's supposedly easier for those interventionalists from neurosurgery or neuroradiology to get jobs.