Stroke vs Critical Care fellowship

[MemberX]

Hey SDN community,

Wanted to get some perspective about fellowship options. Will be applying for fellowships next year and will be deciding between stroke vs critical care. Wanted to know if there are different job opportunities between the two, as well as compensation, work-life balance from people in the field -- particularly in private practice. Additionally, can NCC trained people sit for vascular neurology boards or does that even matter if you are NCC boarded?

Thanks!

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[typhoonegator]

1. They're very different in terms of job opportunities and billing. Compensation is a different question, and depends on whether you're in New York City or Oklahoma City, and what the job entails/how many ICU weeks you want to work.
2. Work-life varies. ICU is intense when you're on service, not when you're off. Stroke can be set up in so many different ways that it's hard to compare. If you're on QOD acute stroke call, work-life would be pretty terrible. Stroke clinic 3 days a week, not so bad.
3. NCC training in an approved fellowship does not allow you to sit for vascular boards. Whether that matters depends greatly on what employers are looking for. Certainly if you wanted to do stroke clinic and bill for reading TCDs/CNIs, you would want formal vascular neurology training.

 

[Hank Rearden]

I would just add that I think there are fewer NCC than stroke jobs out there, at least in the major cities. Most hospitals don't feel like they need more than one ICU doc with this specialized training and some don't feel like they need them at all; they just employ pulm/anesthesia trained CC docs and have Neurology or NSGY weigh in on the neuro cases. I wish more hospitals did employ NCC, but it seems they don't want to shell out for them. I think you would generally make more as NCC (maybe $50-100k more than stroke?), but with less flexibility on where you work.

 

[SheepNeurology]

Is it a necessity in any way to be board-certified in vascular neurology to care for patients in "stroke clinics"? I presume many general neurologists handle stroke patients in the community exceptionally and that this may just come down to hospital certifications, but how about stroke clinics in comprehensive stroke centers/'quaternary care hospitals'?

 

[TUGM]

Stroke and ICU are two different fellowships with two different boards. Some NCC training programs are quite vascular heavy, and have fellows taking stroke call. Even then, you can't sit for vascular neurology boards without doing a vascular neurology fellowship.

Stroke and ICU jobs are both relatively lucrative at this point in time, and many salary offers in the community are comparable, but I would say NCC > vascular neurology in salary, depending on how you set up your practice. NCC is quite revenue deep, as you bill CC time and have procedural aspects too.

That being said, at least in the community setting, either specialty allows you to care for both ICU and stroke patients as consultants. There are some ICU trained people who work as neurohospitalists.