(01-26-2022, 04:54 PM)Guest Wrote: Stop the presses - they don't do boatloads of open vascular at Stanford???
50+ clippings a year is good volume for any program these days. There are <10 places with that though.nToday, vascular means endovascular means stroke call. If you don't like thrombectomies, don't even consider it. Source: friends applying for fellowships.
No program needs to do “boatloads” of vascular but it’s pretty pathetic to have 3 chiefs in one aneurysm. Will they log it honestly or are they all lead?
Lots of programs that get talked about here have multiple multiple residents scrubbing each case and no one calls it out. Stanford called themselves out.
Stanford is a great program and people her are so obviously JEALOUS.
I can’t wait till all the open vasc obsessed chairs retire so depts can focus on things more useful to humanity and not have 5 low effort papers for every 1 aneurysm clipped that probably could have been coiled anyways. Let’s be real most cavmals should be left alone, most AVMs better to do radiation or endovasc treatment, and bypasses/clipping should be super uncommon and they are done because these chairs basically embellish the need and downplay the risks to healthy people in clinic.
(01-26-2022, 10:05 PM)Guest Wrote: I can’t wait till all the open vasc obsessed chairs retire so depts can focus on things more useful to humanity and not have 5 low effort papers for every 1 aneurysm clipped that probably could have been coiled anyways. Let’s be real most cavmals should be left alone, most AVMs better to do radiation or endovasc treatment, and bypasses/clipping should be super uncommon and they are done because these chairs basically embellish the need and downplay the risks to healthy people in clinic.
Another social media intellectual... Thank you for sharing
(01-26-2022, 09:21 PM)Guest Wrote: Stanford is a great program and people her are so obviously JEALOUS.
This is a childish response, face the evidence.
(01-26-2022, 10:05 PM)Guest Wrote: I can’t wait till all the open vasc obsessed chairs retire so depts can focus on things more useful to humanity and not have 5 low effort papers for every 1 aneurysm clipped that probably could have been coiled anyways. Let’s be real most cavmals should be left alone, most AVMs better to do radiation or endovasc treatment, and bypasses/clipping should be super uncommon and they are done because these chairs basically embellish the need and downplay the risks to healthy people in clinic.
What you fail to acknowledge is that the current practice is already 90% endo, and that these 'vasc obsessed chairs' are, for the most part, handling those that are not applicable for endo + all endo fuck ups.
'Most cavmals' ... 'most AVMs' - and who should treat the ones not encompassed in your mosts? Who will treat them after they're retired? Trainees who never saw them treated? You think patients with brainstem cavmals and multiple bleeds should be left alone?
We all know about endo advancements and how they revolutionized the field, but could you please be as honest as you ask of the vasc obsessed people in your attempts to come up with a solution? We are absolutely accepting, overall, worse outcomes with residents performing all kinds of neurosurgery, for the sake of training the next generation. We need to have a honest conversation about how we do that with vascular pathologies not amicable for endovascular treatment, or those that failed it. With the decline in volume, I believe, the vascular heavy places should become national referall places and trainees that want to step in those shoes should be forced to spend time there.
It's a very important issue and your ignorant post helps noone.
(01-27-2022, 03:56 AM)Guest Wrote: (01-26-2022, 10:05 PM)Guest Wrote: I can’t wait till all the open vasc obsessed chairs retire so depts can focus on things more useful to humanity and not have 5 low effort papers for every 1 aneurysm clipped that probably could have been coiled anyways. Let’s be real most cavmals should be left alone, most AVMs better to do radiation or endovasc treatment, and bypasses/clipping should be super uncommon and they are done because these chairs basically embellish the need and downplay the risks to healthy people in clinic.
What you fail to acknowledge is that the current practice is already 90% endo, and that these 'vasc obsessed chairs' are, for the most part, handling those that are not applicable for endo + all endo fuck ups.
'Most cavmals' ... 'most AVMs' - and who should treat the ones not encompassed in your mosts? Who will treat them after they're retired? Trainees who never saw them treated? You think patients with brainstem cavmals and multiple bleeds should be left alone?
We all know about endo advancements and how they revolutionized the field, but could you please be as honest as you ask of the vasc obsessed people in your attempts to come up with a solution? We are absolutely accepting, overall, worse outcomes with residents performing all kinds of neurosurgery, for the sake of training the next generation. We need to have a honest conversation about how we do that with vascular pathologies not amicable for endovascular treatment, or those that failed it. With the decline in volume, I believe, the vascular heavy places should become national referall places and trainees that want to step in those shoes should be forced to spend time there.
It's a very important issue and your ignorant post helps noone.
This has largely already happened and there are more ppl with open fellowship training than there are open cases for (thus why being dual-trained is almost required to sustain a practice). It’s not some cliff. It’s self-selecting and there will likely always be ppl to carry the torch.
I’m at a center that regularly gets open vasc referrals from places that can’t handle them. Are ppl really out there operating on ppl when they’re not trained to?
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(01-27-2022, 06:18 AM)Guest Wrote: (01-27-2022, 03:56 AM)Guest Wrote: (01-26-2022, 10:05 PM)Guest Wrote: I can’t wait till all the open vasc obsessed chairs retire so depts can focus on things more useful to humanity and not have 5 low effort papers for every 1 aneurysm clipped that probably could have been coiled anyways. Let’s be real most cavmals should be left alone, most AVMs better to do radiation or endovasc treatment, and bypasses/clipping should be super uncommon and they are done because these chairs basically embellish the need and downplay the risks to healthy people in clinic.
What you fail to acknowledge is that the current practice is already 90% endo, and that these 'vasc obsessed chairs' are, for the most part, handling those that are not applicable for endo + all endo fuck ups.
'Most cavmals' ... 'most AVMs' - and who should treat the ones not encompassed in your mosts? Who will treat them after they're retired? Trainees who never saw them treated? You think patients with brainstem cavmals and multiple bleeds should be left alone?
We all know about endo advancements and how they revolutionized the field, but could you please be as honest as you ask of the vasc obsessed people in your attempts to come up with a solution? We are absolutely accepting, overall, worse outcomes with residents performing all kinds of neurosurgery, for the sake of training the next generation. We need to have a honest conversation about how we do that with vascular pathologies not amicable for endovascular treatment, or those that failed it. With the decline in volume, I believe, the vascular heavy places should become national referall places and trainees that want to step in those shoes should be forced to spend time there.
It's a very important issue and your ignorant post helps noone.
This has largely already happened and there are more ppl with open fellowship training than there are open cases for (thus why being dual-trained is almost required to sustain a practice). It’s not some cliff. It’s self-selecting and there will likely always be ppl to carry the torch.
I’m at a center that regularly gets open vasc referrals from places that can’t handle them. Are ppl really out there operating on ppl when they’re not trained to?
Yes, and it isn't an open vascular only problem.
(01-27-2022, 06:46 AM)Focus Wrote: (01-27-2022, 06:18 AM)Guest Wrote: (01-27-2022, 03:56 AM)Guest Wrote: (01-26-2022, 10:05 PM)Guest Wrote: I can’t wait till all the open vasc obsessed chairs retire so depts can focus on things more useful to humanity and not have 5 low effort papers for every 1 aneurysm clipped that probably could have been coiled anyways. Let’s be real most cavmals should be left alone, most AVMs better to do radiation or endovasc treatment, and bypasses/clipping should be super uncommon and they are done because these chairs basically embellish the need and downplay the risks to healthy people in clinic.
What you fail to acknowledge is that the current practice is already 90% endo, and that these 'vasc obsessed chairs' are, for the most part, handling those that are not applicable for endo + all endo fuck ups.
'Most cavmals' ... 'most AVMs' - and who should treat the ones not encompassed in your mosts? Who will treat them after they're retired? Trainees who never saw them treated? You think patients with brainstem cavmals and multiple bleeds should be left alone?
We all know about endo advancements and how they revolutionized the field, but could you please be as honest as you ask of the vasc obsessed people in your attempts to come up with a solution? We are absolutely accepting, overall, worse outcomes with residents performing all kinds of neurosurgery, for the sake of training the next generation. We need to have a honest conversation about how we do that with vascular pathologies not amicable for endovascular treatment, or those that failed it. With the decline in volume, I believe, the vascular heavy places should become national referall places and trainees that want to step in those shoes should be forced to spend time there.
It's a very important issue and your ignorant post helps noone.
This has largely already happened and there are more ppl with open fellowship training than there are open cases for (thus why being dual-trained is almost required to sustain a practice). It’s not some cliff. It’s self-selecting and there will likely always be ppl to carry the torch.
I’m at a center that regularly gets open vasc referrals from places that can’t handle them. Are ppl really out there operating on ppl when they’re not trained to?
Yes, and it isn't an open vascular only problem.
Agree with everything you said. I’d add that some people graduating from programs with low volume are not being realistic with their skill set and don’t get additional training because of their program prestige which is dangerous. With this trend as a specialty we will come to accept higher levels of complications.
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