Neurointerventional radiology

[whatslifeneuro]

As a rising MS4 who is interested in Endovascular neurosurgery vs DR to neuro-IR path, I am interested in knowing what the future holds for these paths. Even if you go through the DR and neuro-IR route, are you still considered a neurosurgeon? what are the hours like? and What's the salary like for each?

Thanks!

[Guest]

Well choose whichever residency you’d enjoy more and whatever adjunct practice you would want to have (surgery vs reading studies). Both terminal training paths will get you to endovascular but NS will give you the advantage of doing open vascular training.

[Guest]

If you do radiology and neuro-IR you are a neuroradiologist, not a neurosurgeon.

You will be able to do vertebroplasties, diagnostic cervicocerebral and spinal angiograms, embolize aneurysms, avms, fistulas, treat large vessel occlusion with thrombectomy, etc. Pretty much the same as a neurosurgeon.

On the other hand, you will not be able to take patients to the OR and will be limited to the interventional suite. For example, if you cannot treat a ruptured aneurysm endovascularly, you will have to call the neurosurgeon and have him clip it in the operating room.

So yes, neurosurgery gives you an extra edge and you will be able to take care of the entire spectrum.

It depends on what you want. And the hours are also going to be bad, as an interventional neuroradiologist you will be likely asked to cover stroke call, so yes you will waken up at 2AM to do a mechanical thrombectomy on an 80yo stroke patient.

[Guest]

what do u think about radiation exposure in IR? ive read studies showing that IR guys have 2x or more radiation exposure than is safe. i don't want to fry my nuts.

Quote:average interventional physician in the U.S. gets almost three times the annual radiation dose compared to the average nuclear power plant worker. And this is likely underreported, as we all know colleagues that have either not worn their dosimeters, or even taken them off when they approached their hospital limits. The International Atomic Energy Agency (IAEA) surveyed interventional cardiologists in 56 countries, and discovered only 33-77% utilize radiation badges routinely

https://www.philips.com/a-w/about/news/a...t%20worker.

[Guest]

Radiology-trained interventionalists are absolutely NOT neurosurgeons. They are not surgeons in any way shape or form. Realistically, this decision should be fairly simple for you. Do u want ur practice to consist of surgery when ur not in the IR suite, or do u want it to consist of reading and dictating scans. Because this dichotomy is what should be driving ur decision.

There are very few job postings that exclusively consist of Neuro IR procedures. By this I mean that hospitals are primarily looking for endovascular specialist that will be integrated into either the neurosurgery call pool in some way or into the radiology reading room pool in some way. This isn’t to say u won’t be doing a lot of endovascular procedures, it just means that most endovascular guys have to take some kind of additional call requirement. So u better love whichever specialty u start out from, because odds are you will not be escaping it completely

[Guest]

how much to neuro IR's make in general in academia vs PP?

[Guest]

Neuro IR via radiology vs enfolded neurosurgery?

[Guest]

(04-17-2022, 09:45 AM)Guest Wrote: Neuro IR via radiology vs enfolded neurosurgery?

The field is moving away from allowing enfolded neuro IR for neurosurgery residents as a sole "fellowship". 

If you want to work as an endovascular neurosurgeon, most places will ask now for a post-grad fellowship in endovascular neurosurgery, even if you did 1 year enfolded as a resident. This will have to be accredited by CAST, ACGME, or UCNS.

https://abns.org/rfp-cnsendo/

As other responses have said, they are different fields and although they share some procedures, what you do when not in the IR suite is very different for a radiologist versus a neurosurgeon.

[Guest]

As a radiology (and neuroradiology) trained neuroIR fellow entering the real world, this is 100% true. Radiologist are NOT neurosurgeons. And you cannot treat every intracranial aneurysm endovascularly.... not to mention that almost no AVMs are treated completely endovascularly these days. Ultimately, we support the neurosurgeons. I'm fine with that... are you? Also, I enjoy sitting in a dark room reading studies, having people come to me asking for answers about complex/weird MRIs, being the "expert" imaging person. 

Also, I take a sh*t ton of stroke call. Which I also enjoy... Gotta be fast (and calm). Gets my heart racing and the adrenaline going. Makes me feel like a super-hero. :-) .... Not a ton of strokes come in at 2:00 am..... some, yes, but not a lot. 

Very very different jobs. 

Basically, do you want to be a radiologist or a surgeon?

---

One more thing: $$$$

a pure neuroendovascular person makes the same $$$, regardless of the training (but this is rare, maybe except a few academic places).

Radiologist make a lot of $$$, and the lifestyle is pretty good... AND, you don't have to smell patients, which is amazing. 

Radiology trained NeuroIR make a bit (not a ton) more and diagnostic radiology, but you take a lot of stroke call. 

Neuroendovascular neurosurgeon probably makes slightly more because they do $$$$$ spine $$$$ procedures, and also takes a lot of stroke call. 

S tier would be private practice spine surgeon, I would think. Over 1M sometimes. Only down side: it is spine

[Guest]

(06-09-2022, 09:41 PM)Guest Wrote: As a radiology (and neuroradiology) trained neuroIR fellow entering the real world, this is 100% true. Radiologist are NOT neurosurgeons. And you cannot treat every intracranial aneurysm endovascularly.... not to mention that almost no AVMs are treated completely endovascularly these days. Ultimately, we support the neurosurgeons. I'm fine with that... are you? Also, I enjoy sitting in a dark room reading studies, having people come to me asking for answers about complex/weird MRIs, being the "expert" imaging person. 

Also, I take a sh*t ton of stroke call. Which I also enjoy... Gotta be fast (and calm). Gets my heart racing and the adrenaline going. Makes me feel like a super-hero. :-) .... Not a ton of strokes come in at 2:00 am..... some, yes, but not a lot. 

Very very different jobs. 

Basically, do you want to be a radiologist or a surgeon?

---

One more thing: $$$$

a pure neuroendovascular person makes the same $$$, regardless of the training (but this is rare, maybe except a few academic places).

Radiologist make a lot of $$$, and the lifestyle is pretty good... AND, you don't have to smell patients, which is amazing. 

Radiology trained NeuroIR make a bit (not a ton) more and diagnostic radiology, but you take a lot of stroke call. 

Neuroendovascular neurosurgeon probably makes slightly more because they do $$$$$ spine $$$$ procedures, and also takes a lot of stroke call. 

S tier would be private practice spine surgeon, I would think. Over 1M sometimes. Only down side: it is spine

Weirdo