How to decide on specialty

[Guest]

Any tips? Between neuro onc and functional, will be able to do spine well so avoiding a fellowship in that. How do you decide which way to go when you have opportunities in both? I find both equally interesting.

[Guest]

(07-29-2022, 08:57 PM)Guest Wrote: Any tips? Between neuro onc and functional, will be able to do spine well so avoiding a fellowship in that. How do you decide which way to go when you have opportunities in both? I find both equally interesting.

Not sure what your spine comment means.

[Guest]

As a neuro onc fellowship trained surgeon...

there are vanishingly few jobs, academic or otherwise, allowing you to have a tumor-predominant practice straight out of training. there are simply way too many people doing fellowships.

on the other hand, everyone and their mother is looking for a functional surgeon. everybody wants a DBS program.

[Guest]

(07-29-2022, 09:30 PM)Guest Wrote: on the other hand, everyone and their mother is looking for a functional surgeon. everybody wants a DBS program.

Why? Why is functional in demand, and why doesn’t it pay well? Also do you mean epilepsy as well have or movement disorders specifically?

[Guest]

(07-29-2022, 11:44 PM)Guest Wrote:

(07-29-2022, 09:30 PM)Guest Wrote: on the other hand, everyone and their mother is looking for a functional surgeon. everybody wants a DBS program.

Why? Why is functional in demand, and why doesn’t it pay well? Also do you mean epilepsy as well have or movement disorders specifically?

Differentiation/being a one-stop shop. It’s the same reason PP surgeons will also dabble in cranial.

[Guest]

I don’t agree with the sentiment that functional is in demand. There are very few advertised functional positions currently, and most neurosurgeons I know who have done fellowships in functional have ultimately taken jobs that are mostly general neurosurgery

[Guest]

(07-31-2022, 04:44 PM)Guest Wrote: I don’t agree with the sentiment that functional is in demand. There are very few advertised functional positions currently, and most neurosurgeons I know who have done fellowships in functional have ultimately taken jobs that are mostly general neurosurgery

I think what they mean by in demand is that if you are trained in functional you become very attractive in private practice to get jobs where you do mostly general and some functional

[Guest]

I’ve never once heard a private practice express interest in a functional neurosurgeon. Their surgeries take too long, don’t bill well enough (for the time investment), and often require too many ancillary staff (movement neurologists, etc) to make them useful to private practice.

[Guest]

(08-01-2022, 11:43 AM)Guest Wrote: I’ve never once heard a private practice express interest in a functional neurosurgeon. Their surgeries take too long, don’t bill well enough (for the time investment), and often require too many ancillary staff (movement neurologists, etc) to make them useful to private practice.

I've heard of some pp groups looking (I am currently in the market). A number of larger groups want someone to offer functional as part of insurance contract negotiations. There are more functional jobs right now than neuro onc for sure. Someone coming out of fellowship is probably looking at 3-4 offers max (and maybe one being truly appealing). You're going to be doing some general.

Not sure how long your stage 1s take. The pp guys I know go GA and skip MER. Under those conditions, that's a sub-3h skin-to-skin event.

Final point - market is noticeably rougher for people that want to do epilepsy. You are likely looking at starting somewhere underserved then moving to a more desirable location.

[Guest]

So, a spine and functional trained surgeon has good prospects?