Endovascular job market?

[endo]

Can any recent grads/people looking at jobs now comment on the end-vascular job market? Is it getting saturated?

[Guest]

Increasingly getting saturated, from what I hear. Still a fair amount of positions advertised, but from what I understand more and more new grads are having to supplement their endovascular practice with basic spine and bread and butter general neurosurgery.

This isn’t necessarily a bad thing though, if you enjoy general neurosurgery. My co-chief from residency did an endovascular fellowship, and took a position like the one I described above. He has an exceptionally busy practice, and makes a ton of money, since he has base pay, call pay, and RVU productivity bonuses. He doesn’t have the strictly endovascular practice he thought he wanted during training, but is so successful he’s quite happy nonetheless

[Guest]

It's fairly saturated right now. People who tell you to go into it because of the job market are either too excited or too out of the loop (or both) to realize it. Keep in mind that neurologists and interventional radiologists can also go into this, so you're not just competing with neurosurgeons at a lot of hospitals. It's not a subspecialty you should pick for the job prospects - Spine is numbers 1, 2, and 3 for that criterion. But for those of us who enjoy it there's nothing quite like it. As the above poster said, a willingness to do some general neurosurgery as well as some dedicated, high-level open vascular training will get you further with job prospects if you want to endovascular, especially academic.

[Guest]

If you are looking for a purely Endovascular/vascular job there aer very few out there. Some will open as people retire, but as we all know, those jobs aren't advertised and are done by your mentors knowing people. For those going into the market on their own, you will have to accept Endovascular will be a component of what you will be doing. This isn't some huge change, and has been the case for at least the last 5 years, IMO. outside of academic or large group practices, you will being covering stroke, general neurosurgery, and open vascular if your training allows for it. Outside of academics, I know very few people doing a purely vascular practice. Spine is what pays the bills, and when you start to see the referrals that are being sent to your departments you will see 95% of them are spine, neck pain, back pain, and a handful of vascular and tumor cases.

older saying, but subspecialty training may only be 20-30% of your actual practice, so if you can accept that you may only do some vascular and will be sharing with multiple people, and you will be doing degen spine and some tumors. You'll be fine. but if you think you are going to spend 2 days in IR and a day in the OR doing all vascular and skull base, you're going to have a bad day.

[Guest]

Not endovascular specific - but I find it very bizarre that so many faculty positions go without holding a proper national search with full pool of faculty candidates considered. Even for mid-tier institutions in desirable geographic locations, insider home residency graduate candidates obtain the faculty positions under the table rather than interviewing top tier graduates from the national pool. It is a sellers market, why would the chair not want the best candidate they have the possibility to recruit? Are the insiders taking these jobs just getting low balled on salary, startup package, block time, or otherwise?

[Guest]

I assume you were just born yesterday, so welcome to the world and how it works.....in everything

[Guest]

Yea from my experience as a home resident they offer you a job with a standard contract/pay/benefits. Very little room to negotiate, especially with the power dynamic between a chief resident and your chairman. It’s easier to negotiate as an external candidate.

[Guest]

To the poster who said they find it bizarre, it’s not really. As has been stated before on this forum, pedigree in neurosurgery is fairly meaningless when it comes to jobs. Unfortunately, due to the emphasis on research (which obviously produces researchers, not surgeons), and the fact that many name brand programs have developed reputations as “watching rather than operating” programs, having mass gen or Hopkins on ur resume means nothing to recruiters or jobs. It means far more simply having a faculty member vouch for u that you are a good surgeon and a team player. This is why so many places fill internally (because they know both of these critical details).

I disagree with the idea that there is a power dynamic issue if u get hired by ur home program. I think that is far more dependent on the individual chairman, or the desirability of the location. For example, I was hired by my home program, and they paid me vastly more to keep me there than most other jobs were willing to do. However, I am fortunate to be at a smaller, lesser known program, where it is a bit harder to recruit (I would recommend new grads look for jobs like that, as they will be able to demand more during the hiring process).

To return to my first point, when my program was hiring a new endovascular guy, we also hired from within, and chose a previous grad who was doing a fellowship at a well known place. As a part of that interview process, I can tell u we were much happier hiring a known quantity who we knew was a good operator, and would mesh well with our team. We actually did entertain candidates from well known “name brand “ programs, some of whom seemed quite competent, and some of whom didn’t. Ultimately, we obviously decided to choose from within, because hiring an unknown surgeon who could turn out to be a poor operator or a malignant presence on the faculty could be a mistake that could punish us for years. I would venture a guess that this same mindset is why many other programs similarly forgo choosing outside candidates.