Hey, am MS4 who was applying for neurosurgery but unfortunately did not match. The scramble process was crazy, but I ended up choosing a spot at a respected med-peds program because it will give me a lot of options going forward. Since then, I have done a lot of thinking that neuro critical care would be a field I would really enjoy. After doing some research, I see that several programs say they consider applications from medicine trained residents. I was wondering if any knows if this is a viable option and knows anyone who may have considered this path? Also would job options be limited compared with a neuro trained resident? Thanks so much
Neurocritical Care Fellowship for non Neurology Resident
- Thread starter tarheel86
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There are programs that have trained and are currently training medicine-trained people in NCC. Some of us have concerns about this track, as you come into the program knowing little neurology and not necessarily having much background in critical care. It is a tall order to learn both at the same time in a 2 year training program, even if your neuro knowledge doesn't have to be all-encompassing.
Remember that you will be competing with neurologists for these slots however, and the people ranking you will be mostly neurologists. So you need to have an upside that makes you worth picking. But yes, it is doable.
Remember that you will be competing with neurologists for these slots however, and the people ranking you will be mostly neurologists. So you need to have an upside that makes you worth picking. But yes, it is doable.
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On a somewhat related issue, is the intern year of internal medicine enough to be a clinically excellent neurointensivist. It seems that out of all of neurology, there is the most medicine in NCC.
Typhoon, so if I decide this is definitely what I want to do, what things do you think I could do to give myself a little more upside? Or would it make sense to consider looking for a pgy 2 neurology spot open for next year. Switching is not something I would ideally do as I don't want to put this program in a bad position, but I would consider it if it is the only reasonable pathway. Thanks.
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Ever think about pediatric NCC? Not sure if you liked peds, but you could write your own ticket if you go into pediatric NCC.
Actually that's something I would be very interested in, just do not know too much about it. I think I found one at Northwestern that you can do after peds critical care fellowship (or via child neurology which wouldn't apply to me). Also, I have no clue on what the need/job market would be for peds NCC. Do you happen to have any insight on the training and/or future of the field? Thanks
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I don't, sorry. My mentor who is an adult NCC attending just mentioned it in passing to me and said if I went that route I would have no problem writing my way after that (job and research wise). I am just not super interested in peds myself. Just noticed you are in med/peds, so thought you might have some interest.
There are very few peds NCC trained physicians from my understanding. I think you can count them on your hands. But really don't know much beyond that.
Well thanks, I appreciate it. If you ever happen to hear more about it I'd appreciate a shout. I might ask around to see if anyone knows anything, any ideas of who might know something (there are no ncc docs at my med school)?
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OK,
Peds NCC does exist, and at a few select places they are in high demand. But in most locations there isn't a market for full time pediatric NCC, so most end up doing pedi-CC with a concentration in NCC, which is fine if that floats your boat. From a research standpoint it can be good, although the pedi-head trauma world is already well-populated with neurosurgeons and standard trauma people. I don't know about being able to just do whatever you want after you're trained, though. If you are willing to live in a big city, and willing to do mostly standard PICU, then I guess, but remember that PICUs and pedi-neurosurgeons have been basically doing Pedi-NCC on an ad hoc basis forever, so you'd really need to justify why you're so needed (and I don't think those studies exist). I'm also not sure how just being clinically trained in pedi-NCC makes you more qualified for a grant, particularly given how small the pedi-NCC population is to start and how well-developed the pedi-trauma world is already.
An intern year in medicine does almost nothing to prepare you for critical care neurology. You can learn a lot of medicine during neurology residency if your program is rigorous, but learning critical care is what fellowship is for. The overlap between general medicine and critical care medicine is pretty narrow, anyway.
In my opinion, if you want to do NCC from a med-peds background, you should justify why you didn't do neurology in the first place, and play to your strengths. Peds-NCC is one way to do that. Another way would be research that harnesses more of your medicine background. Basically, you don't want it to look like you fell into medicine by accident, and are trying to rectify the situation by bringing yourself into NCC as a silver medal for the neurosurgical training you always really wanted. That's not what we're here for.
Peds NCC does exist, and at a few select places they are in high demand. But in most locations there isn't a market for full time pediatric NCC, so most end up doing pedi-CC with a concentration in NCC, which is fine if that floats your boat. From a research standpoint it can be good, although the pedi-head trauma world is already well-populated with neurosurgeons and standard trauma people. I don't know about being able to just do whatever you want after you're trained, though. If you are willing to live in a big city, and willing to do mostly standard PICU, then I guess, but remember that PICUs and pedi-neurosurgeons have been basically doing Pedi-NCC on an ad hoc basis forever, so you'd really need to justify why you're so needed (and I don't think those studies exist). I'm also not sure how just being clinically trained in pedi-NCC makes you more qualified for a grant, particularly given how small the pedi-NCC population is to start and how well-developed the pedi-trauma world is already.
An intern year in medicine does almost nothing to prepare you for critical care neurology. You can learn a lot of medicine during neurology residency if your program is rigorous, but learning critical care is what fellowship is for. The overlap between general medicine and critical care medicine is pretty narrow, anyway.
In my opinion, if you want to do NCC from a med-peds background, you should justify why you didn't do neurology in the first place, and play to your strengths. Peds-NCC is one way to do that. Another way would be research that harnesses more of your medicine background. Basically, you don't want it to look like you fell into medicine by accident, and are trying to rectify the situation by bringing yourself into NCC as a silver medal for the neurosurgical training you always really wanted. That's not what we're here for.
Typhoon, I appreciate the honesty, even if it isn't always exactly what I would want to hear. So if I happen to go through this year and decide I really miss treating neurological disease is it advisable to look for open neurology pgy2 spots. Is this something that is doable/commonly done? Also do people ever decide to train in neurocritical care after completing training in a medicine critical care fellowship.
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I mean if you really like treating neurological disease then you should think about switching b/c 2 things might happen
-you get sick of training and just want to practice and would you want this to be general neurology or med/peds
-you don't get into fellowship and would have to use your general residency training to practice
-you get sick of training and just want to practice and would you want this to be general neurology or med/peds
-you don't get into fellowship and would have to use your general residency training to practice
Thanks, that does make a lot of sense. I am really hoping to start this residency and fall in love with something, but not sure if it will happen. How would one go about switching? Do you just try to keep an eye out for pgy-2 openings that may pop up and then contact those programs?
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shouldve just done rads -> interventional neurorads
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What you are actually referring to is neurointerventional (aka endovascular surgical neuroradiology/interventional neurology/endovascular neurosurgery). This pathway is also available to neurologists and neurosurgeons, and not just radiologists.
NIR is a completely separate fellowship from neurocritical care, and it is the latter that this thread is specifically discussing.
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The only thing about med/peds is you have a very off-cycle intern year where there are those extra few months they will be planning on you being there as an "intern" but PGY-2 neurology programs will be starting. If you screw over you current PD you will screw over your career so keep that in mind.
Another option would be, if you are interested in treating kids, is peds neuro. I think two years of med-peds could work b/c you can do one year of medicine and one year of peds instead of two years of peds. You also get boarded in neurology with a special distinction in child so you could still treat adults. You could position yourself to be involved in transitional care which would harness your med peds background and be a natural transition into neuro.