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INR
Hello everyone-
I am R1 resident interested in interventional neuroradiology. My only concern is the long training, and was wondering what would be a good strategy to reduce training years?. A bit of background about me , I was a neurosurgery resident did 2 years of that before switching to rads. I know most of reputable INR fellowships are CAST regulated which require at least year of neurorad. And would it make any difference in finding a job if I do a Non CAST INR fellowship?. Please advise. -
11 Replies
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A long time ago, programs would interpret it as ‘1 year of neuroradiology training’. So if someone was able to add a few neurorad electives to his regular NR time, they only needed a few months to top-off which is time the INR fellowship was sometimes able to accomodate. Not sure whether they can still do that.
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I think you are looking at 2 years of fellowship no matter how you slice it. In the long run does 1 extra year matter? Do what you see yourself doing.
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NIR lifestyle is garbage, bro.
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If I were you I would not do a non CAST fellowship. Both neurosurgery and Neurology are working on their own certifications. I have not heard anything from radiology. Its a very specialized area. If you are spending all those years I would get a CAST fellowship. As time goes by there will be more regulation. Lifestyle is great if you are in a practice where there are two other guys and love doing NIR. It very different from radiology. As you know most of us identify as neurointerventioalist rather than as radiologist. Good luck.
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I thought this post was about International Normalized Ratio. ick..
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I think NIR is fine if you are at a big hospital with full neurosurgery support and neurological ICU. Out in the community not a chance of doing NIR. No support and network.
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2 years of fellowship is the optimistic situation. You are most likely looking at 3 years of fellowship: 1 year diagnostic neuroradiology, 2 years INR. INR fellowships are usually 2 years, even though CAST accredits only one year, because of the steep prerequisites for the CAST year includes, for radiologists, 200 catheter cerebral angiograms as primary operator, and 6 months clinical service on neurosurgery, vascular neurology, or neuro ICU. For you, since you did two years neurosurgery, I presume the 6 month requirement is satisfied. However, you would still have to manage to do 200 angiograms during residency or DR fellowship in order to convince an INR program director you are ready to do a 1-year-only INR fellowship. Primary operator time is hard to come by in most programs (and all neurosurgeries as a rule as I’m sure you know as a junior resident) unless you are formally the endovascular fellow, but perhaps you could negotiate a spot as a minifellow/enfolded fellow as an R4, similar to how neurosurgery residents can enfold a year. That highly depends on the politics of your program (is there enough elective time as an R4, is the radiology program on good terms with the neurosurgeons, etc). I will also say I have never heard of this happening, so good luck.
As stated above, you should still try to do a CAST fellowship. You will have uncertainty if you do not. For example, the Joint Commission was creating its criteria for so-called thrombectomy-capable stroke center (a designation somewhere between primary stroke center and comprehensive stroke center), and it initially required all thrombectomy operators to be CAST trained or equivalent. However, a bunch of IRs threw a fit because it turns out a lot of non-neuro-trained IRs do stroke thrombectomy and they certainly do not have the equivalent of CAST-accredited training. Joint Commission has suspended all requirements for individual thrombectomy operators aside from minimum 15 thrombectomies a year or 30 over two years, but it is certainly within the realm of possibility that in another half career’s time, there would be a specific training requirement again.-
We have not discussed the elephant in the room…OP switching to radiology will not advance your career prospects in INR. It is possible…but you have switched from smooth sailing to stormy waters. Having diag neuro / CAQ would be important to have options open.
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to OP:
Why did you switch?If you are procedural/NeuroIR type, then NS is the best place to be.
If you want a normal lifestyle and don’t like big procedures, DR is the place to be at.
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Gotta do CAST certified fellowship. If you graduated prior to 2015, you might be able to get the CAST certificate for yourself. But in 2020 you need to get into a CAST certified fellowship to move forward.
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Given he started with neurosurg Im guessing qol isnt his priority
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