[paul.stanley_364]

I’m a neurorad – not NIR. I think I would contact 5 or 6 places where you would like to train for NIR and ask them how it works for them. Some places may have the whole thing integrated. A NIR fellow where I did my neuro fellowship left the Harvard system because they wanted him to do 2 years of neurorads before 2 years of NIR. At our center (also a name brand), he only had to do one year of diagnostic neuro before NIR (2 years).
 
Also, need to look closely at neurosurgery’s role in the fellowship. Many fellowships now have neurosurgery residents (pseudofellows) coming through along with the radiology trainees. I think the resurgence of stroke intervention has made neurosurgeons less interested in endovascular stuff, but for a while it seemed they would take over the field entirely. In my limited experience, these spots aren’t that hard to get if you are reasonably qualified. Don’t sweat NIR specific research too much. There aren’t a ton of rads interested in doing this stuff. You are definitely a clinician and not a “radiologist” anymore. Our guys are on call 10+ nights a month in perpetuity. 

[ruszja]

The diagnostic NR fellowship prior to INR made sense when MRI  was a newfangled thing that the regular radiologist didn’t know much about and CTA didn’t really exist in the brain. Also, the diagnostic NR fellowship is when you learned your neuroangiography skills prior to going on to learning intervention. Today, every radiology resident coming out of training should know enough cross-sectional to do NIR and diagnostic NR fellowships are scrounging for angio cases. There is really no point in forcing people to do a NR fellowship, let alone two years of it.

[mfs301s_540]

I’m an NIR fellow at a pretty good program, CAST accredited. 
The research helps a little but not necessary.  Instead, find a handful of programs you are interested in and reach out to PD’s. I cold called them, explaining in a friendly fashion my interest etc.  Several of them actually paid attention and here I am. Research in general (I had random peds and QC papers published) just goes to show them you can focus a little extra outside of the reading room.

Btw: as someone budding in the field it’s imperative you are a good diagnostic neuroradiologist prior to starting the interventional year.  That’s where you add value different from the neurosurgeon, neurologist, etc.  And you’ll quickly see the difference. Yes, I agree they have you beat with the clinical knowledge (and many of my colleagues are amazing interventionalists in addition to that), but YOUR value as a radiologist comes from differentiating the subtle imaging nuances that are typically overlooked by the rest, and frankly what makes you a radiologist.  Plus its a nice thing to do when you have down time or cant do interventional any longer.
 
Feel free to DM!

[jrosmo]

When would you recommend starting to reaching out to programs?

[dorisbueno]

What are the top NIR programs for radiologists?

[Unknown Member]

If a trainee wants to settle in specific geography, e.g. St. Louis metro, chicago, SF Bay Area (e.g. anywhere therein) …. would you say that NIR will be limiting your chances of living where you want? 

[Unknown Member]

Depends on what you really want to do.

If you want to treat aneurysms, AVFs and high end elective cases, most of those are controlled by NS in big academic centers and radiologists have a slim chance to get hired. They hire 80% NS and 20% neurologists to cover NeuroICU. Anyway it limits the job opportunities even for NSs.

But if by NeuroIR you mean DR plus few emergent cases a month like some stroke interventions plus a few elective cases that may or may not come your way, then there are good job opportunities out there. I know a few people who do DR plus NeuroIR plus some body IR and they are very succesful.

[Unknown Member]

Yes NeuroIR usually limits geography for radiologists.

My 0.02:

1.) I do not recommend it to most radiology trainees anymore.

(Unless they have a job / need to bring to an underserviced area.)

If you do like and are excellent at reading scans, then radiology and its other fellowships (incl diagnostic neuro) are better options.

If you dont enjoy diagnostic imaging, why not switch (eg neurosurgery -neuro ir.)?

2. If you decide to proceed anyway yes, a solid skillset in diagnostic neuro and CAQ is important for the reasons listed above by other poster.

3.) best would be to maintain solid proficiency in gen rad too for flexibility and future job options. Not easy with high level neuroir though.

IMHO, in 2021, Diagnostic Radiology remains a great specialty, but I dont recommend pairing it with neuroIR.

[yamin]

If coming from radiology, then yes, good neuroradiology fellowship is a must as said above. Good imaging and anatomy skills are going to be important. Regarding the field, you go into it because you love it, it is totally different from radiology and more similar to neurosurgery. 
 
There will be geography limitations especially if you’re looking for a specific type of job, but this applies to many subspecialties. You’ll be most flexible geographically as a generalist (same applies to every field in medicine).