Education Research: Challenges Faced by Neurology Trainees in a Neuro-Intervention Career Track

Abstract

ObjectiveThe widespread adoption of endovascular therapy (EVT) for emergent large vessel occlusion has led to increased nationwide demand for neuro-interventionalists, heightened interest among Neurology residents to pursue neuro-intervention (NI) as a career, and increased importance of NI exposure for all Neurologists who care for patients with AIS. Currently, exposure to NI and its career path are not well-defined for Neurology trainees.MethodsThe Society for Vascular and Interventional Neurology (SVIN) Education Committee conducted a multi-center electronic survey directed towards Neurology residents, Vascular Neurology (VN), Neuro-critical care (NCC) and NI fellows in June 2018. Two hundred fifty programs were invited to participate; 76 trainees completed the survey.ResultsRespondents self-identified as 22% postgraduate year (PGY)-2, 40% PGY-3/4, 30% VN fellows, and 8% NI or NCC fellows. Eighty-seven percent of trainees had greater than 2 months exposure to VN during residency, 41% to NCC and only 3% to NI. Sixty-eight percent of respondents had no exposure to NI during residency. While 72% felt that a background in Neurology was good preparation for NI, only 41% agreed that fellowship training pathway in NI is well structured for Neurology residents when compared to other sub-specialties.ConclusionIn this survey, respondents identified lack of exposure to NI and a well-defined training pathway as obstacles towards pursuing NI as a career. These obstacles must be addressed for the continued development of NI as a sub-specialty of Neurology.

Securing a Training Position as an Interventional Neurologist: How to Overcome the Barriers

“…While neurology trainees are demonstrating clear interest in recent surveys, there exist both structural and cultural barriers to a neurology-based pursuit of NIR across the training spectrum. 10 The demand is big, but the pipeline is critically stenosed. It is time we unclog it and pave a clear path down the NIR career pipeline.…”

“…While neurology trainees are demonstrating clear interest in recent surveys, there exist both structural and cultural barriers to a neurologybased pursuit of NIR across the training spectrum. 10 The…”

Exposure to Neurointervention During Neurology Training

“…Neurointervention exposure was identified as an obstacle to pursue neurointervention as a subspecialty. 8 While some trainees favored a mandatory neurointervention rotation, many preferred the availability of 4 to 8 weeks of elective time within or outside the VN rotations during their residency training. Similarly, a recent analysis of demographic and educational backgrounds of neurointervention program directors by Vilanilam et al 9 revealed that a majority of programs are led by neurosurgeons (51.3%) followed by radiologists (33.3%) and lastly by neurology (12.8%).…”

“…Neurointerventionalists with neurosurgery and neurology background perform a nearly equal number of thrombectomy procedures (24% and 23%, respectively), while neuroradiologist represent 42% of the interventionalists. 8 If during residency or fellowship, there was a mandatory 4-week rotation, more residents and fellows will gain exposure to the specialty and be better prepared for the rapidly evolving landscape. Increasingly, university programs with neurology trained neurointerventionists would attract and train more neurology trainees in neurointervention.…”

“…Neurointerventionalists with neurosurgery and neurology background perform a nearly equal number of thrombectomy procedures (24% and 23%, respectively), while neuroradiologist represent 42% of the interventionalists. 8…”