How many epilepsy/neurophys fellowship programs do I need to apply to?

[bestwhit]

Simple question but probably hard to answer. I am working on my applications to epilepsy as well as CNP programs and I'm frankly unsure of what # of applications I should generally be aiming for. Anyone have any experience or knowledge/tips? Thanks!

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[Postictal Raiden]

I guess it depends on the caliber of programs and location you’re looking into.

I’m doing 10-15

 

[xenotype]

Pretty surprising. I just stayed at my home program and only applied there. I think entire approach here depends if you want academics/research based practice or are planning on PP/community practice. Leaving out EMG is a huge mistake if you want flexibility and comfort with general neurology (2 months in CNP fellowship is not adequate EMG experience). If you want to do surgical epilepsy at a big center you'll need 2 years/the full epilepsy fellowship in my opinion for competence. I wasn't aware either fellowship was particularly competitive but probably a lot of variability year to year because of internal candidates- we usually take our own people.

In my opinion a mixed CNP fellowship is still the best choice for most general neurologists- they are getting harder to find and you won't get them at name places. Procedural volume is key for fellowship along with good teaching from faculty, and I am lucky to have both in spades.

 

[hisham]

When should we expect the interview invitations? Do they send rejection letters or just ignore your application if not interested in you? I am wondering because there is no match and we might get offers from early interviews while waiting for other programs interview invitation. Is it fair to say if no invitation by end of November, we move on and strike out these programs?

 

[Postictal Raiden]

I applied mainly in the West. Interviewed, for offers and accepted a position as of last week.

 

[Splenda88]

I applied mainly in the West. Interviewed, for offers and accepted a position as of last week.

Aren't you a PGY3?


Can you apply for neuro fellowship as a PGY3?

 

[sommerwing]

Aren't you a PGY3?


Can you apply for neuro fellowship as a PGY3?

Neuro fellowships are usually found pgy3 year. Epilepsy/neurophys fellowship acceptances can be as early as September on PGY3 year.

 

[Postictal Raiden]

Aren't you a PGY3?


Can you apply for neuro fellowship as a PGY3?

Yeah it’s weird

 

[Splenda88]

@Ibn Alnafis MD

I did not think you would pursue a fellowship. Will an epilepsy fellowship worth it in term of opportunity cost?

 

[Postictal Raiden]

@Ibn Alnafis MD

I did not think you would pursue a fellowship. Will an epilepsy fellowship worth it in term of opportunity cost?

I didn't think I would either. I'm so against this exploitive scheme. I don't get why I need to spent 1-2 years after a 4 year rigorous training to become an expert while midlevels "can" do this by obtaining an online degree.

However, neurology (which is mostly an outpatient specialty) has a residency curriculum that is a 70%+ inpatient experience. You graduate from residency knowing hot manage acute strokes and other neurological conditions while being half asleep but still lack competence in recognizing/diagnosing/treating movement and neuromuscular disorders, let alone neurodiagnostic modalities (EMG, EEG, IOM, VNG, polysomnography).

Also most neurology residents pursue fellowships because they are either interested in doing academia (a larger proportion in neuro compared to other specialties) or they simply want to have a "niche" or focus their practice on a specific patient population.

Furthermore, fellowship positions in neurology are abundant and relatively easy to match into. Unlike IM, you don't need to be a stellar to match a "competitive" subspecialty/program.

Due to the reasons above, I felt that I would truly miss out if I don't do a fellowship, specially that I'm less geographically flexible compared to many people.

I applied and "matched" neurophysiology actually. I didn't want to "pigeonhole" myself into one subspecialty just yet and I am interested in learning EMGs. It is the most fellowship that suits my future career interests (private practice).

Financially worth it? I think so. I'll be sacrificing making 300-400k for a year (fellowship salary is ~70k), but i'll also be learning billable procedures that not only improve my marketability but can also potentially boost my income by another 50k-100k.

If I was willing to live outside metro areas, I wouldn't do a fellowship. An upper classmate of my friend at a different program signed up for a position in a small town (60k population) within 1.5hr drive from a 4M metro area on the west. 500k (including incentives but 350K base) working mostly banker hours. Straight out of residency.

 

[chickensoupdr]

How competitive is an epilepsy fellowship? What are programs looking for?

 

[Thama]

How competitive is an epilepsy fellowship? What are programs looking for?

As Ibn mentioned above, neurology fellowships are not very competitive pretty much across the board.

I'll qualify that a little. Fellowships that neurologists can do but which are predominantly within other specialties (NIR, pain, etc) can be very competitive, especially for neurology applicants.

The other thing to keep in mind is that while a particular type of fellowship (like epilepsy) will likely not be competitive and have many more spots available than applicants, an individual fellowship program may be quite competitive for a particular cycle. Since many fellowships only take 1-2 fellows a year, and many of those are filled by internal applicants who will always have an advantage, you may not get the specific program you want no matter how competitive you are.

That said, what most programs are looking for is a normal human being who is on track to complete neurology residency and pass their boards with recommendation letters that indicate they are capable of being a fully functioning human doctor that isn't going to burn the place down around them via personality disorders and/or gross incompetence. Research productivity, leadership roles, etc are all nice bonuses that only matter at certain places.

 

[xenotype]

To piggyback- for applicants/students- I highly recommend picking residency programs that have competitive multispecialty fellowships neurology department owned if you have any inkling you are the procedural type. A program owning the pain fellowship essentially guarantees 1-2 spots per residency class, or a straight in pathway for NIR. You'll find many 'prestigious' programs leave you little hope of getting these coveted spots. This is seldom thought of in the application process, but residents in these programs have way more options available to them down the road. Outside the few competitive ones (pain, NIR, maybe NCC) most are easy to get with a modicum of planning with a lot of variation year to year due to internal candidates.

 

[child_neurologist_2020]

I don't think it's necessary to apply to very many programs. I applied to Epilepsy this year for a two-year trajectory and only interviewed at my home program plus one other program in a geographical area of personal interest, and got offers at both. I was done with my cycle by November 2020.

That said, it's not a huge field and there are generally a very limited number of spots per program, and there may be internal candidates in any particular year who will take precedence. So targeting any one particular program (especially if it's not your home institution) can be risky.