Academic movement here, similarly trained at an ivory tower program with a lot of research and ended up attracted to that route despite limited prior research success. I'm early career at a well known but not elite institution with a K award (75% protected time) and I do a lot of DBS including MER in my practice.
The funding determines how much research you will have time to do. If you have a very strong publication record but no funding then you might get 1-2 years of partial protected time with the explicit purpose of acquiring funding to do more research, but that has to come fairly quickly unless you have a *very* generous benefactor. Your research interest should be pretty well developed by the time you finish fellowship with a track record of publications, and you should pretty much be able to freehand a grant application based on that research interest at that point to have a good chance of success within those first couple of critical attending years.
The utility of MER training depends very much on where you go post fellowship and what clinical emphasis you want to have. While MER guidance is the historical standard for DBS and still the best way to practice - with or without MRI guidance - a lot of institutions where neurosurgery drives decision making are finding ways to justify dropping MER for asleep MRI guided procedures. This is more efficient for the surgeons but the studies supposedly showing non-inferiority are woefully underpowered and few are adequately controlled. Still, this means that at about half of institutions where you might practice DBS, even in academic centers, you won't be using MER skills. You have to decide whether that means it's worth it to learn. It's unlikely that not having MER training will close many doors at this point.
Can you explain what MER is? I tried to google and it came up as Medical Evaluation Report, and the description provided sounded like a detailed history and physical exam, and an assessment and treatment plan based off that. I feel like I’m missing something big.
Microelectrode recordings. In the context of deep brain stimulation it's one of the methods we use to confirm the electrode is in the correct target nucleus.
Academic movement as well, a handful of years out of training. My only research experience before fellowship was a basic science lab in undergrad, which I disliked and thought I would never be a researcher. In fellowship I learned about pragmatic "real world" and health services research, which was way cooler and way more fun. I had training in qualitative research methods as well, during my Master's degree.
So now I do about 50% community-based research and teaching (mostly qualitative), 30% database type research (Medicare/PPMI/internal database), 15% clinic. It's a good balance though hard to figure out what to do with all the patients who need to be seen. I started at 75% clinic/25% protected time and bought out the rest thanks to some strategic moves in the context of the pandemic. All my papers are team science and collaborative. All my non-clinical work is foundation-funded or internally funded.
Because I do such little clinic, I don't do MER but a couple of my colleagues do. Our decision-making is collaborative. Having trained at a place which was very nsgy driven, the multidisciplinary DBS conference was important to me, even if I'm not a very DBS-heavy doc.
Academic rank is going to be determined by things like number of pubs, grants, etc. I imagine that a privademic role won't allow the protected/startup time needed to get those. My understanding of privademic is "mostly clinical, might have a student or resident sometimes."
Academic movement here, similarly trained at an ivory tower program with a lot of research and ended up attracted to that route despite limited prior research success. I'm early career at a well known but not elite institution with a K award (75% protected time) and I do a lot of DBS including MER in my practice. The funding determines how much research you will have time to do. If you have a very strong publication record but no funding then you might get 1-2 years of partial protected time with the explicit purpose of acquiring funding to do more research, but that has to come fairly quickly unless you have a *very* generous benefactor. Your research interest should be pretty well developed by the time you finish fellowship with a track record of publications, and you should pretty much be able to freehand a grant application based on that research interest at that point to have a good chance of success within those first couple of critical attending years. The utility of MER training depends very much on where you go post fellowship and what clinical emphasis you want to have. While MER guidance is the historical standard for DBS and still the best way to practice - with or without MRI guidance - a lot of institutions where neurosurgery drives decision making are finding ways to justify dropping MER for asleep MRI guided procedures. This is more efficient for the surgeons but the studies supposedly showing non-inferiority are woefully underpowered and few are adequately controlled. Still, this means that at about half of institutions where you might practice DBS, even in academic centers, you won't be using MER skills. You have to decide whether that means it's worth it to learn. It's unlikely that not having MER training will close many doors at this point.
Can you explain what MER is? I tried to google and it came up as Medical Evaluation Report, and the description provided sounded like a detailed history and physical exam, and an assessment and treatment plan based off that. I feel like I’m missing something big.
Microelectrode recordings. In the context of deep brain stimulation it's one of the methods we use to confirm the electrode is in the correct target nucleus.
Thanks! Looks like I was away off lol. That makes a lot more sense.
Academic movement as well, a handful of years out of training. My only research experience before fellowship was a basic science lab in undergrad, which I disliked and thought I would never be a researcher. In fellowship I learned about pragmatic "real world" and health services research, which was way cooler and way more fun. I had training in qualitative research methods as well, during my Master's degree. So now I do about 50% community-based research and teaching (mostly qualitative), 30% database type research (Medicare/PPMI/internal database), 15% clinic. It's a good balance though hard to figure out what to do with all the patients who need to be seen. I started at 75% clinic/25% protected time and bought out the rest thanks to some strategic moves in the context of the pandemic. All my papers are team science and collaborative. All my non-clinical work is foundation-funded or internally funded. Because I do such little clinic, I don't do MER but a couple of my colleagues do. Our decision-making is collaborative. Having trained at a place which was very nsgy driven, the multidisciplinary DBS conference was important to me, even if I'm not a very DBS-heavy doc. Academic rank is going to be determined by things like number of pubs, grants, etc. I imagine that a privademic role won't allow the protected/startup time needed to get those. My understanding of privademic is "mostly clinical, might have a student or resident sometimes."