neurology career

[rewind]

Due think neurology has better career opportunities and better lifestyle comparing with FM and IM?

Thank you very much

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[typhoonegator]

Yes.

 

[neurodoc]

+1.

 

[danielmd06]

Agree with above.

 

[Yoyomama88]

any of you kind gentleman care to elaborate?

 

[rewind]

Any more input please.

 

[Thama]

Could you please elaborate a little.

Might help if you were a little more specific or gave some info regarding what stage of your career you're at, what you mean by "better career opportunities", etc. I'm just a lowly student around here but I have a hard time imagining myself as an attending being able to give you much more of an answer to the question you just posed.

 

[rewind]

Thank you for your response.

I am just exploring my residency options and would like to know where neurology stands comparing with IM and FM in terms of job opportunities, income, and overall lifestyle.
As far as I know:
1. The residency program in all these specialties are not competitive
2. IM has best fellowship options like cardio and GI
3. Both IM and FM are among the most recruited specialties for job and you can get a job easily in any location you want
4. In terms of lifestyle, FM may be better than IM. The pay is low in both except for a few IM subspecialties

Neuro..only had two week rotation and I like it, but I don't have enough detail about the field and where to stand comparing with IM and FM

 

[danielmd06]

Hey guys. It's hard to answer this type of question in detail without taking an hour to respond, but I'll try.

Arguing competitiveness is hard. As a rule, neuro is more competitive than IM, FM, peds, and psych, and I think it's pretty comparable to PM&R, and path. This is debatable, and no matter how you try to answer this or phrase your response someone always comes around and challenges a blanket statement. It doesn't help that I graduated from medical school in 2006, either.

Neuro pays better than primary care. I guess there is always some exception somewhere, but as a general statement this is true.

Neuro is in demand, and is slated to be in increasing demand as our population ages.

Neuro can be an excellent lifestyle if you want it to be. Their are hospitalist jobs, strictly outpatient jobs, super-busy call jobs, and (depending on fellowship selection) jobs without call.

Neuro offers as many fellowship options as any specialty beyond IM. One of its greatest strengths is the flexibility to pursue so many different types of paths. You can do sports neuro, pain, sleep, stroke, epilepsy, movement disorders, interventional neuro, neurocriticial care, headache, neuromuscular, etc, etc, etc. Most neurologists pursue subspecialty training and intend to do so from the beginning or residency.

Neuro has good research opportunities, too.

 

[rewind]

Thank you very much for the input and it really helps.

One more question to add about residency... how difficult and what is the difficult part? Are you expected to memorize every detail of neuro anatomy and physiology? How about for the board? do you think that is one of the reason that many people are not going to neurology? During your inpatient month, what do you do if there is no neuro consult/patient..same in ICU?

Thank you everyone again.

 

[danielmd06]

Thank you very much for the input and it really helps.

One more question to add about residency... how difficult and what is the difficult part? Are you expected to memorize every detail of neuro anatomy and physiology? How about for the board? do you think that is one of the reason that many people are not going to neurology? During your inpatient month, what do you do if there is no neuro consult/patient..same in ICU?

Thank you everyone again.

Your questions are somewhat curious. Where are you in your training again?

My residency was pretty tough. The hardest two years were PGY-2 and PGY-3. Most people have their toughest year during PGY-1. It's difficult for the same reason IM is difficult. You can have a lot of patients on your census, the ER calls you for practically anything quais-neurological, including psych, ENT, ophtho, and neurosurg. There are some sick patients in that neuro ICU, also. Taking call can be hard.

Memorize trivial minutiae about anatomy and physiology? No. Memorize important details with clinically relevant anatomy and physiology? Sure.

The board was no problem.

I think neurology is of lesser competitiveness than many other specialties is because it doesn't pay better than many, has a four year (plus) training path, is a potentially hard residency, deals with a part of the body that is often not taught well (and thus people don't want to deal with it), is often represented by...unique...attendings and residents, etc. I have discussed this on this forum before. Please check the seach function for more detailed answer.

 

[neurologist]

I think in general neuro has a somewhat "better" lifestyle than general IM, but that's also somewhat dependent on region and workplace setting.

Other question depends what you mean by "career opportunities."

There are plenty of jobs available for both.

With IM, there are obviously far more subspecialty options than with neuro or FM, many of which also pay better than neuro or FM (or general IM).

If you just want to be a primary care IM/FM doc and are lazy and don't want/need a super-high salary, you can carve out a pretty cushy lifestyle by doing outpatient-only work and just referring everything that requires any real work to specialists (Headache? refer to neuro. Crazy? Refer to psych. Joint pain? Refer to ortho/rheum. Insulin-requiring DM? Refer to endocrine. You get the idea.) Many of the primary care IM docs around here follow that pattern. They clear $150-180K a year for seeing runny noses and sore throats and simple hypertension and filling out referral forms for everything else. Bastards won't even take back one of their own patients with stable infrequent migraines who just needs occasional beta blocker/tricyclic and imitrex refills -- "Oh, no, you have to go see the neurologist for that now . . . "

 

[BlackFrancis33]

I think its important to point out the obvious. Do neurology because you like it, first and foremost. It is not an easy residency in that you will be on call PGY2 and beyond. The most unhappy residents I have seen are those that chose neurology because they couldn't really figure out what to do, and neurology was available, so they signed up. If you are really uncertain about specialty, IM is probably the best choice as you can go in more directions after training.

 

[bustbones26]

The most unhappy residents I have seen are those that chose neurology because they couldn't really figure out what to do, and neurology was available, so they signed up.

I sort of fell into that category, but am not unhappy.

I once considered IM myself, and gradually fell into neuro, so I'll try to add some insight onto this.

Deciding what to do is not always easy or clear cut but be warned, there are downsides to every single specialty and somebody will always try to talk you into or talk you out of almost anything, so at the end of the day, do what is best for yourself.

I assume that if you are considering IM/FP versus Neuro, then you have already decided against any type of surgical specialty?

For both specialties, lifestyle varies, depending upon what you do. The only food for thought that I can offer to you is to consider that if you do neuro, you will eventually become very good a neuro and bad at everything else (per se). If you want to be a physician with a broad knowledge base, then IM/FP is for you.

Myself, I went to an osteopathic school so I felt as if I was somewhat forced to do more primary care type of rotations as a med student than I really wanted to. I noticed that I was not as bored on neurology rotations. That is not to say that you won't see fun or exciting stuff in the IM/FP world, I just feel that the number of "fascinomas" were more prominent in neurology. I also felt that I took an interest in neurological cases whenever performing FP/IM rotations as well.

The only unhappiness I could really state is the fact that I do not feel as if I have a typical neurologist personality, so I really don't fit in with my peers. Outside of work, I am more interested in spending time with my children and watching Duck Dynasty than I am about buying the box set for Battlestar Galactica (sorry if I offended anybody, I did not mean it that way).

 

[Achillees]

I sort of fell into that category, but am not unhappy.

I once considered IM myself, and gradually fell into neuro, so I'll try to add some insight onto this.

Deciding what to do is not always easy or clear cut but be warned, there are downsides to every single specialty and somebody will always try to talk you into or talk you out of almost anything, so at the end of the day, do what is best for yourself.

I assume that if you are considering IM/FP versus Neuro, then you have already decided against any type of surgical specialty?

For both specialties, lifestyle varies, depending upon what you do. The only food for thought that I can offer to you is to consider that if you do neuro, you will eventually become very good a neuro and bad at everything else (per se). If you want to be a physician with a broad knowledge base, then IM/FP is for you.

Myself, I went to an osteopathic school so I felt as if I was somewhat forced to do more primary care type of rotations as a med student than I really wanted to. I noticed that I was not as bored on neurology rotations. That is not to say that you won't see fun or exciting stuff in the IM/FP world, I just feel that the number of "fascinomas" were more prominent in neurology. I also felt that I took an interest in neurological cases whenever performing FP/IM rotations as well.

The only unhappiness I could really state is the fact that I do not feel as if I have a typical neurologist personality, so I really don't fit in with my peers. Outside of work, I am more interested in spending time with my children and watching Duck Dynasty than I am about buying the box set for Battlestar Galactica (sorry if I offended anybody, I did not mean it that way).

I thank you for your reply. I'm in the same boat regarding being unsure and falling towards Neuro, still an M3 tho. You're right about downsides to every specialty. I started off thinking I would do IM, however, I ended up being wrong about my desire for variety...so IM fell down on the list by a few spots. Discovered I'd rather be master of one trade versus a moderate jack of all.
Like you, I also don't think I have a typical neurologist personality. I picture wanting to "turn off" after a day of neuro patients.

 

[Acherona]

2. IM has best fellowship options like cardio and GI

It's a matter of perspective. You couldn't pay me enough to look up people's butts all day.