Advice for an aspiring neurologist?

[montag617]

Hello all. I'm a third year student trying to decide between neurology and internal medicine , and I was hoping to get some advice... Not to say whats already been said by many others but the brain is freaken cool and my favorite experiences so far have been neurological/neurosurgical issues. However, my school does not permitt us to do a neurology rotation untill the begining of our 4th year, and I am reluctant to definitely go this route without technically ever been on a hospital's neurology service.

How much should I be thinking about applying for away rotations now for October and November? How important are they to do? I have a neurology Sub-I scheduled at my school this July, a month off for Step 2, and then a medicine Sub-I for a month as is. Also, I have absolutely no idea what kind of neurology residency programs I should be looking at/what is realistic for me. I am a US student, my grades and Step 1 (250's) are good, and I have some research experience with my name on a paper (not 1st author). I ideally would like to stay in the NE but am flexible, and would prefer a program that will allow me to ultimately go into a fellowship...

Any advice you guys might have would be much appreciated and helpful! Please feel free to contact me via email ([email protected]) if that is more convenient.

Thanks!!!

---

Members don't see this ad.

 

[charcot]

With a 250 on step 1 and your good handle of the english language, you should be able to match in the top 10 programs in the country!

I was chief resident, and therefore sat on the selection committee my last year at one of the top 5 programs and can tell you that although the applicant pool is gteting better, it is still rather pathetic compared to derm, optho, rads, ortho.

 

[Vriesea]

Hello all. I'm a third year student trying to decide between neurology and internal medicine , and I was hoping to get some advice... Not to say whats already been said by many others but the brain is freaken cool and my favorite experiences so far have been neurological/neurosurgical issues. However, my school does not permitt us to do a neurology rotation untill the begining of our 4th year, and I am reluctant to definitely go this route without technically ever been on a hospital's neurology service.

How much should I be thinking about applying for away rotations now for October and November? How important are they to do? I have a neurology Sub-I scheduled at my school this July, a month off for Step 2, and then a medicine Sub-I for a month as is. Also, I have absolutely no idea what kind of neurology residency programs I should be looking at/what is realistic for me. I am a US student, my grades and Step 1 (250's) are good, and I have some research experience with my name on a paper (not 1st author). I ideally would like to stay in the NE but am flexible, and would prefer a program that will allow me to ultimately go into a fellowship...

Any advice you guys might have would be much appreciated and helpful! Please feel free to contact me via email ([email protected]) if that is more convenient.

Thanks!!!

If the brain is "freakin cool" and your "favorite experiences so far have been neurological/neurosurgical issues" why not be a baller and step up and consider neurosurgery.

 

[montag617]

After spending a few weeks on a neurosurgery service in a busy city hospital(and dodging into every neurosurgery case I can since), I was really thinking about it. In the end, I think neurology would be a better match for me. For starters, I don't see myself having the personality those guys need or wanting the lifestyle and stress they have. Secondly, it seems like it could get pretty repetitive - about 80% is spinal work (slipped discs, etc.). My impression is that in order to do the proverbial "really cool stuff" (i.e. DBS), a neurosurgeon has to specialize and do just mostly that. Finally, I like the idea of (as a neurologist) having to be familar with all the different treatment options out there (including surgical) so I can refer my patients to the most appropriate treatment.

Interventional neurology and neuro ICU sound pretty interesting as well...

Thanks for your responses guys.

 

[Nerdoscience]

Even a busy third year can find time some time to shadow a neurologist on a weekend or day off to get some experience. Also, July of your fourth year is the an ideal time to do Neuro. You will want to get your letters then.

 

[Bonobo]

After spending a few weeks on a neurosurgery service in a busy city hospital(and dodging into every neurosurgery case I can since), I was really thinking about it. In the end, I think neurology would be a better match for me. For starters, I don't see myself having the personality those guys need or wanting the lifestyle and stress they have. Secondly, it seems like it could get pretty repetitive - about 80% is spinal work (slipped discs, etc.). My impression is that in order to do the proverbial "really cool stuff" (i.e. DBS), a neurosurgeon has to specialize and do just mostly that. Finally, I like the idea of (as a neurologist) having to be familar with all the different treatment options out there (including surgical) so I can refer my patients to the most appropriate treatment.

Interventional neurology and neuro ICU sound pretty interesting as well...

Thanks for your responses guys.

The specialization argument for neurosurgery doesn't hold since you will probably have to specialize in neurology also, or succumb to numerous EMGs, etc--the neurology equivalent of spine cases. It is probably better to be a neurosurgeon to go into INR at this point (though the future of stroke management may change that), and I agree, the neuro ICU is very interesting. But take it from me, the decision between neurosurgery and neurology is very difficult, and one you should think very carefully about lest you end up finding yourself wishing that you could be involved in the cool bypass surgeries for Moyamoya, or the implantation of chemotherapeutic disks for brain tumors, etc. The biggest reasons not to go into neurosurgery is length of training and lifestyle, and both are problems if you do interventional anyway.

So why neurology then? My own reasons were research and the flexibility to tone down my lifestyle if I so chose to in the future (a luxury not afforded to the vast majority of junior neurosurgeons out there). But this is at great costs given that I would've loved to clip an aneurysm some day, and would generally prefer a spine case over a 4-limb EMG any day.

That said, neurology is rapidly expanding, and may one day become like cardiology (the greatest field in medicine if one could actually become interested in the heart after having tasted the wonders of the brain...). You are likely to be a candidate for the top 5 programs in the nation, and probably can choose the program you wish to match at--the same cannot be said if you decide to do neurosurgery instead.

Good luck in your decisions, and please PM me if you have any further questions.

B

 

[Unsure Person]

With those credentials you should look good on paper. But keep the following in mind when applying. Yes, neuro is not ultra-competitive and it's relatively easy to match into a neuro spot somewhere. But just like other academic residency fields such internal medicine, the top programs in the country are competitive. I know a few people with similar credentials like your's who did not get interviews at all the places they applied to...often, such places were usually top 10 or 20 programs. I also know some people who ended up (to my surprise and theirs) not getting their top 2 or 3 choices as they had ranked only elite programs (top 10 or 20 programs as their first choices). They were excellent neuro applicants. Just to juxtapose another field to better illustrate, I know of at least 3 people this year who attended good medical schools, had high board scores (250's and 260's), had honored almost every course in those med schools, AOA status, and had publications who did NOT match into their top 2 or 3 spots in Internal Medicine. They were surprised, to their dismay. However, they had ranked very elite programs as there top choices (e.g. Mass Gen, UCSF, etc...). The same goes for Neuro...there is no gaurantee that you will get a top 10 program if you only rank them as your top choices. If you want to increase your chances even more at such elite programs, you should really show long-term promise and committment to neuro. For example, get publications in neuro fields and get some letters of rec from premiere academic neurologists who are well known in the field (seems like all the top academic neurologists know each other). If you are an MD/PhD student you will almost automatically increase your chances at securing a spot (at least an interview) at an elite program because that shows promise towards an academic field like neuro. Bottom line is that there are many supposedly elite students who graduated from good med schools who do not end up in top 10 programs so make sure you have some back ups. In the meantime, continue to show promise in neuro and you should, regardless, have a successful residency match. Neuro is a great field and there are very few fields where you will find attendings and academicians who truly love what they do. In some fields the object of the game is get your stuff done and run home asap. In neuro, I think a much larger percentage of people are there because they really have a passion for the field. This is without a doubt the case at the more elite programs, but nevertheless, still a predominant view at most of the neuro programs across the country. Good luck with things.

Hello all. I'm a third year student trying to decide between neurology and internal medicine , and I was hoping to get some advice... Not to say whats already been said by many others but the brain is freaken cool and my favorite experiences so far have been neurological/neurosurgical issues. However, my school does not permitt us to do a neurology rotation untill the begining of our 4th year, and I am reluctant to definitely go this route without technically ever been on a hospital's neurology service.

How much should I be thinking about applying for away rotations now for October and November? How important are they to do? I have a neurology Sub-I scheduled at my school this July, a month off for Step 2, and then a medicine Sub-I for a month as is. Also, I have absolutely no idea what kind of neurology residency programs I should be looking at/what is realistic for me. I am a US student, my grades and Step 1 (250's) are good, and I have some research experience with my name on a paper (not 1st author). I ideally would like to stay in the NE but am flexible, and would prefer a program that will allow me to ultimately go into a fellowship...

Any advice you guys might have would be much appreciated and helpful! Please feel free to contact me via email ([email protected]) if that is more convenient.

Thanks!!!

 

[ectopic_thought]

With a 250 on step 1 and your good handle of the english language, you should be able to match in the top 10 programs in the country!

I was chief resident, and therefore sat on the selection committee my last year at one of the top 5 programs and can tell you that although the applicant pool is gteting better, it is still rather pathetic compared to derm, optho, rads, ortho.

what do you mean by "pathetic" regarding the neuro applicant pool? is this simply characterizing the applicant pool based on step I?

judging from personal experience, applicants to fields like derm or rads are not necessarily brighter than neuro applicants (or any other field, for that matter). in fact, they seem a bit more myopic about their jobs in that they're about hours and dollars. not necessarily anything wrong with that; i'm just calling it as i see it.

it seems to be just a matter of the numbers and test scores being higher for derm/rads/ophtho because of the competition for cushy lifestyles with huge paychecks, as opposed to fields like neuro that attract people for the intellectual engagement more so than for the modest paycheck. nothing wrong with that for either group. i just wonder what you mean by "pathetic."

 

[stochastic]

I was getting a tad discouraged hearing this kind of thing so often (i.e., the neuro applicant pool being pathetic). I was beginning to think that the field I was interested in was perceived as being full of substandard minds even though the complexity, acheivements, and future potential seemed to say the opposite. After spending time in other forums on SDN and talking with classmates that desire such specialties, your words ring true.

cheers

 

[mysophobe]

what do you mean by "pathetic" regarding the neuro applicant pool? is this simply characterizing the applicant pool based on step I?

judging from personal experience, applicants to fields like derm or rads are not necessarily brighter than neuro applicants (or any other field, for that matter). in fact, they seem a bit more myopic about their jobs in that they're about hours and dollars. not necessarily anything wrong with that; i'm just calling it as i see it.

it seems to be just a matter of the numbers and test scores being higher for derm/rads/ophtho because of the competition for cushy lifestyles with huge paychecks, as opposed to fields like neuro that attract people for the intellectual engagement more so than for the modest paycheck. nothing wrong with that for either group. i just wonder what you mean by "pathetic."

I believe the word "pathetic" was referring to the number of applicants.

 

[Airul]

Looking through the top 10 programs in the country and the credentials of their residents, I had also noticed that most of them tend to be MD/PhD's. I am currently in second-year med school and am very interested in neuro, both clinical and research sides. I was wondering what people's take would be on doing a PhD after the 4 year med curriculum and applying for residency afterwards. Do you think the huge PhD gap in between would be a disadvantage for an applicant for neuro?

Thanks in advance for your input

 

[GopherBrain]

Looking through the top 10 programs in the country and the credentials of their residents, I had also noticed that most of them tend to be MD/PhD's. I am currently in second-year med school and am very interested in neuro, both clinical and research sides. I was wondering what people's take would be on doing a PhD after the 4 year med curriculum and applying for residency afterwards. Do you think the huge PhD gap in between would be a disadvantage for an applicant for neuro?

Thanks in advance for your input

While I don't disagree with your premise that the top programs tend to be PhD heavy, it doesn't have to be that way. If you are a strong enough applicant, you can end up anywhere, without getting that PhD first. For example, in my entering class of 7 @ UCSF (not counting the peds neuro people), I think there is only 1 MD/PhD. Residency programs are giving more value to producing clinical researchers and teachers than they used to, and are consiquently not so focused on filling up with basic science types.

 

[Astrocyte]

Looking through the top 10 programs in the country and the credentials of their residents, I had also noticed that most of them tend to be MD/PhD's. I am currently in second-year med school and am very interested in neuro, both clinical and research sides. I was wondering what people's take would be on doing a PhD after the 4 year med curriculum and applying for residency afterwards. Do you think the huge PhD gap in between would be a disadvantage for an applicant for neuro?

Thanks in advance for your input

You sound like you are thinking about doing PhD partially because you want to get into a top 10 program. Don't do it for that reason! PhD is hardwork, and very time consuming. It makes sense to do PhD only if you think you would enjoy the process and seriously think about basic science research for a career. Also, it's better to do PhD between second and third year of medical school. You really don't want to restart your clinical training after years of labwork. It might not be a disadvantage in application, but you will be amazed how much you can forget.

Otherwise, just go for neuro residency straight-up. Neuro is in buyer's market. It is also research friendly. You can have a research-track residency training in any major academic center. Don't need to aim for top 10. Besides the top guy(s) in your research field of interest might not be in a so-called 'top 10' program. If that is the case, lucky you.