MtMed said:
I thought i'd ask the question in hopes of hearing potential responses. I have some fears/uncertainties about going into Neuro - namely, tedium of disease management vs effective intervention; but i'd like to know if anyone out there prepared for this and still likes neuro, or prepared for this yet regret their decision to enter the field.
anyone? i'd love some feedback.
cheers
Neuro is like anything else, it becomes routine, so after you get good at it, there is no such thing as tedium. It is tedious at first because, but gets easier and easier, no fear, senior residents and attendings know this, they know you are just starting out, but show them effort and do reading on the side. I feel confident that by the time I am PGY-4, I will be much much better.
People always complain that neurologist treat diseases that are incurable. This is true for the most part, but think of it this way, if you had a neurologic condition: MS, parkinsons, Myasthenia, etc. Wouldn't you want a neurologist to treat you? This is the art of neurology, there may be no cure for most things we treat, but patients really do appreciate your care, taking the time to explain things to them, and just doing favors for them, yes favors. An MS patient truly appreciates it when you set them up for home health infusion of steroids versus sitting in the hospital doing nothing for three days, etc. There are sometimes social issues to work around. My experience has been this, if you are kind, caring, compassionate, and really show patients that you would do anything for them, they love you, they actually look forward to seeing you despite their condition. The doctor-patient relationships in neurology is the greatest part. Of course, this can backfire on you when you get the occasional borderline needy patient.
So, if you are cut and dry, see patient, do exam, find the lesion, give the drug, then follow up, you will hate neurology. Have to enjoy the art of giving care to these people.
Also, neuro has room to grow, which is what I like. When you think about what cardiologist can do for coronary issues, neurologist are cavemen when it comes to treating strokes, but research is in progress, new advances are being made. Neuro is a field where there is always room for improvement and I do feel that over the years we will see progress.
Lots of room to do procedures. I am DO, so I do like to use OMT on patients which they love!!. Botox or nerve blocks for headaches, trigger point injections, LP's of course, carotid ultrasounds (depends on program and your preferences). And of course, EEG and EMG.
Lastly, neurologist work long hours (at least in residency) but it is not brutal. What do I mean? Ok, if you are on call for internal medicine or surgery, you get called all night long to put out fires. For neurologist, the reason why you may be working long hours is because it just takes a long time to examine and evaluate a patient, but its not like you are getting bombed with call after call after call.
Attending life is pretty good. YOu will work long hours on the days you have to do inpatient consults and take call, but if you are in a partnership, this of course will not be every day of your life. Or some neurologist basically have an NP or PA do all inpatient rounds. Office hours are usually light, follow ups are quick and easy, and new patients just take a lot of time to see. Its not like family practice where you have to see a patient every 15 minutes from 9-5. If you do any procedures, get nice reimbursements. For now at least, botox still a cash only procedure. But the pay isn't there for neuro. Don't get me wrong, you make good money, but may make only slightly more than an FP or general internist, so this makes neuro unattractive to most people.
