Choosing a Neurology Sub Specialty

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tash22

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Hi! I'm interested in doing a sub specialty in neurology. So far, I'm between
behavioral neurology
neurointensivist/ critical care neurology
Neuromuscular
Sleep medicine

However what I really want to do is work with people who have Alzheimer's and dimensia from a neurological point of view( not pysch ). Or anything really where memory dream cycle etc can be linked to brain chemistry and functioning. What specialty would I have to do to work with patients like this?

For any of the subspecialties above could you please give any information regarding lifestyle, pay, job demand, hours, pros cons etc.

all for a hospital setting too not private practice and differences between big city, suburbs etc.




Thank you so much!!!!

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Um, those are all very different fields. And if you want to do AD research, then the only one with much clinical overlap will be behavioral. Or I guess maybe sleep if you're interested in memory consolidation, but even then a cognitive fellowship would probably be more pertinent.

You should do a search. You're asking for a lot of information, and no one is going to have the time or patience to spoon feed you a spreadsheet with all of the variables you have requested. Many have been discussed on this forum before.
 
you need to learn how to spell dementia before you can go into the field. i know that was snarky but i couldn't help it.

behavioral neuro is really interesting from a research perpective, the problem is that clinically there are like 2 treatable causes of dementia which requires lengthy evaluations that are not well reimbursed only to end up putting a everyone on aricept which is little better than a placebo.
 
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A pretty interesting area of research involves how sleep is affected by neurodegenerative disease and what sleep disturbances can serve as predictors for certain neurodegenerative diseases, specifically the dementias, parkinsons.

The deal with becoming a neurologist is that most people in private practice that are fellowship trained will be able to see a decent number of people in their specialty but you will also be seeing some general neurology patients and participating in the general call pool. Theoretically behavioral would be better as no one is calling in the middle of the night with acute onset lewey body dementia.

Behavioral will get you involved with a lot more psychosocial aspects of medicine including family and caregiver counseling, helping families coordinate what type of care facility their loved one goes to and when, and unfortunately getting adult protective services involved in cases of neglect and abuse (which a sleep med doc will rarely be calling APS)

Sleep is more profitable because of being able to read polysomnograms which is money in the bank...... for now. I'm guessing that reimbursement will normalize for that and more private payors (If they still exist) will be making people go through some kind of sleep apnea screen since the majority of sleep patients will be sleep apnea evals which you really don't need a polysomnogram to diagnose.

Both would allow you to look at those academic areas you were talking about, but I think sleep would have more options, but both would be doable.
 
I'm guessing that reimbursement will normalize for that and more private payors (If they still exist) will be making people go through some kind of sleep apnea screen since the majority of sleep patients will be sleep apnea evals which you really don't need a polysomnogram to diagnose.

You cannot diagnose sleep apnea without a diagnostic polysomnogram or a home sleep study (class II, III, or IV). Usually at a minimum class III. Reimbursement will fall from current levels, but still remain quite competitive for neurology in my opinion.

Can't be done with clinical evaluation or questionnaire.

Research for memory consolidation and sleep staging is interesting, and appreciated at the current time. Research regarding dreaming and REM sleep is also out there and both are most viable via sleep medicine fellowship in my opinion.
 
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