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[pink_peonies]

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[Telamir]

Do you like your NEUROLOGY rotation? Are you okay with the bread and butter stroke/seizure/dementia/MS/neuropathy? If so then who cares? I liked my general surgery rotation more than internal medicine. Turns out mental masturbation about things you're not interested in sucks.

 

[DerpyNeuroMD]

I liked GS but not only did I hate the lifestyle, I could see it getting extremely boring. Granted you can tailor your practice, but at the end I was like "if I see one more lap chole or hernia repair I'm going to gouge out my eyes".

Medicine was just boring in general. I didn't like having to know a little about everything and then letting the specialists have all the fun. It just felt super algorithmic. Plus all the BS you've got to manage related to dispo, admits, discharge, etc. Always felt like I was kind of just running around feeling busy and waiting for the next shoe to drop. I just want to give my recs and follow rather than ever have to be primary.

I loved my neuro rotations. Definitely still some medicine involved, but the cases and pathologies are often interesting and thought-provoking. Also, if you get the chance to rotate or shadow in a private practice, I highly recommend it. Different strokes (no pun), but that was what clinched it for me. Really enjoyed the thought process while working up undifferentiated patients. I'm also interested in starting my own practice, and I think there are few, if any, specialties that are as well-suited as neurology, for many reasons.

I just matched though, so take that with a grain of salt.

 

[Thama]

Surgery was a blast, but by the end of the rotation it was clear it wasn't for me in the long run. Neurosurgery was particularly fun, and it almost persuaded me, but the hours were just too much and what I liked the most about it was the interface with neurology.

 

[liquidshadow22]

If you like surgery, trust me you will not like neurology. Neurology and medicine, day to day is very similar despite what others will say here.

If you like being in the OR, do surgery if you can deal with the stress/lifestyle issues. Otherwise you will get bored doing any non procedural specialties.

The subject matter gets old after a while, just focus more on the your day to day activities: cutting each day or talking to pts, writing notes, writing scripts. Rinse and repeat.

 

[mrbreakfast]

A good proportion of the neurologists I know, including myself, heavily considered surgery. Medicine was one of my least favorite rotations in med school (I liked it more as a resident, but still). I personally like neurology for all the reasons you mentioned (and more) but as others said you really need to see how you like your actual neurology rotation - and if your school doesn't have one, try to do an away rotation.

 

[xenotype]

M3 still exploring neurology. On my rotation, sometimes I felt like a fish out of water since every neurologist I talked to loves medicine, hated the OR.

I really enjoyed neurology for the anatomy, 3D visualizations, imaging, and physical exam. I’ve also always loved and am a nerd for the nervous system. I always feel grateful studying it.

However, I only felt “alright” with my medicine rotation. I wasn’t super excited about analyzing abnormal labs, hormones, etc. in reference to every organ in the body and didn’t feel particularly skilled at it. I enjoyed neurology more because I viewed these intangible things more in reference to one organ system which I could visualize more easily. I wouldn’t consider myself primarily an analytical person or someone who likes problem-solving, but I liked being able to do the physical exam, visualize 3D anatomy, think about labs in reference to one organ system, and find pathology that way if that makes sense. Don’t super love non-visual puzzles, love visual ones. I also loved cutting in the OR, but surgery is a no for me as the lifestyle does not align with my family priorities.

You have given me hope! Thank you. My neurology rotation only consisted of 3 weeks of child neurology, so I will try to schedule some shadowing days my rotations soon.

I really don't care for child neurology. It is quite different than adult neurology, with different diseases and very different approaches to treatment, besides the fact that I don't like kids or their parents. You've rotated enough to know whether you want to do child neurology, but not enough to know whether you want to do adult neurology. The neuroICU and stroke are a completely different animal than child neurology, and most child neurologists really hate stroke (and are afraid of it on some level).

I hate internal medicine. It is as many mentioned a lot of mental masturbation before eventually calling the relevant consultant to actually take care of the problem, especially in the high litigation environment of today with easy access to consultants compared to 30 years ago. A lot of it is literally just social work and paperwork- discharge summary and H&P. They have no ability to dictate care to the ER, unlike neurology where we basically just tell the ER what we want to do with the patient in terms of disposition. I did not enjoy my IM rotation in med school. I did not enjoy internship- PGY2 in neurology was busier and more fun. Many IM positions nowadays there are little to no procedures done either, except in more rural locations. IM was a harder more interesting specialty when consultants weren't as available, and CT and ultrasound didn't exist so detailed exam was a crucial skill. Now the exam they do is cursory and finished in under 60 seconds most of the time, and often meaningless as every item of interest has already been scanned by the ED. The exam is critical in neurology, somehow we do far more procedures these days in the average neurologist's practice, we make more money, and we actually have to come to an accurate diagnosis based on exam findings, occasionally with quite rare diseases in the wild. As for outpatient practice in IM- family medicine often has more experience at critical aspects like basic gyn care and office procedures, and more experience in actual outpatient medicine.

I didn't like the OR for a long list of reasons, so I didn't like surgery.

If you like surgery, trust me you will not like neurology. Neurology and medicine, day to day is very similar despite what others will say here.

If you like being in the OR, do surgery if you can deal with the stress/lifestyle issues. Otherwise you will get bored doing any non procedural specialties.

The subject matter gets old after a while, just focus more on the your day to day activities: cutting each day or talking to pts, writing notes, writing scripts. Rinse and repeat.

You can meet neurologists at the end of their career that still don't feel like they have a full grasp of the 'subject matter', especially if they have to see cases outside of their immediate subspecialty interests. As for the 'day to day' similarity to medicine this is also not necessarily true, you can easily get 40% of your entire week to be procedures in many jobs- EMG day, botox day, EEG reading afternoons, VNS/RNS/DBS clinic. Or just do hospital neurology and triage stroke alerts and round on hospital patients. Intervention, pain, critical care are there if even more procedures are needed but these can be competitive for the few that want it.

 

[liquidshadow22]

I really don't care for child neurology. It is quite different than adult neurology, with different diseases and very different approaches to treatment, besides the fact that I don't like kids or their parents. You've rotated enough to know whether you want to do child neurology, but not enough to know whether you want to do adult neurology. The neuroICU and stroke are a completely different animal than child neurology, and most child neurologists really hate stroke (and are afraid of it on some level).

I hate internal medicine. It is as many mentioned a lot of mental masturbation before eventually calling the relevant consultant to actually take care of the problem, especially in the high litigation environment of today with easy access to consultants compared to 30 years ago. A lot of it is literally just social work and paperwork- discharge summary and H&P. They have no ability to dictate care to the ER, unlike neurology where we basically just tell the ER what we want to do with the patient in terms of disposition. I did not enjoy my IM rotation in med school. I did not enjoy internship- PGY2 in neurology was busier and more fun. Many IM positions nowadays there are little to no procedures done either, except in more rural locations. IM was a harder more interesting specialty when consultants weren't as available, and CT and ultrasound didn't exist so detailed exam was a crucial skill. Now the exam they do is cursory and finished in under 60 seconds most of the time, and often meaningless as every item of interest has already been scanned by the ED. The exam is critical in neurology, somehow we do far more procedures these days in the average neurologist's practice, we make more money, and we actually have to come to an accurate diagnosis based on exam findings, occasionally with quite rare diseases in the wild. As for outpatient practice in IM- family medicine often has more experience at critical aspects like basic gyn care and office procedures, and more experience in actual outpatient medicine.

I didn't like the OR for a long list of reasons, so I didn't like surgery.



You can meet neurologists at the end of their career that still don't feel like they have a full grasp of the 'subject matter', especially if they have to see cases outside of their immediate subspecialty interests. As for the 'day to day' similarity to medicine this is also not necessarily true, you can easily get 40% of your entire week to be procedures in many jobs- EMG day, botox day, EEG reading afternoons, VNS/RNS/DBS clinic. Or just do hospital neurology and triage stroke alerts and round on hospital patients. Intervention, pain, critical care are there if even more procedures are needed but these can be competitive for the few that want it.

none of these procedures in neuro will be anything remotely as involved or complex as surgery. If you enjoy doing procedures, dont waste your time with neurology.

Managing DBS/RNS/VNS and EEG are not procedures. They are cognitive tasks.

EMG/Botox for anyone who likes doing procedures are unappetizing.

Figure out if you want to cut or not, the rest is just details IMO.

 

[xenotype]

none of these procedures in neuro will be anything remotely as involved or complex as surgery. If you enjoy doing procedures, dont waste your time with neurology.

Managing DBS/RNS/VNS and EEG are not procedures. They are cognitive tasks.

EMG/Botox for anyone who likes doing procedures are unappetizing.

Figure out if you want to cut or not, the rest is just details IMO.

Agreed, but my point was that general neurologist does more procedures these days than the average hospitalist. If the OP truly loves the OR, there is no substitute for a surgical specialty.