Mar 25, 2010
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Greetings Board,

I am a current 3rd year med-student and budding neurologist (well, at least in my own mind) needing some assistance in finalizing my 4th year electives.

On the one hand, I want to do as many neuro electives as I can in order to A) get a feel for what kind of program I should lean towards when that magical day comes B) get a feel for what part of the country is most appealing to me, and C) make a good impression somewhere, although I know that is not usually needed, and can at times be detrimental. (And along those same lines, how useful are electives in neuro sub-specialties at the MS IV level?)

On the other hand, I feel as though I would be doing myself a disservice if I didn't spend time doing some cardio, rads, endocrine, rheum, ER, neurosurg etc. that not only might help me be a better neurologist, but also a more well rounded physician. Is there any non-neuro elective that a budding neurologist should not be without?

Thanks in advance.
 

typhoonegator

Neurointensivist
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I don't know how everyone else feels here these days, but my opinion is that neurology residency is there to teach you how to be a neurologist. I always assumed that my juniors knew nothing about neurology coming in, and I was usually right. Even if you learn a bunch of neuro now, it will most likely get forgotten during your intern year once your survival instincts kick in.

MS4 year is your chance to round out things that (a) will help you be a more effective and comfortable RESIDENT, and (b) satisfy your curiosity about the world of medicine outside neurology.

I would recommend that you first focus on becoming good at dealing with internal medicine issues, because those issues are so pervasive. Being a good junior neurology resident is more about being good at IM (and cardiology) than neurology. The more you learn now (and in internship) the more you will be able to focus on the neurology later (when it actually counts).

I would recommend taking a neurology elective or two during your MS4 year in order to solidify your interest in the specialty, and then focus the rest of your year on IM sub-internships, cards, MICU/SICU, and perhaps neurosurgery electives. Everything else is just gravy.
 

PhakeDoc

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I would recommend taking a neurology elective or two during your MS4 year in order to solidify your interest in the specialty, and then focus the rest of your year on IM sub-internships, cards, MICU/SICU, and perhaps neurosurgery electives. Everything else is just gravy.
Wholeheartedly agree with this, especially since depending on where you go for your intern year, you may have very few elective months (if any). I would also try to do perhaps a 2 week ophtho and 2 week rads rotation. Get comfortable with the fundus exam, reading CXRs/AXRs, and other basic imaging because that's what you'll be dealing with primarily as an intern.
 
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Wholeheartedly agree with this, especially since depending on where you go for your intern year, you may have very few elective months (if any). I would also try to do perhaps a 2 week ophtho and 2 week rads rotation. Get comfortable with the fundus exam, reading CXRs/AXRs, and other basic imaging because that's what you'll be dealing with primarily as an intern.
I agree with ophtho...the program director at the residency I'm going to told me I should "get good at the fundoscopic exam" because it's an underutilized skill, and very important in the field of neurology. I actually think the more neuro rotations the better though, for your fourth year. I had the opportunity to do 4, 1 at a different school, 1 outpatient, and 2 inpatient at the same hospital. I got to see different approaches and each doctor has a few 'tricks' to the neurological exam that are interesting to pick up. It also helped me rule out a school I thought would be my #1 choice for residency (before going there). Don't do an 'audition rotation' as your first neurology rotation, that could be embarrassing, and you're right, don't worry too much about doing an audition rotation just to get an interview. That doesn't always seem to work out..
 

danielmd06

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It seems I see this same question in multiple iterations every year from intelligent, well-meaning medical students. My answers/opinions have remained remarkably simlilar for three years. The gospel according to a (mere) PGY-4 Neurology chief resident:

There are plenty of MS3/4 electives that can benefit you as a general physician and as a Neurologist. The three best in my opinion...

(1) Internal Medicine
(2) Cardiology
(3) MICU

Sub-specialty MS3/4 electives that can benefit you specifically as a Neurologist are, of course, varied. It is based upon your particular career goals. The three best in my opinion...

(1) Neuroradiology
(2) Ophthamology
(3) Neurosurgery

Please don't underestimate the power of a solid two-month stretch of Neurosurgery/Neurocitical care. It's tough, but well worth every hour.

Good luck!

Regards,

Dan
 

BlackFrancis33

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I did rotations in Neuropath, neurointerventional/neurorads, neuroanatomy (helped with MSI class), 2 neurology rotations, and EEG as an MSIV. That may seem like a lot, 6 'neuro' rotations, but I was much better prepared to start neurology residency. I still had time to do SICU and Cardiology which were helpful. My opposing viewpoint is that you should use your MSIV year to expand your neurology experiences. You will learn to be an intern in your intern year. You will not be an internist, you will be a neurologist at the end of it all. The medicine you learn will be obsolete by the time you finish a neurology residency. Again, focus on learning as much neuro-stuff as you can. I love the recommendation to do NeuroICU as you will learn a lot of medicine in addition on this rotation. Ophth is also a great recommendation. I carried my pan-optic around as an MSIV and did fundo exams on everyone I could as an MSIV, but I should've done an opth rotation, neuro-ophth would be even better obviously.