How smart are neurologists compared to other physicians?

[Neonderthal_Misc]

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I've always heard talk about how neurology is one of the most intellectually challenging specialties, where practitioners are forced to think on their toes, that is it like a solving a puzzle or "localizing the lesion". Is this a field where simply having good memory of attained knowledge is not enough to succeed?

To add on this, I would wager that neurologists are FAR underpaid for the work they do. Their average salaries should approach that of cardiologists, if not more. Meaning, their residency spots should also be MUCH more competitive. Yes, cures may not be as instant, or even prevalent, but as innovation continues we are beginning to see several advances in potential treatment options, particularly in this field. They may not be spending their lives in the OR like neurosurgeons, but their intellectual input and services to offer to ICU patients who are suffering from particularly threatening diseases such as cancer or leukodystrophies is largely undervalued. Their level of thinking is on par with that of most engineers from what I have observed.

 

[Telamir]

The smartest, duh.

In all honesty part of the challenge with neurology or why it makes it challenging is the subtlety of the symptoms. In order to call a nephrologist you typically have abnormalities in a renal profile. To call a cardiologist you may have someone complaining of chest pain, or with ST/troponin/BNP elevations. Similarly when you call critical care you have someone who is objectively septic or crashing. For neurology though? Something tingles, someone passed out, "he ain't actin' right", hell it could even be a primary psychiatric problem.

Sometimes symptoms are transient, other times vague. You may be stuck trying to prove a negative as well (rule out seizures, rule out TIA). Often times the symptoms are neurologic, but not due to a primary neurologic problem (consult for "tremors" turns out is asterixis). Other times the consults may be partly due to laziness (rule out Guillain-Barré syndrome, no one tried to get reflexes). There are very few objective tests from the get-go, and it's usually a combination of ancillary testing or tests "suggestive" of a certain etiology along with clinical acumen that may land you a diagnosis. History and physical exam are important, and therefore at times other colleagues look at what we do as wizardry. All in all I'd say it's plenty challenging, and a lot of the work is cerebral. Hospitals realize neurology is an essential specialty, often times transfers to my hospital are initiated only because "they need a neurologist". We are also quite rare, and demand for our services is quite strong and depending on your practice setting the pay may also reflect that.

 

[Radetzky]

Exactly how many patients do you think there are floating about hospitals with leukodystrophies?

Every specialty has their bread and butter and their more unusual cases that they get good at through doing it all the time. There is nothing magical or mystical about any of it and it does not require any magical abilities other than an interest in the field.

 

[Telamir]

Leukodystrophies are thankfully quite rare and a diagnosis mainly made through imaging. With prevalence of CT in a hospital setting you’re likely to catch them mostly since on CT they appear as white matter disease greatly out of proportion to age.

 

[Thama]

Everyone here has seen Rick and Morty, duh.

 

[Thama]

But seriously, I don't think intellect is really the defining attribute of neurologists compared to other specialists. What draws us in is curiosity. When confronted by the overwhelming complexity of the nervous system, most people think "damn, this is hard and I'm not good at it, better stay far away", we think "damn this is hard and I'm not good at it, which is kind of awesome... CHALLENGE ACCEPTED".

 

[BoneWizard]

But seriously, I don't think intellect is really the defining attribute of neurologists compared to other specialists. What draws us in is curiosity the bowties.

 

[Thama]

That's not a cause, it's a symptom.

 

[Giovanotto]

Everyone here has seen Rick and Morty, duh.

I watch the show, but not sure where the reference is.

 

[Neonderthal_Misc]

I watch the show, but not sure where the reference is.

+1

 

[DrSatan]

To be fair, you have to have a very high IQ to understand Rick and Morty. The humour is extremely subtle, and without a solid grasp of theoretical physics most of the jokes will go over a typical viewer's head. There's also Rick's nihilistic outlook, which is deftly woven into his characterisation- his personal philosophy draws heavily from Narodnaya Volya literature, for instance. The fans understand this stuff; they have the intellectual capacity to truly appreciate the depths of these jokes, to realise that they're not just funny- they say something deep about LIFE. As a consequence people who dislike Rick & Morty truly ARE idiots- of course they wouldn't appreciate, for instance, the humour in Rick's existential catchphrase "Wubba Lubba Dub Dub," which itself is a cryptic reference to Turgenev's Russian epic Fathers and Sons. I'm smirking right now just imagining one of those addlepated simpletons scratching their heads in confusion as Dan Harmon's genius wit unfolds itself on their television screens. What fools.. how I pity them.

And yes, by the way, i DO have a Rick & Morty tattoo. And no, you cannot see it. It's for the ladies' eyes only- and even then they have to demonstrate that they're within 5 IQ points of my own (preferably lower) beforehand. Nothin personnel kid

 

[Thama]

To be fair, you have to have a very high IQ to understand Rick and Morty. The humour is extremely subtle, and without a solid grasp of theoretical physics most of the jokes will go over a typical viewer's head. There's also Rick's nihilistic outlook, which is deftly woven into his characterisation- his personal philosophy draws heavily from Narodnaya Volya literature, for instance. The fans understand this stuff; they have the intellectual capacity to truly appreciate the depths of these jokes, to realise that they're not just funny- they say something deep about LIFE. As a consequence people who dislike Rick & Morty truly ARE idiots- of course they wouldn't appreciate, for instance, the humour in Rick's existential catchphrase "Wubba Lubba Dub Dub," which itself is a cryptic reference to Turgenev's Russian epic Fathers and Sons. I'm smirking right now just imagining one of those addlepated simpletons scratching their heads in confusion as Dan Harmon's genius wit unfolds itself on their television screens. What fools.. how I pity them.

And yes, by the way, i DO have a Rick & Morty tattoo. And no, you cannot see it. It's for the ladies' eyes only- and even then they have to demonstrate that they're within 5 IQ points of my own (preferably lower) beforehand. Nothin personnel kid

Now here's a man who appreciates a good copypasta.

 

[dodobirddh]

I've always heard talk about how neurology is one of the most intellectually challenging specialties, where practitioners are forced to think on their toes, that is it like a solving a puzzle or "localizing the lesion". Is this a field where simply having good memory of attained knowledge is not enough to succeed?

To add on this, I would wager that neurologists are FAR underpaid for the work they do. Their average salaries should approach that of cardiologists, if not more. Meaning, their residency spots should also be MUCH more competitive. Yes, cures may not be as instant, or even prevalent, but as innovation continues we are beginning to see several advances in potential treatment options, particularly in this field. They may not be spending their lives in the OR like neurosurgeons, but their intellectual input and services to offer to ICU patients who are suffering from particularly threatening diseases such as cancer or leukodystrophies is largely undervalued. Their level of thinking is on par with that of most engineers from what I have observed.

I think that the landscape of Neurology is changing fast. My take...

1. The cognitive load to reach a diagnosis has lessened from times of Charcot. This has been due to ready resources available in the form of
a) ebooks readily carried on iPad/ Tablets
b) Neurology apps for ready references eg. Stroke Scale, OKN strips app etc.
OKN Strips Stroke Scale
c) Instant Differential Diagnosis apps eg. Neurology Pro
Neurology Pro

2. Many hitherto untreatable diseases are eminently treatable now eg stroke, SMA, Muscular Dystrophy. The list is expanding every year with breakthroughs in endovascular technologies, gene therapy, CRISPER etc

3. The advent of Artificial Intelligence will further change this landscape. Time will tell...