how subspecialized are neuro jobs

[Abc63]

I'm a medical student considering neurology. How realistic is it as a neurologist to practice only what you do your fellowship in and not see general neurology patients?

I'm interested in movement disorders, behavioral neurology (dementia), or sleep medicine fellowships. I like the idea of being a specialist in one of these areas and only seeing those patients in my clinic. Is it common for neurologists to find jobs in their subspecialty only or are most neurologists still seeing general neurology patients or required to do inpatient general neuro/stroke coverage? Thanks!

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[kchan99]

It depends on the demand of the subspecialty at the particular institution. Are you considering an academic career? It would be hard to have a pure movement disorders or behavioral neurology practice in a private practice group, but there are exceptions. For example, there had been a movement disorders only private practice group in Maryland for many years.

Have you thought about psychiatry --> neuropsychiatry (same fellowship as behavioral neurology)?

Please PM me if you have more questions.

 

[RenegadeSynapse]

I'm a behavioral neurology fellow, so will add a bit on that. Kchan99 is right, it's very rare to get a private job outside of academics. Even there, you'll likely do some general neurology on consults, wards, or resident clinic. The vast majority of your clinical time though is likely to be in your subspec in academic practice. A co-fellow in behavioral took a private job, will get 50% BN and 50% general. Behavior doesn't pay for itself on clinical billing alone in most cases. Also feel free to PM me, happy to answer any questions.

 

[kchan99]

Even there, you'll likely do some general neurology on consults, wards, or resident clinic. The vast majority of your clinical time though is likely to be in your subspec in academic practice. Behavior doesn't pay for itself on clinical billing alone in most cases.

This has been my experience. If I were to successfully obtain research grants, then I can reduce my clinic/service time, and then I'll have a higher proportion of patients with neurodegenerative issues. I see patients with movement disorders and/or cognitive complaints that helps reduce the amount of general neurology. If someone were to train two subspecialties, with sleep being one of them, then it would be more conceivable to have an almost purely subspecialty practice earlier on.

 

[neurolddoc]

If you want to see only sub-specialty patient, then you are looking at an academic career. In practice you will see all comers, especially at first. With time your focus could narrow down the range of patients you see.

Another approach is to transition for academics to specialty practice. This has been the model for the above referenced practice in Maryland although one of the members has made a reverse transition back into academics.