If I hate working nights, what sort of subspecialties/practice arrangements in neurology should I look into?

Aug 25, 2018
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Interested in hearing about people's day-to-day practice and satisfaction/gripes! Right now I like most everything I've seen in neuro, and I totally understand that residency is residency - you'll be on call a lot and super busy. However, for long-term career, I think waking up at 3am every few weeks to go see patients at the hospital would burn me out. I know headache and movement disorder docs generally have a more "chill" lifestyle, but would like to hear people's opinions on minimizing working overnight regularly as a neurologist.
 
Jul 23, 2018
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There is a degree of variability. Some practices utilize neurohospitalists for overnight hospital coverage while the clinic docs either have no call or outpatient call (i.e. clinic patients calling in with questions, much easier than being on call for a hospital/ED). This is possible with larger practices.

Other groups may have no neurohospitalists and there is a rotating inpatient call schedule. Or the group may not be affiliated with a hospital at all thereby negating the need for inpatient call.
 
Jan 19, 2019
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The concussion specialist (idk what the official title is... sports neurologist? neurotrauma?) had by far the most chill schedule of all the physicians on my rotations. 9-5, 5 days a week with no call. Had at least 30 minutes for every patient whether new or established, usually an hour for new ones. Patients generally skewed younger as athletes, with some worker's comp here and there. Had it written into their contract that they were outpatient only. Probably not bringing in a ton of income that way, but if you don't mind that, it seems like a pretty sweet gig.

Fair bit of competition between that clinic and the sports med docs in the same network, though. Weird vibe there, but they were appreciative having neuro backup for the few concussions that didn't go by the book, so I think the two can coexist under the right circumstances/clinic setup.
 
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Ibn Alnafis MD

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Many neurology subspecialties are outpatient focused (movement, neuromuscular, epilepsy, neurodegenertive, MS, headache, sleep, neurophysiology, neuro-ophth, and others). As an outpatient neurologist, you can choose to not set a foot in the hospital or work nights/weekends for the rest of your career. However, as mentioned above, many groups have rotating inpatient coverage (ie 3 weeks of outpatient and 1 week of inpatient), but you don't need to join a group. You can have your own practice and design your schedule the way you please.

On the other hand, stroke and NCC are obviously hospital based specialties and require night/weekend coverage to some degree.
 
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popopopop

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The local neuroicu attending by me works 7 on 7 off, no nights. He's a young guy too, so it wasn't a seniority thing.
 

neglect

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typhoonegator

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There's waking up and going in a couple nights a week, and then there's multiple calls per night that you field from home...every night you're on call. The stress associated with each is different, but I can assure you that both eventually add up to be pretty awful. These days, it's not hard to find jobs where you "take all your call from home" but that consists of a bunch of teleneurology sites that want to "run it by you" for every TIA/UTI that rolls in, or telestroke where you're doing video and massive hand-holding, etc. I guess what I'm trying to say is not to underestimate the effect of these cumulative micro-aggressions on your sleep and well-being.