Im considering neuro, what can u tell me about it?

[drivesmecraazee]

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If someone had a direct contact with neurology (rotation, internship, residence, attending) please tell me about it's bread and butter, I know the field that studies (duh!) but I would like to know how do you guys manage in the job.
I am a costarrican med studen, still have a year left before the clinical rotation (IM will be my first).

 

[neurologist]

The most common things seen by neurologists are:

Stroke
Headache
Seizure/epilepsy
Chronic pain
Various neuropathies

If you get a good handle on these, you will have about 90% of neurology under your belt.

 

[buckley]

still just about to take the plunge...but here are my thoughts:

I like neurology because 1. the diseases are so interesting from stroke syndromes to MS to Parkinsons to Dementia 2. i love the academe and neuro's one of those specialties which maintain very very close ties with the academe, 3)so much is yet to be discovered...and I really believe that neurosciences research is going to get very very exciting in the coming years

I have been warned though that it can be depressing...that is, many diseases still have no treatments, but i think that also becomes part of the challenge that somebody has to take up. I've also been warned that jobs(and residency slots) are tougher to come by than IM. But I'm still one of those people who believe that if you follow what you really want, things have a way of taking care of you. I hope : ) Good luck to us!

 

[drivesmecraazee]

Neurology could definetly be a posibility for me, I find it soooo interesting...it kinda holds me back the fact that a lot of pathologies don't have a treatment, like busckley said, it's depressing...and I think it's a little bit limited...but Im really considering it, I just have to find out if Im ready to be one of those that take this challenge.

 

[buckley]

Just keep an open mind about it, especially when you do your clerkship. If it's for you, it's for you (which is what I tell myself as I bite my fingers looking for the very few hospitals I can apply in) In any case, I think any decent doctor should have a good grasp of basic neurology, so that interest of yours won't really be wasted. I would even consider doing an lctive there. I know it's not really a "popular" choice, but my friend and I did it. He's going to IM : ) I'm going to Neuro : )

 

[drivesmecraazee]

Is neurology competitive? Or it's just that the hospitals don't need many neurologists (at least that's what THEY think)?

 

[Nerdoscience]

It's not very competitive because there aer not that many people who want to go into Neurology, just a passionate few. It does not afford a cush lifestyle of a gigantic paycheck compared to many more competitive specialties.

As for the stereotype that Neuro is full of uncurable diseases, that topics has been beat to a bloody pulp. The funny thing is that most people think the frustrating parts are, "Here's a pretty picture of your brain tumor that we can't do anything about" or "We know you had a stroke, but you're SOL." Actually, those cases are more like, "Here's a picture of your brain tumor. Form my expertise, I believe it is a such-and-such kind of tumor. We will work inconjunction with the neurosurgeons and radiation oncologists about how to arrange surgical, radiation, and chemotherapeutic treatment, as well as talk about rehab options" and "You had a stroke at such-and-such time. We can give you clot busting medications for that/send you to a neurointerventional suite to get the clot lysed or pulled out/ admit you to do more workup. We will find the etiology of your stroke, set up secondary prevention for future strokes, and set up rehab for you."

The really frustrating thing that people don't mention as much is "You may or may not have epilepsy, but your biggest problem is that you have depression, anxiety, and many cluster B personaility traits. The spells you are having where you bark like a dog/start break dancing on the floor/become unresponsive, close your eyes really tight, and start hyperventilating are NOT related to a Neurologic problem. No, really. No, I'm not telling you you're faking it. Yes, I am saying you'r crazy."

 

[neurologist]

It's not very competitive because there aer not that many people who want to go into Neurology, just a passionate few. It does not afford a cush lifestyle of a gigantic paycheck compared to many more competitive specialties.

As for the stereotype that Neuro is full of uncurable diseases, that topics has been beat to a bloody pulp. The funny thing is that most people think the frustrating parts are, "Here's a pretty picture of your brain tumor that we can't do anything about" or "We know you had a stroke, but you're SOL." Actually, those cases are more like, "Here's a picture of your brain tumor. Form my expertise, I believe it is a such-and-such kind of tumor. We will work inconjunction with the neurosurgeons and radiation oncologists about how to arrange surgical, radiation, and chemotherapeutic treatment, as well as talk about rehab options" and "You had a stroke at such-and-such time. We can give you clot busting medications for that/send you to a neurointerventional suite to get the clot lysed or pulled out/ admit you to do more workup. We will find the etiology of your stroke, set up secondary prevention for future strokes, and set up rehab for you."

The really frustrating thing that people don't mention as much is "You may or may not have epilepsy, but your biggest problem is that you have depression, anxiety, and many cluster B personaility traits. The spells you are having where you bark like a dog/start break dancing on the floor/become unresponsive, close your eyes really tight, and start hyperventilating are NOT related to a Neurologic problem. No, really. No, I'm not telling you you're faking it. Yes, I am saying you'r crazy."

Nicely said. 🙂

 

[buckley]

: ) The worst thing to tell a hypochondriac is that she's crazy...hahaha...the gift of delivering that news makes the neurologist---"Perhaps it could be related to this severe anxiety that you are undergoing..."

Neuro is competitive in the sense that not many hospitals are offering it, compared to let's say, IM. If you're an IMG, it is even tougher because many neuro programs look for US clinical experience as an absolute requirement--they even say "observerships do not count"...or they demand that the ECFMG certificate is present on application. With those two alone, the list of programs I can apply to is severely slashed down. I've even looked into Alaska--and I have never seen snow in my entire existence! Looking into IM categorical--I'm helping my friend also--they are really less stringent. Plus with neuro, you have to vie for prelim IM which is more difficult to get than categorical positions. One program actually lists different cut-off MLEs for the prelim (>90) and categ (>85). Oh and prematches and visa issues are also waaaaaay easier on categ according to the grapevine

So as my friend tells me, logic and reasoning points to IM categ, why the hell am I being adamant to go into neuro? As nerdoscience puts it...perhaps I am one of the passionate few....HOPEFULLY I get to be one of them.

I'm still sniffing around for neuro slots...I think I've gone through freida's list! So confusing though because sometimes the info on the webpage is not the same as the info you get when you call up. And you just have to keep faith on what you do believe in. I'm crossing my fingers that my ECFMG certification gets released asap. That would open up quite a number of schools...

 

[neurofav]

I totally diagree with above posts. Neurology is the most challenging speciality ,without which many patients will be labeled as psychic and will be subjected to extensive useless testing. Most of the physicians have no clue whether its a seizure or stroke happenening and thats why they call us for everything. We treat some of the worst diseases epilepsy, MS, Parkinsons stroke, disabling neuromuscular problems. The speciality is expanding to include sleep, pain and interventional neuroradiolgy. So whatever your interest whether its in money, lifestyle or academic excellence, you can achieve with subspecialization.

 

[AlternateSome1]

To Neurologist's post I would add dementia and delirium.

I totally diagree with above posts. Neurology is the most challenging speciality ,without which many patients will be labeled as psychic and will be subjected to extensive useless testing. Most of the physicians have no clue whether its a seizure or stroke happenening and thats why they call us for everything. We treat some of the worst diseases epilepsy, MS, Parkinsons stroke, disabling neuromuscular problems. The speciality is expanding to include sleep, pain and interventional neuroradiolgy. So whatever your interest whether its in money, lifestyle or academic excellence, you can achieve with subspecialization.

What are you disagreeing with?

 

[Wheezy]

: Neuro is competitive in the sense that not many hospitals are offering it, compared to let's say, IM. If you're an IMG, it is even tougher because many neuro programs look for US clinical experience as an absolute requirement--they even say "observerships do not count"...or they demand that the ECFMG certificate is present on application. With those two alone, the list of programs I can apply to is severely slashed down. I've even looked into Alaska--and I have never seen snow in my entire existence! Looking into IM categorical--I'm helping my friend also--they are really less stringent. Plus with neuro, you have to vie for prelim IM which is more difficult to get than categorical positions. One program actually lists different cut-off MLEs for the prelim (>90) and categ (>85). Oh and prematches and visa issues are also waaaaaay easier on categ according to the grapevine

So as my friend tells me, logic and reasoning points to IM categ, why the hell am I being adamant to go into neuro? As nerdoscience puts it...perhaps I am one of the passionate few....HOPEFULLY I get to be one of them.

I'm still sniffing around for neuro slots...I think I've gone through freida's list! So confusing though because sometimes the info on the webpage is not the same as the info you get when you call up. And you just have to keep faith on what you do believe in. I'm crossing my fingers that my ECFMG certification gets released asap. That would open up quite a number of schools...

I'm an IMG that got into neuro. Two pointers: 1. apply to a lot of programs. 2. Apply to programs even if they say that a US elective is a must or if they want higher scores than yours i.e. don't reject yourself, apply & let them decide when they have the full picture whether they want you.

Some may say it's a waste of money but I got in without US electives or US reference letters (mind you 2 of my referees trained in the US). I have other strengths and I'm sure you do too.

The bottom line question I used is "would I rather match here or not match at all?".

One last thing "logic & reason point towards going for the career that you will be happy with, not the career others think you can get!" Good luck. 😎

 

[buckley]

I really appreciate that : ) Yaaaaaayyyyy!!! I'm juts happy to hear from people who actually managed to do it. I'm very proud of you.
Well, money is an issue, which is why I'm not applying to the programs who look for US clinical experience. But I can sense that you have a lot of wisdom behind those words so I am keeping it close by. In case I don't come up with a decent number of hospitals, I'll start taking my chances. I've scrapped a ot of good schools based on those criteria.

I do have a question: Did you have your ecfmg certificate in hand when you applied? Mine is coming out probably (!!!) in October. IS it better to wait until the certificate comes out or to apply as early as September 1, then just follow up? Would appeciate your opinion! Thanks.

I love your logic...hahaha...that's simply awesome! I happily stand corrected

 

[Wheezy]

The match is expensive, but I ended up spending more on hotels and flights than on ERAS. I mean adding another program for 30 dollars is usually worth the outside chance (I'm not sure what the actual cost is but if you stay at a cheeper hotel you've already made the difference). But you know your finances better than me.

Oh, and no i don't have stock in ERAS😀

About ECFMG certification. I had it when I applied. but I wouldn't wait until october to apply. I'd apply and then when your ECFMG comes out just email all the programs you've applied to "Just thought I'd up date you on my application. I know have my ECFMG certification. Looking forward to hearing from you. Thanks" or what ever way you'd like to phrase it. This way you get your application in early and don't miss out on the bonus of ECFMG certification.

 

[buckley]

Thanks : ) I know, I know...I don't want to be penny wise, peso foolish...
I have 30 hospitals i'm eyeing for neuro alone. And then there's prelim. Haha... How many did you apply to? I had a friend who applied to 28 and just got 6 interviews, so he was so nervous when match season came. Luckily he matched on his 2nd choice. O might be hijaccking the thread already...
SUFFICE IT TO SAY PEEPS, there are really neuro-loving people out here who go into it for the sheer love for the subject-matter, not necessarily the big bucks or lifestyle.