Learning Neurology in Residency?

[NeurologyICU]

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It seems to me that Neurology is such a vast field, with tons and tons of information to learn because the breadth of information is huge compared to other fields. I am really interested in Neurology as a career choice, but what scares me is that once you get into a residency program, can everyone learn the information in 4 years to adequately be a good clinical Neurologist? In other words, I'm worried about getting into a program, and then not being able to learn all the aspects of Neurology relevant to practice effectively. Am I the only one that feels this and is this something to worry about when deciding to pursue Neurology as a career? Is the residency enough for one to learn the nuances of Neurology from beginning to end?

 

[BlackFrancis33]

No my friend. Residency is not adequate. Medicine requires a lifelong dedication to knowledge acquisition, I am probably wasting valuable time right now! Every specialty including neurology is in this category. Neurology can be more daunting than some specialties due to a relatively larger body of basic science knowledge required to be an up to date neurologist. You can't learn all the nuances of neurology in a lifetime, much less a residency. In residency you learn what you need to know to practice and how to deal with uncertainty. Uncertainty is a daily part of what we do, but I love it. Sorry if that sounds 'preachy'.

 

[NeurologyICU]

No my friend. Residency is not adequate. Medicine requires a lifelong dedication to knowledge acquisition, I am probably wasting valuable time right now! Every specialty including neurology is in this category. Neurology can be more daunting than some specialties due to a relatively larger body of basic science knowledge required to be an up to date neurologist. You can't learn all the nuances of neurology in a lifetime, much less a residency. In residency you learn what you need to know to practice and how to deal with uncertainty. Uncertainty is a daily part of what we do, but I love it. Sorry if that sounds 'preachy'.

Thanks for the response. I understand I can't learn ALL of neurology in residency, but I was more concerned about learning the neurology in residency to be able to practice it. Suppose that I don't know any neurology, can residency make you proficient to be able to comfortably practice it in say a private setting (given Neurology is so vast)? Come on friends, I realize most people on SDN are superstars, and I am just an average student. However, am I the only one that is concerned about this?

 

[Head]

As a newly minted Neurologist, I can tell you that it is challenging seeing patients on your own after residency. I feel I was well trained and can easily diagnose and treat > 50% of new consults that come through my door. There is another 30%-40% that has neurologic disease related to psychiatric disease. Those cases are challenging, but rewarding in their own way. It's that last 10-20% that I worry about, the ones that clearly have Neurologic disease, but you just can't figure it out. Thankfully by staying in academics I have some incredible gurus to bounce cases off of when I get stuck. Most of the time, if I can't figure it out, they can't figure it out either. The bottom line is, there is a fair bit of Neurologic disease out there that hasn't been well characterized yet or clearly identified. To me this is exciting, but to some it can be quite frustrating and intimidating. If you go into private practice, I definitely recommend joining a group with a senior Neurologist on board. This will be invaluable when you come across these challenging cases.

 

[Charlie83]

#1 Johns Hopkins Hospital
Baltimore, MD

#2 Mayo Clinic
Rochester, MN

#3 Massachusetts General Hospital
Boston, MA

#4 New York-Presbyterian University Hospital of Columbia and Cornell
New York, NY

#5 University of California, San Francisco Medical Center
San Francisco, CA

#6 Cleveland Clinic
Cleveland, OH

#7 Ronald Reagan UCLA Medical Center
Los Angeles, CA

#8 St. Joseph's Hospital and Medical Center (Barrow Neurological Institute)
Phoenix, AZ

#9 NYU Langone Medical Center
New York, NY

#10 Barnes-Jewish Hospital/Washington University
Saint Louis, MO

 

[Head]

The above post is the latest US News and World Report ranking on best hospitals for Neurology/Neurosurgery. Just so med students aren't led astray, this is not representative of the quality of the Neurology residency programs in this country. Barrow for example has excellent Neurosurgery, but doesn't belong in the top ten for Neurology.

 

[LocusCeruleous]

It is true that the US News & World Report rankings may not always correlate directly with quality of the neurology residency programs at those institutions.

 

[LocusCeruleous]

I have heard from my friends in Phoenix that there has been a major change in the Barrow Neurological Institute's Department of Neurology. Last Friday (2/15/2013) the chairman abruptly resigned (or was fired?). Everyone says that this guy was liked by the faculty and residents and had apparently been doing a good job bulding up the department. There had recently been a management change at the institution and the Department of Neurology was under attack by the admistration. The chairman had been successfully resisting the changes (some of which consisted of salary cuts for members of the Department and a take over by the neurosurgeons). I am really sad to hear this and the likely result is a going to be a long period of decline for neurology at the BNI and the institution as a whole.

 

[TUGM]

So, would any experienced residents/faculty/interviewees care to comment on the training provided at BNI?… It seems like it would be an awesome place to learn neurology, but I am worried that the Neurology department is overshadowed and potentially takes a backseat to the neurosurgeons there.

 

[typhoonegator]

Friends,

I've had to remove a few posts from this thread because one of them specific and personal comments about a named individual. Regardless of peoples' opinions, we cannot have negative comments or conjecture made about specific individuals on this forum. There are two sides to every story, and while my actions are in no way meant to endorse the opinions of anyone, this is not the place for a public airing of dirty laundry from specific programs. Please carry on.

By the way, a few of the removed posts had to be taken down not because they did anything wrong, but because they quoted the post in question.

 

[FloridaBob1]

So, would any experienced residents/faculty/interviewees care to comment on the training provided at BNI?… It seems like it would be an awesome place to learn neurology, but I am worried that the Neurology department is overshadowed and potentially takes a backseat to the neurosurgeons there.

All the people I talk to feel that neurosurgery is the dominant department at Barrow and that whatever happens with neurology is not important. My favorite neurosurgery attending at my medical school told me that Dr. Spetzler, the head of the BNI, is 70 years old and is retiring in the next year or two and that the BNI will never be as good as it once was after that. I was planning on applying to Barrow next year for a neurosurgery residency but after hearing that I'm now thinking of just sticking with all university based residency programs that have more depth.