Life as a Neurologist: Notes from the Field

[neuro2013]

This thread is for gathering answers to a survey about life as a neurologist. It is meant to give people thinking about pursuing a career in Neurology a more descriptive idea about what it might be like to practice in the field.

Please feel free to answer the survey as a post, or send me a PM and I'll post it. If there are too many questions, answer as many or few as you like.

PM me if you have any suggestions for questions to add. Also, if you know neurologists (either in residency or beyond), ask them to answer too! The more the better, that way we can create variety. I want to make sure we get answers from at least a few private practice neurologists as we don't have much exposure to them in med school - so if any of you medical students are on a private-practice rotation, print this baby out and bring it in!

I'm hoping to keep this thread limited to survey answers, but use your discretion if you have a question for someone. Thanks!

-------------------------------------------------------

Survey for residents and practicing Neurologists. If you are a senior medical student and would like to answer, that is great too!


1) What stage of your career are you in?

2) Are you primarily a clinician or a researcher? How much time do you spend in each?

3) Are you happy with your choice to pursue Neurology as a career as opposed to another specialty?

4) Are there any other specialties that you perhaps should have considered going into (now that you are "older and wiser"?)

5) Do you feel like finances, and paying back student loans, are particularly difficult for neurologists compared to other specialties?

6) Do you feel satisfied with the treatment options you can offer your patients?

7) What do you love about Neurology?

8) What do you not love about Neurology?

9) Do you feel like you fit in with neurologists -- as a personality type and/or an approach to life? Why? Do you find that most neurologists fit in with the stereotype of a neurologist?

10) Do you have any advice for people going into Neurology regarding how to have a happy and fulfilling career?

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[neuro2013]

First submission, thanks!

1) What stage of your career are you in?
Graduated medical school last year, continuing research from my college days (peds neuro, cognitive/strokes). Applying this cycle.

2) Are you primarily a clinician or a researcher, and what is the difference in these two? (i.e. how much time do you spend in each?)
Planning to be mainly clinical, will do some research (likely a 80-20 split... if that's possible)

3) Are you happy with your choice to pursue Neurology as a career as opposed to another specialty?
Yes, very happy with it

4) Are there any other specialties that you perhaps should have considered going into (now that you are "older and wiser"?)
Can't say that yet, but seeing how patients are older (read: dementia, strokes, etc.), I am happy where I am now.

5) Do you feel like finances, and paying back student loans, are particularly difficult for neurologists compared to other specialties?
Haven't started yet, but doesn't seem like it would be extremely difficult. That just requires good financial planning (read: don't make splurge purchases with your first paycheck, keep a budget, investing). Case in point: I will be getting a house and using it to supplement income by renting out rooms to other residents, playing stocks, etc.

6) Do you feel frustrated that you can't offer more "curative" treatments for your patients?
No specialty truly "cures" everything. Surgical patients need to come back for revisions. Cancer can come back. This is a thought that has been perpetuated by the "old guard". The new toys and research coming out will change neuro.

7) What do you love about Neurology?
Very detail oriented and a specialty that really relies on the physical exam, something that is increasingly difficult to find these days (read: jumping immediately to imaging, labs, etc. instead of observing the patient). Great potential for expanding and so much untapped knowledge that you will always learn something new. Lastly, neuro is similar to a puzzle and when solved, can radically improve a patient's quality of life.

8) What do you not love about Neurology?
More annoying than disliked, but perceptions by other specialties as being the "armchair intellectual" and "diagnose then adios". Income should be higher for this specialty, given the work that goes into it.

9) Do you feel like you fit in with neurologists -- as a personality type and/or an approach to life? Why?
Yes. Relaxed and easy-going but also very focused and dedicated when necessary. I love to learn, to teach and to expand my life beyond medicine. I've been teased for being a "Renaissance Man".

10) Do you have any advice for people going into Neurology regarding how to have a happy and fulfilling career?
Can't really give it since I haven't started residency yet, but this applies more to medicine in general. Be realistic (not pessimistic) in your goals regarding specialties. Have a life outside of medicine. You will burn out and forget why you chose this profession in the first place. Take time off (in your training) if you need to. A physician is best equipped to care for others when he/she is at 100%.

 

[typhoonegator]

1) What stage of your career are you in?
Attending, academic medical center

2) Are you primarily a clinician or a researcher? How much time do you spend in each?
Researcher, 80/20

3) Are you happy with your choice to pursue Neurology as a career as opposed to another specialty?
Yes.

4) Are there any other specialties that you perhaps should have considered going into (now that you are "older and wiser"?)
No.

5) Do you feel like finances, and paying back student loans, are particularly difficult for neurologists compared to other specialties?
Compared with procedural specialties, no. Difficulties for neurologists depend on practice environment and subspecialty training. I live comfortably but relatively more frugally than outsiders might expect.

6) Do you feel satisfied with the treatment options you can offer your patients?
No. If you find a physician in any specialty who does, they have given up and should be fired.

7) What do you love about Neurology?
Vascular neurology and critical care.

8) What do you not love about Neurology?
An overall lack of interest in acute neurology; many neurologists are poorly equipped for it and many trainees seem disinterested in learning it.

9) Do you feel like you fit in with neurologists -- as a personality type and/or an approach to life? Why?
Few NCC people do. And I spend most of my time with scientists that are not specifically neurologists.

10) Do you have any advice for people going into Neurology regarding how to have a happy and fulfilling career? Have kids, don't overbuy your mortgage, try to live close to where you work, find a good mentor who has the power to protect your time, be willing to adapt yourself to your environment, or be willing to accept marginalization, be diverse in your investments, make sure people know what you do with your time, demonstrate why you are indispensible or people will decide you are not.

 

[Thama]

Typhoon- you say you're 80/20 research/clinical in NCC. Honestly, NCC looks on the surface to be one of the more procedural and less research-heavy subspecialties, but I always hear that academic NCC departments often do have high research demands. What kinds of research do you and your colleagues tend to do? Is is mostly clinical/human, or is there a fair amount of bench, animal, imaging, etc?

 

[neuro2013]

Typhoonegator - thanks for your answers!

Just a couple things about 80/20 and practice settings.

I have found, this year, that a lot of the happiest people I have found are 80/20 (i.e. 80% research 20% clinical). And most of them also love clinical neurology (i.e. they are not doing research b/c they are running away from clinical). But doing some research allows them to ask interesting questions and then look into them. I like that.

I also had a preconceived notion, as of last year (4th year of med school), of what a "researcher" was. And that I was NOT one - and didn't want to be. My med school wasn't particularly research oriented. But turns out a lot of the questions I have are actually research questions, even if they also fall under the realm of "public health" or "health literacy" or "global health". That appears to also be quite possible as a research interest, and it looks like the people doing public health and neurology are also having a lot of fun doing so.

Anyways, point is, when I was deciding on neurology, I wish I would have known your answer to #5 -- and that you should just pick your specialty based on the patient population and diseases that you find most interesting. Then it really is more about practice environment and subspecialty training (and having good research questions that people will fund!).

 

[typhoonegator]

Typhoon- you say you're 80/20 research/clinical in NCC. Honestly, NCC looks on the surface to be one of the more procedural and less research-heavy subspecialties, but I always hear that academic NCC departments often do have high research demands. What kinds of research do you and your colleagues tend to do? Is is mostly clinical/human, or is there a fair amount of bench, animal, imaging, etc?

Most of my group does some research, many are R01 or K08 supported. NCC has the benefit of a relatively dense reimbursement scale, so you can cover a decent (by academic standards) salary between your 20% clinical billing and research effort (compared with someone for whom 20% means a day of non-procedural clinic visits per week, who would need relatively more research or administrative support).

We are relatively unusual at our hospital -- most NCC people are into more clinical research, and the percentage of our field with NIH funding is relatively low. Several people in my group do bench work, a couple are trialists, and I do translational research.

 

[bustbones26]

This thread is for gathering answers to a survey about life as a neurologist. It is meant to give people thinking about pursuing a career in Neurology a more descriptive idea about what it might be like to practice in the field.

Please feel free to answer the survey as a post, or send me a PM and I'll post it. If there are too many questions, answer as many or few as you like.

PM me if you have any suggestions for questions to add. Also, if you know neurologists (either in residency or beyond), ask them to answer too! The more the better, that way we can create variety. I want to make sure we get answers from at least a few private practice neurologists as we don't have much exposure to them in med school - so if any of you medical students are on a private-practice rotation, print this baby out and bring it in!

I'm hoping to keep this thread limited to survey answers, but use your discretion if you have a question for someone. Thanks!

-------------------------------------------------------

1) What stage of your career are you in?
Attending

2) Are you primarily a clinician or a researcher? How much time do you spend in each?
Clinician, do some research on the side.

3) Are you happy with your choice to pursue Neurology as a career as opposed to another specialty?
I like neurology. I am not really sure what else I would have done?

4) Are there any other specialties that you perhaps should have considered going into (now that you are ”older and wiser”?)

How about pain medicine. Boy what a racket!! Hardly any preapproval process for sticking a needle in backs and neck. Procedure only, then pawn the after care off onto a PA-C/CNP, etc.

5) Do you feel like finances, and paying back student loans, are particularly difficult for neurologists compared to other specialties?

I feel that any doctor can pay back his/her loans so long as they are frugal and smart with their money. This is the biggest mistake that I see. The ones whining the most about money are the same ones living in mcmansions, buying BMWs, and are on their third gold digging trophy wife.

6) Do you feel satisfied with the treatment options you can offer your patients?

I enjoy my victories. I also deal with defeats, but these are mainly noncompliant and/or belligerent patients. Can't fix stupid.

7) What do you love about Neurology?

I learn something new nearly every day. Its more than neurology, you really do have to apply some general medicine to this specialty.

8) What do you not love about Neurology?

Bluntly, we are dumped on!! Every pseudoneurological complaint comes are way. Even a psychiatrist will throw you under the bus for obvious conversion disorders. We pretty much are the only docs that have the stones to tell people that they have a psychiatric illness at times.

9) Do you feel like you fit in with neurologists -- as a personality type and/or an approach to life? Why?

No, I do not fit in with other neurologists.

10) Do you have any advice for people going into Neurology regarding how to have a happy and fulfilling career?

Grow a thick skin. Listen to your gut.

 

[neuro2013]

Thanks for the reply Bustbones! I especially appreciate your answer to #5.

A few questions/clarifications I am wondering about:

- Are you in private practice or a university setting?

- Have you considered going back and doing a fellowship in pain medicine (as it is a subspecialty neurologists can also go into)?

- Why don't you feel you fit in with other neurologists? (Sorry if I am encouraging generalizations, but it is interesting to hear about)...

 

[bustbones26]

Thanks for the reply Bustbones! I especially appreciate your answer to #5.

A few questions/clarifications I am wondering about:

- Are you in private practice or a university setting?

- Have you considered going back and doing a fellowship in pain medicine (as it is a subspecialty neurologists can also go into)?

- Why don't you feel you fit in with other neurologists? (Sorry if I am encouraging generalizations, but it is interesting to hear about)...

I am sorry, short questions you ask but I will give you somewhat long answers. I will PM you some information that may (or may not be enlightening).

 

[danielmd06]

1) What stage of your career are you in?
Attending.

2) Are you primarily a clinician or a researcher? How much time do you spend in each?
Clinician. 100%. I do dabble with posters and research from time to time.

3) Are you happy with your choice to pursue Neurology as a career as opposed to another specialty?
Yes. I would definitely do over what I've already done. No question.

4) Are there any other specialties that you perhaps should have considered going into (now that you are "older and wiser"?)
I liked diagnostic neuroradiology, and neurosurgery. I prefer what I do to both. Though note that I do not practice general neurology.

5) Do you feel like finances, and paying back student loans, are particularly difficult for neurologists compared to other specialties?
No.

6) Do you feel satisfied with the treatment options you can offer your patients?
As a sleep specialist, the majority of my patients improve, so the answer is "yes." This did frustrate me in general neurology, however.

7) What do you love about Neurology?
Neuroanatomy, sleep, headache, and stroke in particular. I love to read about most any topic in neurology though, with the exception of genetics.

8) What do you not love about Neurology?
Psychiatric overlap. Pseudoseizures. Neuromuscular patients and neuropathy (non-sports or non-trauma related). Chronic pain patients who were dumped on our service after an orthopaedic surgeon or pain specialist made thousands and didn't want to deal with persistent issues/pain. The lack of objectivity in patient complaints bothers me a bit from time to time, also.

9) Do you feel like you fit in with neurologists -- as a personality type and/or an approach to life? Why?
No. By virtue of my appearance, mannerisms, and personality, I am usually confused with an orthopaedic surgeon.

10) Do you have any advice for people going into Neurology regarding how to have a happy and fulfilling career?
Be honest with what you want out of a career and follow your own bliss (as Joseph Campbell would say). Attendings are not your parents, and you don't have to do research or practice in a sub-specialty they practice in just to make them happy. Be aware that neurology is a wonderful field that may be very, very different than what medical student rotations are like at your home institiution. Don't let weird attendings, low quality residents, or poor exposure to neuroscience in your pre-clinical years steer you away from a fantastic organ system and specialty!

 

[Thama]

Most of my group does some research, many are R01 or K08 supported. NCC has the benefit of a relatively dense reimbursement scale, so you can cover a decent (by academic standards) salary between your 20% clinical billing and research effort (compared with someone for whom 20% means a day of non-procedural clinic visits per week, who would need relatively more research or administrative support).

We are relatively unusual at our hospital -- most NCC people are into more clinical research, and the percentage of our field with NIH funding is relatively low. Several people in my group do bench work, a couple are trialists, and I do translational research.

Thanks, typhoon. Is the 80-20 split pretty expected among academics in NCC from what you've seen, or are larger clinical splits OK with administration?

I'm looking at residency programs with an interest in academics in mind, and am attracted to acute neurological care. If you have any advice about what I should be looking for, I'd be grateful.

 

[typhoonegator]

Thanks, typhoon. Is the 80-20 split pretty expected among academics in NCC from what you've seen, or are larger clinical splits OK with administration?

I'm looking at residency programs with an interest in academics in mind, and am attracted to acute neurological care. If you have any advice about what I should be looking for, I'd be grateful.

It is hard to be a career scientist with less than 75% research time. You're competing against PhDs who are 100% research.

"OK with administration" is a strange term. Once a clinical service has enough people to cover it, then the department doesn't really care, as long as you can cover your salary. No department is going to pay the salary of someone who never gets funded. If you can't make your salary with your small clinical exposure + grants, then you will either be expected to add more clinical coverage, or find a new job.

Not all services have room for more people to just add more time. You probably could see more outpatients if the clinic space has room, but adding weeks on an inpatient service often isn't easy -- you're taking food off someone else's table. When you get a job as a clinician-scientist, you need to think about what would happen if you had a lapse in grant coverage, or if the U.S. Government went into sequestration or something and your funding went down the drain. Would you have to find a new job, or could you increase your service time to make up the difference?

The vicious cycle is that when you don't get funded, you have to do more clinical time, which prevents you from doing more research, which decreases the chance that you will get funded.

 

[Thama]

It is hard to be a career scientist with less than 75% research time. You're competing against PhDs who are 100% research.

"OK with administration" is a strange term. Once a clinical service has enough people to cover it, then the department doesn't really care, as long as you can cover your salary. No department is going to pay the salary of someone who never gets funded. If you can't make your salary with your small clinical exposure + grants, then you will either be expected to add more clinical coverage, or find a new job.

Not all services have room for more people to just add more time. You probably could see more outpatients if the clinic space has room, but adding weeks on an inpatient service often isn't easy -- you're taking food off someone else's table. When you get a job as a clinician-scientist, you need to think about what would happen if you had a lapse in grant coverage, or if the U.S. Government went into sequestration or something and your funding went down the drain. Would you have to find a new job, or could you increase your service time to make up the difference?

The vicious cycle is that when you don't get funded, you have to do more clinical time, which prevents you from doing more research, which decreases the chance that you will get funded.

At my school, I hear about people getting hired with start-up funding and very little clinical responsibility for a couple of years and if they "don't make it", getting transitioned to a pure clinical track. What you said makes this make more sense.

 

[neuro2013]

Thanks for everyone's insightful and thoughtful answers to the questions. I am loving this thread!

 

[dhavalp]

thanks for everyone's insightful and thoughtful answers to the questions. I am loving this thread!

+1

 

[RenegadeSynapse]

1) What stage of your career are you in?
I'm a MS4 matching into neurology, so some of my answers may be nieve, subject to change, or just unknown at this point, but in any event, here goes..

2) Are you primarily a clinician or a researcher? How much time do you spend in each?
My aspirations are toward the 80/20 split, research heavy. We shall see if residency changes that.

3) Are you happy with your choice to pursue Neurology as a career as opposed to another specialty? So far. I've loved my experiences in neurology, and certainly hope to continue to feel that way. I

4) Are there any other specialties that you perhaps should have considered going into (now that you are ”older and wiser”?) Not as of yet. I considered psychiatry, but did not enjoy the clinical day to day of it. I loved geriatrics, but found much of medicine fairly boring. I still feel like neurology fits me and my interests much better than anything else. I looked at everything I could think of that involved daily interaction with the nervous system, but found everything wanting in significant ways when compared to neuro.

5) Do you feel like finances, and paying back student loans, are particularly difficult for neurologists compared to other specialties? It scares me, ya. I don't have a ton of debt by some schools standards, but it's still a lot, and I suppose I'd feel better about it if I thought my future salary was likely to be higher. But in the end, I'll be fine. I grew up in a fairly modest, working-class family where the combined household income was below even the low-end starting salary for neuro. It's about perspective, I suppose.

6) Do you feel satisfied with the treatment options you can offer your patients? No. I love dementia care, and I'm certainly not happy with what we can offer now. I think that even for the more poorly treated conditions (ALS, Huntington's, various dementias) where it's mostly or completely symptomatic and supportive, you can still find satisfaction in helping a patient and their family understand what is happening to them. You can help reduce aspiration risk. Reduce the chances of them falling. But in the end, the degeneration marches on. This is a large reason why I say my interests are in a research-heavy career.

7) What do you love about Neurology? Caring for patients who are often disregarded by others. Getting to think about the most elegant part of human anatomy and physiology on a daily basis. Being around colleagues who generally are as excited about the nervous system as I am.

8) What do you not love about Neurology? The "this patient is strange and has neurons" consults. Patients with psychiatric / functional problems (which are very real, and very debilitating) and challenging effectively treat.

9) Do you feel like you fit in with neurologists -- as a personality type and/or an approach to life? Why? Ya. It's where I've felt most as home. I'm a pretty big nerd by most standards, and while there are diverse interests in neurology, I certainly felt comfortable being myself around most of them. By and large, I've found neurologists to be fairly materialistic in the philosophical sense; they usually approach things logically, and are comfortable with "I don't know" if that's the answer most consistent with the data. That describes me very well.

10) Do you have any advice for people going into Neurology regarding how to have a happy and fulfilling career? Those further along probably have more insight, but a mentor once told me, "Figure out what you love to do and then find a way to do it." That's the approach I'm still trying to take. I'll let you know if it works out in another 5-10 years.

 

[Iliopsoas]

1) What stage of your career are you in?
PGY3

2) Are you primarily a clinician or a researcher? How much time do you spend in each?
My residency owns me, so I would say I am more clinically based. However, I do spend approximately 5-10% of my time in research. While research is not a substantial portion of my time it allows me to constantly ask new questions when I am at work.

3) Are you happy with your choice to pursue Neurology as a career as opposed to another specialty?
I love Neurology and feel that it has opened a lot of doors for me. Going into NCC

4) Are there any other specialties that you perhaps should have considered going into (now that you are ”older and wiser”?)
Pulm/CC – those guys can be put in any bad situation and figure a way out

5) Do you feel like finances, and paying back student loans, are particularly difficult for neurologists compared to other specialties?
No, there are tons of well-paying jobs for vascular neurologist & neurohospitalist

6) Do you feel satisfied with the treatment options you can offer your patients?
Yes and no. Yes because there is nothing more exciting than giving a high NIHSS patient tPA and watching them improve in front of your eyes – it’s like magic. No because many of the other diseases are not reversible. The brain is less forgiving than the heart or kidneys.

7) What do you love about Neurology?
I love how much we talk to patients and their families. The brain is a mysterious organ that many people don’t fully understand. My job is to bridge the gap in knowledge. No matter if the outcome is good or bad, families are always happy and grateful when you take the time to talk to them.

8) What do you not love about Neurology?
I strongly dislike when uneducated doctors suggest that we don’t treat anything.
It also bothers me that a majority of people do not know the difference between a neurologist and neurosurgeon. I stopped correcting people after my first month of neurology residency.

9) Do you feel like you fit in with neurologists -- as a personality type and/or an approach to life? Why?
Only the sarcastic ones

10) Do you have any advice for people going into Neurology regarding how to have a happy and fulfilling career?
Like any other field, knowledge is power in Neurology. Always strive to learn about things within your area of interest, but more importantly in the areas you are weak in. I’ve found that once you are a neurologist in the real world, people don’t care that you did an Otologic emergencies fellowship at Queen Square. Everyone expects you to know everything. Even if you are in academics your family will call you up & ask about your aunt’s EMG or your uncle’s memory.

 

[midnightneuro]

This is a nice thread that I'd like to contribute to.

1) What stage of your career are you in?
Attending, about 2-3 years out now from training

2) Are you primarily a clinician or a researcher? How much time do you spend in each?
Clinician primarily; spend about 5-10% research

3) Are you happy with your choice to pursue Neurology as a career as opposed to another specialty?
Love it most of the time; days are long and those are the times that I wish it could be more time-efficient. Beats seeing so many patients in primary care though. I see how hard my colleagues from other subspecialties work (i.e - nephrology, cards, ID), pretty similar work hours I have with some of them, so I can't complain too much I guess.

4) Are there any other specialties that you perhaps should have considered going into (now that you are "older and wiser"?)
Looking back, still can't think of another field that I would choose over this one. Fits me well, I think. Also, it evolves so much that I now do things that I never ever even dreamed of doing....just riding the wave where it takes me.

5) Do you feel like finances, and paying back student loans, are particularly difficult for neurologists compared to other specialties?
Slightly better than for primary care, much less than other more lucrative specialties like surgery, radiology, etc...this is obvious.

6) Do you feel satisfied with the treatment options you can offer your patients?
Yes. So much has been advanced over time. We can make dramatic benefits to people's lives who suffer from epilepsy, MS, movement disorders, stroke, neuromuscular, chronic headache to name a few. It leads to hope for the future. Will only get better. Even for people who deal with non-treatable disorders like ALS, just having you there to help them cope with things makes such a big difference for them and their families. Sometimes people just need guidance, someone who can help make their lives a little bit easier.

7) What do you love about Neurology?
See answer to #6. Seeing that smile on their face when they understand what is going on with them, or when they come back happy with improvements in their condition with treatment that was started. Doesn't happen a lot of times, but when it does, makes all the BS worthwhile.

8) What do you not love about Neurology?
It's frustrating when I see an obvious psychogenic case and the patients refuse to accept that diagnosis, only to be seen by someone else who pigeonholes them to a somewhat organic diagnosis and justify their symptoms. Also, I have found that sometimes people look for symptoms to go onto disability and it's a challenge to respectfully decline while they get more irate. Maybe I'll get more proficient at it with even more experience. But dealing with the non-organic cases can get frustrating, when I feel that patients are trying to get secondary gain and get the sense that they are being manipulative, and not really seeing me to try to get better.

9) Do you feel like you fit in with neurologists -- as a personality type and/or an approach to life? Why?
I fit in with non-basic research neurologists better I think. I think we get each other better and can understand the trials and tribulations that we go through better. True, neurologists can be quirky, but I deal with quirky much of the day when I see patients too, so it's no big deal.

10) Do you have any advice for people going into Neurology regarding how to have a happy and fulfilling career?
I went in not really knowing what reimbursement would be like (only that it might pay more than pediatrics, might pay more than pcp's). It "spoke" to me when I rotated in it. The pay that results is not the most, but more than reasonable (currently before big cuts) and I live very comfortably.

Every neurologist will have weaknesses now, with many gaps in knowledge in the field as a whole. Neurology is so rapidly expanding, it's easier to subspecialize in an area and focus on that. Also, it will be much easier to work in a group practice because of this and business reasons to offset costs with EMR requirements and things like that. I think you will be much for effective for your patients if you can limit the scope of your practice a little bit, but if you feel comfortable truly seeing all comers, then more power to you.

 

[Stixman28]

I find it interesting that everyone answers that they don't fit in personality wise with the achetypal 'Neurologist'.

 

[unsung]

I find it interesting that everyone answers that they don't fit in personality wise with the achetypal 'Neurologist'.

Personally, I really like the "classic" neurologist personality. It was surprising to me how few fit that stereotype out on the interview trail. A lot of people seem to be going into neurology for the intervention/procedural side of things. A lot are interested in EMGs, or neuromuscular. Almost seem like they could have gone into PM&R or something. Some are basically uninterested in the cognitive side of things... the classical neurology. Then you've got the legion going into epilepsy (many who happen to be female, for some reason).

So only a minority seem to fit that stereotype of being analytical, particular, etc. Behavioral neurology is probably the last bastion... which is fine as it's the most appealing to me, anyway.

Addendum: the psych overlap is a plus for me. I think I would enjoy figuring out pseudo-seizures as much as treating real seizures. Plus, the behavioral changes associated with disorders such as Parkinson's. Depression, and the OCD personality, etc. Fascinating, isn't it? The separation between the two fields is so artificial, imo... it's all organic. Schizophrenia is clearly organic. Psychiatry = neurologic disorders we don't understand yet. It's totally arbitrary that movement disorders belong to neurologists, and psychosis belongs to psychiatrists. It's clearly all in the brain. I'm one of those few who believe the two fields should have a reconciliation one day.

 

[BlackFrancis33]

We all love this sort of self-indulgence...


1) What stage of your career are you in?

Attending, subspecialist. Large government medical center.

2) Are you primarily a clinician or a researcher?

How much time do you spend in each? Cinician 90% (or more). I like to believe I am a clinical researcher. I am trying to pursue
clinical trials etc, but I don't yet have much to support the contention that I am a clinician/researcher who could justify the vaunted 80/20 designation. I need to stop posting on SDN and get back to work.

3) Are you happy with your choice to pursue Neurology as a career as opposed to another specialty?

Yes. I couldn't have done anything else, period.

4) Are there any other specialties that you perhaps should have considered going into (now that you are "older and wiser"?)

No. I heart neurology, and I am completely consumed by it. I couldn't stand to do anything else. I do Neuro-Oncology so maybe I could do Oncology in an alternative reality.

5) Do you feel like finances, and paying back student loans, are particularly difficult for neurologists compared to other specialties?

Gov't employee throughout so this doesn't apply. I agree with some of what has been said, there are some high paying neurohospitalist jobs out there for example. Look the reimbursement system doesn't favor what we do. No matter how you rationalize that fact, it is likely to continue to be the case.

6) Do you feel satisfied with the treatment options you can offer your patients?

No. The therapies in my subspecialty aren't good enough. Don't misconstrue this statement, an affirmative answer when glioblastoma is your 'bread and butter' would be ridiculous. I love what I do, which may be hard to understand.

7) What do you love about Neurology?

Everything. No bull#$%!. I don't do EMG/NCS, EEG, and I don't feel real great about my neuromuscular/neurophys knowledge. That doesn't mean I don't think its f#$% cool.

8) What do you not love about Neurology?

What everyone has already said. I also loathe the obviously somatoform patient in which you get the 'no indication of a somatoform disorder'. That is painful, but this is a big part of what we do. Not as much of this in Neuro-Oncology.

9) Do you feel like you fit in with neurologists -- as a personality type and/or an approach to life? Why?

Who wants to admit to fitting in with the archetypal neurologist when you are picturing bowties mixed with pedanticism? The neurologists I identify with do not fit with the stereotypes that exist for our specialty. But I am a neurologist through and through, so I guess I probably fit right in even if I am wearing jeans and Husker Du Tshirt.

10) Do you have any advice for people going into Neurology regarding how to have a happy and fulfilling career?[/B][/QUOTE]

You can never really understand the central nervous system and by association many of your patients. But that is why I love neurology. I'm not sure if that is advice, but its true.

 

[neuro2013]

Hey all!

Thanks for the great responses, super interesting hearing all of the perspectives out there (and exciting because y'all sound so smart and insightful!)

So, in the question "Do you feel like you fit in with neurologists -- as a personality type and/or an approach to life? Why?" I was more trying to elicit a response about how neurologists actually are, not necessarily regarding the stereotype. Both are interesting to hear about, but if anyone wants to discuss the difference, that might be interesting. I've just added a second question to the original survey to address this too.

My experience -- I have found that I don't fit in with the stereotype per say (bowties and excessively intellectual), but I surprisingly do fit in with the way that many neurologists actually are - curious, self-motivated, happy, asking some of the "bigger" questions... Perhaps most importantly, people that are willing to accept that some questions don't have answers (and probably never will). It is the brain after all!

In fact, I think it is one of the most exciting discoveries in my decision process - that there are a LOT of neurologists I really respect and get along with (and a few eccentric ones in the mix too, which is ideal). Don't get me wrong, I love to bow-tie-wearing ones too - as they do round out the diverse personality-types.

Perhaps it is the new batch of more interventionally-minded folks that have added some balance too - I think the field (from what I've noticed at least) used to be more of the "intellectually-curious-to-the-extreme" folks, and now there are more younger folks with a bit more treatment on their minds. In the end, I have found it a great balance...

 

[BlackFrancis33]

As to the fitting in question - everyone answered either completely in the negative (bustbones), claimed to be like another specialty (danielmd), or rationalized the fact that they do in fact fit in amongst neurologists (myself and others). We are obviously all sensitive about the stereotype and visualize ourselves as being different. Or in other words 'Really, I am the cool neurologist'...

 

[bustbones26]

As to the fitting in question - everyone answered either completely in the negative (bustbones), claimed to be like another specialty (danielmd), or rationalized the fact that they do in fact fit in amongst neurologists (myself and others). We are obviously all sensitive about the stereotype and visualize ourselves as being different. Or in other words 'Really, I am the cool neurologist'...

Back in my residency days, I was nominated to go to a very special MS conference just for residents and fellows. A big wine and dine event held by some of the top MS specialist in the country.

As I sat there, we were given a lecture on treating the comorbid conditions related to MS. Whenever we arrived to the topic of sexual dysfunction, we lecturer stated that if women have abnormal perineal sensations with pain, they can apply a bag of frozen peas to the region in order to calm down pain prior to engaging in sexual intercourse. One high speed resident raised their hands and asked, "where is the evidence behind that?".

That was the day where I asked myself, "Am I really one of these people?".

 

[danielmd06]

As to the fitting in question - everyone answered either completely in the negative (bustbones), claimed to be like another specialty (danielmd), or rationalized the fact that they do in fact fit in amongst neurologists (myself and others). We are obviously all sensitive about the stereotype and visualize ourselves as being different. Or in other words 'Really, I am the cool neurologist'...

Weeeeell let me explain a bit. For the record, I have nothing against the stereotypical bow-tie wearing armchair intellectuals.

For starters, I am an American, allopathic grad, which admittedly makes me a bit uncommon in adult neurology.

Next, I entered neurology with a first choice of doing interventional neurology, which by definition made me a minority at the time (most were interested in clinical neurophysiology or MS or something non-stroke and non-neurocritical care). Even when I switched to sleep medicine, I was still in the minority compared to my co-residents and colleagues (lots of "Rip van Winkle" jokes and so forth). I wasn't interested in neuromuscular cases, and *was* interested in neurovascular anatomy and hyper-localization of symptoms in the cortex and brainstem.

During residency, when everyone else was in a tie and pressed white coat daily, I managed to wear scrubs 99% of the time. I also would typically not shave for 3 days at a stretch. I am afraid this did not endear me to the attendings at my institution, though they still had me as chief resident.

Last, I was (and still am) in the gym 4-6 times per week. There were a whopping two other neurology residents in my entire program who actually set foot in the gym during a roughly five year period other than myself. I'm 5'11" and at the time was bench pressing 365lbs (bet I can still get 315). Hence, I was commonly mistaken for an orthopod.

I was also pretty gregarious with other residents, was very popular among the nursing and ancillary staff, and loved to consume rum on my weekends, which were all in stark contrast to most of my co-residents. C'est la vie.

Definitely think of myself as a nerd, though. I'm interested in eclectic topics like Ancient Egyptian mythology, classical music, military history, classical literature, herpetology, and so forth. Just didn't seem to fit in to neurology (or medical school really) much.

 

[neuro2013]

Aha.

Rum on weekends sounds great. Not sure about the gym 4-6 times/week, but more power to ya if the medical profession didn't success at making you sedentary and angry at the thought of exercise (my friend calls it the "medical school tire" - the excess roundness everyone gets in their mid-belly by 4th year).

Secondly, love the fact that you edited your post and actually wrote down why you edited it. The best is the reason for editing -- "spelling". If all neurologists were dyslexic and felt like they didn't fit into medical school, I'd take it.

Thanks for your explanation. Really fun to read.

I think one thing I like about the neurologist personality is the appreciation for true understanding and less emphasis on memorization - at least no one is really impressed if you can memorize a list but can't explain it. This was different from a lot of other specialities I encountered. I found that this translated into less pimping (at least from my experience) and some pretty amazing teachers too...

In the end, I found that I had a similar value system -- despite some superficial differences...

 

[QuacksterVu]

Weeeeell let me explain a bit. For the record, I have nothing against the stereotypical bow-tie wearing armchair intellectuals.

For starters, I am an American, allopathic grad, which admittedly makes me a bit uncommon in adult neurology.

Next, I entered neurology with a first choice of doing interventional neurology, which by definition made me a minority at the time (most were interested in clinical neurophysiology or MS or something non-stroke and non-neurocritical care). Even when I switched to sleep medicine, I was still in the minority compared to my co-residents and colleagues (lots of "Rip van Winkle" jokes and so forth). I wasn't interested in neuromuscular cases, and *was* interested in neurovascular anatomy and hyper-localization of symptoms in the cortex and brainstem.

During residency, when everyone else was in a tie and pressed white coat daily, I managed to wear scrubs 99% of the time. I also would typically not shave for 3 days at a stretch. I am afraid this did not endear me to the attendings at my institution, though they still had me as chief resident.

Last, I was (and still am) in the gym 4-6 times per week. There were a whopping two other neurology residents in my entire program who actually set foot in the gym during a roughly five year period other than myself. I'm 5'11" and at the time was bench pressing 365lbs (bet I can still get 315). Hence, I was commonly mistaken for an orthopod.

I was also pretty gregarious with other residents, was very popular among the nursing and ancillary staff, and loved to consume rum on my weekends, which were all in stark contrast to most of my co-residents. C'est la vie.

Definitely think of myself as a nerd, though. I'm interested in eclectic topics like Ancient Egyptian mythology, classical music, military history, classical literature, herpetology, and so forth. Just didn't seem to fit in to neurology (or medical school really) much.

Good Lord, danielmd06 and I have way too much in common (save for the fact I am vertically challenged with a bench of 225). Add whiskey in addition to rum and that is me.

 

[neuro2013]

So YOU two are the typical neurologists! Oh, I get it!! I had been so confused : )

 

[Mattchiavelli]

Survey for residents and practicing Neurologists. If you are a senior medical student and would like to answer, that is great too!


1) What stage of your career are you in?
PGY-2

2) Are you primarily a clinician or a researcher? How much time do you spend in each?
Clinician and do some extra administrative type stuff

3) Are you happy with your choice to pursue Neurology as a career as opposed to another specialty?
yes, although I still think there are some fields I could have matched into and still been happy

4) Are there any other specialties that you perhaps should have considered going into (now that you are ”older and wiser”?)
I really considered PM&R and psych, and seeing as right now my residency compared to those two is a lot more intense it makes me second guess myself, but I know that the other things treated in neurology outside of what I'm interested in are more interesting to me having been exposed to them (namely epilepsy and acute inpatient consultation)

5) Do you feel like finances, and paying back student loans, are particularly difficult for neurologists compared to other specialties?
not really, at least not from what I've heard

6) Do you feel satisfied with the treatment options you can offer your patients?
Yes and no, we've gotten a lot of device-based treatments recently which have made a lot of people's lives better and opened up a new segment of options for treatment which is exciting. There are still a lot of disease types where the treatment options are wanting (dementia and MS I'm looking at you)

7) What do you love about Neurology?
helping people get their lives back and feeling more like a functional person than a disease state, knowing special tricks about the neurologic exam to test specific things in multiple ways, and being able to examine a patient in a coma and write more than 3 lines in a physical

8) What do you not love about Neurology?
getting referrals for vague somatic symptoms with the reasoning "it must be neurological" because people have sensations, which are sensed and processed through the nervous system, but are actually related to something else both clinic and inpatient. A lot of our diagnoses come from historical data which can take a long time to collect. Terminal diagnoses can get emotionally taxing if you get over involved.

9) Do you feel like you fit in with neurologists -- as a personality type and/or an approach to life? Why? Do you find that most neurologists fit in with the stereotype of a neurologist?
Yes, at least the people in my current program. Driven but not excessively intense, bright, very analytical. And yes, I guess we do fit the stereotype some in the sense that we talk a lot about things that we can't do anything about in the end, but really it's because diagnosis and pathophysiology are still getting worked out.

10) Do you have any advice for people going into Neurology regarding how to have a happy and fulfilling career?
Follow your bliss, find people that are doing the things you want to do and ask them how they got there, be it professional goal or life goal like managing an academic position and having a child... neurologists really like talking about things they've learned

 

[neurologist]

1) What stage of your career are you in?
Attending.

2) Are you primarily a clinician or a researcher? How much time do you spend in each?
Clinician, minimal research

3) Are you happy with your choice to pursue Neurology as a career as opposed to another specialty?
Nope. Definitely would not do it again. That being said, I do thank God on a regular basis that I'm not an internist

4) Are there any other specialties that you perhaps should have considered going into (now that you are "older and wiser"?)
Path (which I did consider as a med student). Maybe rads, which never occured to me at the time.

5) Do you feel like finances, and paying back student loans, are particularly difficult for neurologists compared to other specialties?
I'm not starving. I'd be doing even a bit better if I lived in a less expensive part of the country, but that's my choice. From a financial perspective, I'm not living as well as a cardiothoracic or ortho/spine surgeon, but I also have a less demanding schedule and I suspect more downtime for family and other outside interests. I don't have any med school debt, so I can't really address that part of the question.

6) Do you feel satisfied with the treatment options you can offer your patients?
Like it or not, we have what we have when we have it.
If you want to be in the business of "curing," this is definitely not the specialty for you.
I find that many patients (and sometimes even other MDs) often have unrealistic expectations of what we can do. They think the neurologist is gonna come in and wave their magic wand and "cure my migraines" or "fix my back" or "make grandma talk again after her stroke." Ummmm, no.

7) What do you love about Neurology?
Well, I still think it's an intellectually fascinating field. I like the neuroanatomy, physiology, etc. But I've never found that any of that really, truly translates into my everyday clinical practice to any great extent. You don't need a whole lot of neuroanatomy knowledge to treat chronic daily headache, fibromyalgia, anxiety, and depression.

8) What do you not love about Neurology?
In a more general sense, I'm just not that crazy about taking care of patients and probably would have been happier in a non-direct-care field like path or rads. Speaking specifically of neuro, it is a big dumping ground -- easily 50% of what I see in general neuro clinic could or should be handled by either primary care or some other specialty besides neuro. I like my areas of subspecialty practice and I think I make some real contribution to patient well-being there, but it's just 1/2 of what I do. The other "general neurology" half is where I feel I'm just spinning my wheels.

9) Do you feel like you fit in with neurologists -- as a personality type and/or an approach to life? Why? Do you find that most neurologists fit in with the stereotype of a neurologist?
Yeah, I like the people. There is a certain stereotype of neurologists and it developed for reason.

10) Do you have any advice for people going into Neurology regarding how to have a happy and fulfilling career?
Make sure you know what neurologists really do before you commit to the field - once residency is done we don't spend a whole lot of time sitting around pontificanting about the interconnections of the basal ganglia.
If you are a med student thinking about neuro, make sure you GTFO of the academic neuro department and spend some extensive time with a community general neurologist to see what they do on a day to day basis. Retrospectively, that's what was sorely lacking in my med school neuro experience and I think it gave me an inaccurate picture of what neurology was all about.
Realize that the few things that actually make money for neuro practices (EMG, EEG, sleep studies) are being cut significantly in terms of reimbursement. Not saying that $ should be the deciding factor, but it probably is at least a factor to consider in a rational decision.
You can probably find your "dream job" (in any specialty, not just neuro) but be aware that you may have to make some compromises/sacrifices to do it (i.e, living in an area you may not really like, compromising on salary, etc). So, while I would be happier doing 100% subspecialty work, I'd have to trade off on other aspects of my (and/or my family's) life, that might be just as problematic as me not loving my job 100%. Life is all about that kind of thing.
Along those same lines, don't be desparate to find or start a job the day you finish residency/fellowship. Take your time and find a spot you really like. Neuro is in high demand, oftentimes not easy to fill, and you can afford to take your time before committing.

 

[Dvt2000]

1) What stage of your career are you in?

Attending. Finished training 18 years ago .

2) Are you primarily a clinician or a researcher? How much time do you spend in each?

100% clinical

3) Are you happy with your choice to pursue Neurology as a career as opposed to another specialty?

Yes. I've never had a boring day at work, ever.

4) Are there any other specialties that you perhaps should have considered going into (now that you are ”older and wiser”?)

Many (most?) other branches of medicine are much less challenging, and more lucrative, but I would chose neurology again.

5) Do you feel like finances, and paying back student loans, are particularly difficult for neurologists compared to other specialties?

No.

6) Do you feel satisfied with the treatment options you can offer your patients?

Yes. Every branch of medicine/surgery has its untreatable side. Neurology is no worse than the others, though many mistakenly believe that is so.

7) What do you love about Neurology?

Every patient is a challenge, in some way, and every patient can teach you something. You have to be a curious person, to love neurology.

8) What do you not love about Neurology?

The quirky rep of neurologists in general.

9) Do you feel like you fit in with neurologists -- as a personality type and/or an approach to life? Why? Do you find that most neurologists fit in with the stereotype of a neurologist?

I'm actually far more confrontational than other neurogists, and have the evals to prove it.

10) Do you have any advice for people going into Neurology regarding how to have a happy and fulfilling career?

Check out any job very, very thoroughly beforehand. Work there temorarily as locums if you can.

 

[deleted102545]

1) What stage of your career are you in?
Attending.

2) Are you primarily a clinician or a researcher? How much time do you spend in each?
Clinician, minimal research

3) Are you happy with your choice to pursue Neurology as a career as opposed to another specialty?
Nope. Definitely would not do it again. That being said, I do thank God on a regular basis that I'm not an internist

4) Are there any other specialties that you perhaps should have considered going into (now that you are ”older and wiser”?)
Path (which I did consider as a med student). Maybe rads, which never occured to me at the time.

5) Do you feel like finances, and paying back student loans, are particularly difficult for neurologists compared to other specialties?
I'm not starving. I'd be doing even a bit better if I lived in a less expensive part of the country, but that's my choice. From a financial perspective, I'm not living as well as a cardiothoracic or ortho/spine surgeon, but I also have a less demanding schedule and I suspect more downtime for family and other outside interests. I don’t have any med school debt, so I can’t really address that part of the question.

6) Do you feel satisfied with the treatment options you can offer your patients?
Like it or not, we have what we have when we have it.
If you want to be in the business of "curing," this is definitely not the specialty for you.
I find that many patients (and sometimes even other MDs) often have unrealistic expectations of what we can do. They think the neurologist is gonna come in and wave their magic wand and "cure my migraines" or "fix my back" or "make grandma talk again after her stroke." Ummmm, no.

7) What do you love about Neurology?
Well, I still think it's an intellectually fascinating field. I like the neuroanatomy, physiology, etc. But I've never found that any of that really, truly translates into my everyday clinical practice to any great extent. You don't need a whole lot of neuroanatomy knowledge to treat chronic daily headache, fibromyalgia, anxiety, and depression.

8) What do you not love about Neurology?
In a more general sense, I'm just not that crazy about taking care of patients and probably would have been happier in a non-direct-care field like path or rads. Speaking specifically of neuro, it is a big dumping ground -- easily 50% of what I see in general neuro clinic could or should be handled by either primary care or some other specialty besides neuro. I like my areas of subspecialty practice and I think I make some real contribution to patient well-being there, but it's just 1/2 of what I do. The other "general neurology" half is where I feel I'm just spinning my wheels.

9) Do you feel like you fit in with neurologists -- as a personality type and/or an approach to life? Why? Do you find that most neurologists fit in with the stereotype of a neurologist?
Yeah, I like the people. There is a certain stereotype of neurologists and it developed for reason.

10) Do you have any advice for people going into Neurology regarding how to have a happy and fulfilling career?
Make sure you know what neurologists really do before you commit to the field - once residency is done we don't spend a whole lot of time sitting around pontificanting about the interconnections of the basal ganglia.
If you are a med student thinking about neuro, make sure you GTFO of the academic neuro department and spend some extensive time with a community general neurologist to see what they do on a day to day basis. Retrospectively, that's what was sorely lacking in my med school neuro experience and I think it gave me an inaccurate picture of what neurology was all about.
Realize that the few things that actually make money for neuro practices (EMG, EEG, sleep studies) are being cut significantly in terms of reimbursement. Not saying that $ should be the deciding factor, but it probably is at least a factor to consider in a rational decision.
You can probably find your "dream job" (in any specialty, not just neuro) but be aware that you may have to make some compromises/sacrifices to do it (i.e, living in an area you may not really like, compromising on salary, etc). So, while I would be happier doing 100% subspecialty work, I'd have to trade off on other aspects of my (and/or my family's) life, that might be just as problematic as me not loving my job 100%. Life is all about that kind of thing.
Along those same lines, don't be desparate to find or start a job the day you finish residency/fellowship. Take your time and find a spot you really like. Neuro is in high demand, oftentimes not easy to fill, and you can afford to take your time before committing.

That's how I feel as well. I wish I had a better idea of what non-academic neurology was like. I don't know what I'd do instead though.

 

[Armadillos]

Make sure you know what neurologists really do before you commit to the field - once residency is done we don't spend a whole lot of time sitting around pontificanting about the interconnections of the basal ganglia.
If you are a med student thinking about neuro, make sure you GTFO of the academic neuro department and spend some extensive time with a community general neurologist to see what they do on a day to day basis. Retrospectively, that's what was sorely lacking in my med school neuro experience and I think it gave me an inaccurate picture of what neurology was all about.
.

Sorry if this is a bit niave, but if you liked what you saw in academics better than what happens out in the community, why didnt you stay in academics?

 

[Thama]

Speaking specifically of neuro, it is a big dumping ground -- easily 50% of what I see in general neuro clinic could or should be handled by either primary care or some other specialty besides neuro. I like my areas of subspecialty practice and I think I make some real contribution to patient well-being there, but it's just 1/2 of what I do. The other "general neurology" half is where I feel I'm just spinning my wheels.

Out of curiosity, can you tell us what areas of subspecialty you practice?

 

[Silent Cool]

Weeeeell let me explain a bit. For the record, I have nothing against the stereotypical bow-tie wearing armchair intellectuals.

For starters, I am an American, allopathic grad, which admittedly makes me a bit uncommon in adult neurology.

Next, I entered neurology with a first choice of doing interventional neurology, which by definition made me a minority at the time (most were interested in clinical neurophysiology or MS or something non-stroke and non-neurocritical care). Even when I switched to sleep medicine, I was still in the minority compared to my co-residents and colleagues (lots of "Rip van Winkle" jokes and so forth). I wasn't interested in neuromuscular cases, and *was* interested in neurovascular anatomy and hyper-localization of symptoms in the cortex and brainstem.

During residency, when everyone else was in a tie and pressed white coat daily, I managed to wear scrubs 99% of the time. I also would typically not shave for 3 days at a stretch. I am afraid this did not endear me to the attendings at my institution, though they still had me as chief resident.

Last, I was (and still am) in the gym 4-6 times per week. There were a whopping two other neurology residents in my entire program who actually set foot in the gym during a roughly five year period other than myself. I'm 5'11" and at the time was bench pressing 365lbs (bet I can still get 315). Hence, I was commonly mistaken for an orthopod.

I was also pretty gregarious with other residents, was very popular among the nursing and ancillary staff, and loved to consume rum on my weekends, which were all in stark contrast to most of my co-residents. C'est la vie.

Definitely think of myself as a nerd, though. I'm interested in eclectic topics like Ancient Egyptian mythology, classical music, military history, classical literature, herpetology, and so forth. Just didn't seem to fit in to neurology (or medical school really) much.

Daniel,

Is this to say that most Neuro residents are either DO or Carib?

thanx

 

[danielmd06]

Daniel,

Is this to say that most Neuro residents are either DO or Carib?

thanx

Hello Silent Cool,

No, I didn't mean to infer that a straight majority of slots were filled by DO or IMG graduates in neurology. Rather, my answer was meant to emphasize the relative ratio of DO or IMG entering neurology compared to other medical/surgical subspecialty American residency programs.

This ratio is higher in neuro than other medical/surgical subspecialties (ie more DO and IMG graduates fill proportionately more neurology slots than they do...say urology). This is fairly well known/is no secret.

These links summarize some information for the match in 2012. The first includes the information per specialty by state. As a trend, you can check out neurology versus the others...

http://www.nrmp.org/data/resultsbystate2012.pdf

And here on page 13 are the pure numbers per specialty for PGY-1 and PGY-2, and you can see how neurology compares, and actually found on page 11 the information gets put down in plain percentages for you and you can see how all specialties fill percentage-wise with AMG:

http://www.nrmp.org/data/resultsanddata2012.pdf

The straight majority matching into neurology are AMGs, but there are more IMGs and DOs percentage-wise than most other subspecialties.

The proposed reasons for neurology not attracting more American allopathic graduates start a discussion beyond the scope of this thread (but talked about on others than can be searched) and usually boil down to a lack of money in neurology compared to other fields (which just got worse with the recent EMG cuts).

 

[Silent Cool]

Hello Silent Cool,

No, I didn't mean to infer that a straight majority of slots were filled by DO or IMG graduates in neurology. Rather, my answer was meant to emphasize the relative ratio of DO or IMG entering neurology compared to other medical/surgical subspecialty American residency programs.

This ratio is higher in neuro than other medical/surgical subspecialties (ie more DO and IMG graduates fill proportionately more neurology slots than they do...say urology). This is fairly well known/is no secret.

These links summarize some information for the match in 2012. The first includes the information per specialty by state. As a trend, you can check out neurology versus the others...

http://www.nrmp.org/data/resultsbystate2012.pdf

And here on page 13 are the pure numbers per specialty for PGY-1 and PGY-2, and you can see how neurology compares, and actually found on page 11 the information gets put down in plain percentages for you and you can see how all specialties fill percentage-wise with AMG:

http://www.nrmp.org/data/resultsanddata2012.pdf

The straight majority matching into neurology are AMGs, but there are more IMGs and DOs percentage-wise than most other subspecialties.

The proposed reasons for neurology not attracting more American allopathic graduates start a discussion beyond the scope of this thread (but talked about on others than can be searched) and usually boil down to a lack of money in neurology compared to other fields (which just got worse with the recent EMG cuts).

Daniel,

Thanks for the heads up. What can a typical Neurologist take home these days? 200K?

 

[danielmd06]

Daniel,

Thanks for the heads up. What can a typical Neurologist take home these days? 200K?

http://forums.studentdoctor.net/showthread.php?t=817247&highlight=mgma+2010+salary

The first post in the thread has a link to the data. Note that this was three years ago now.

 

[EuroDoc]

I was wondering - what is the typical work schedule as a resident (PGY1-4)?

It varies by program, I know, but is it typically 60-80 hours/week?

E.g. 5 days a week 6AM-6PM plus occasional call/night float?

Any experience you might have will be greatly appreciated - please include program name if you're comfortable with that.

 

[Thama]

I know a neurologist who recently graduated from a large program: what he told me was that inpatient rotations were 60 to 70, with 80 hours being fairly uncommon, and outpatient rotations being 40 to 50. It's a large group so in-house call isn't too frequent, and senior residents take almost all call from home.

I don't know if that's typical, but it's 1 data point from a large program with a good reputation.

 

[typhoonegator]

The standard deviation is very high. For my residency, essentially every service rotation was at the 80 hour limit, both for juniors and seniors. Non-service rotations are easier. Weekends on service are the standard black/half/golden style. This is true for many programs. Call is rapidly evolving at many programs to meet ACGME standards, with much more short call and NF than previously.

 

[neuro2013]

Anyone else interested in answering the survey? With applicants thinking about (and talking about) several of these issues, any additional input would be greatly appreciated. Thanks!

 

[neuro2013]

Bringing this to life again : )

 

[boanssi]

Does neurology get too repetitive as you subspecialize (in the long run, I mean)?

 

[typhoonegator]

Does neurology get too repetitive as you subspecialize (in the long run, I mean)?

I don't think so. You just start to appreciate nuance more.

 

[boanssi]

Thanks.
I was asking this because I was also interested in Cardiology but I ended up discovering that a lot of them do very repetitive tasks, depending on their subspecialty (echos, ECGs, etc.).

 

[Vader]

Thanks.
I was asking this because I was also interested in Cardiology but I ended up discovering that a lot of them do very repetitive tasks, depending on their subspecialty (echos, ECGs, etc.).

Depending on your set up in practice, you could make any specialty repetitive. If you do EMG/NCS all day (without corresponding consultations), for example, this may become repetitive. If you see all headache this may become "repetitive", though like typhoonegator stated, subspecialists appreciate the nuance more (i.e. the various headache types, differences between the various triptans, the array of prophylactic migraine meds, alternative therapies, etc). Sub-specialists also tend to get the more complicated or refractory cases, and are more likely to stay up-to-date on the latest advances in the particular field.

One of the great things about neurology is that there is incredible variability in clinical presentation (i.e. even for stroke) by the nature of localization in the nervous system. A small stroke for example, just 5mm of location difference in the brainstem can have dramatically different clinical presentations. This makes the field both challenging and fun (for those who enjoy a challenge). Also, there are many treatment options nowadays to know about for various neurologic conditions (i.e. MS, the new oral medications like fingolimod, dimethylfumarate, etc, older meds like interferons, glatiramer, and natalizumab, and cutting-edge meds that will come out over the next few years). That neurologic is advancing so rapidly as a field also makes it stay fresh and interesting even for those out in practice.