MS3 newly interested in neuro

[CD4TH2]

Hey guys, just started my neuro rotation last week and I have been enjoying it much more than I thought I would. I really wasn't considering neuro for residency and now it might be my top choice. Had a few quick questions for current residents/attendings.

1. I really enjoy the clinical aspect and I'm pretty intimidated by the amount of background neuroscience it seems you guys have mastered. I did decent in neuro during our 1st year course. Do you feel what you have study is more clinically relevant neuro or more basic science minutiae stuff? When I asked my residents they said the most difficult was the neurorads stuff.

2. My residents told me that basically you go into a fellowship if you feel your residency hasn't prepared you well for a certain field or you have an overwhelming interest in a particular sub specialty, because in your job you basically will still see everything in general neuro. But they all relayed the fact that the current and future job market is in need of neurologist and jobs are plentiful with good salaries. Besides neurohospitalist, are there a lot of outpatient only jobs or is it mostly 50/50 inpt/output? What kind of offer have you guys finishing residency seen or heard of?

Thanks for the future responses. For what it's worth I go to a MD school in the southeast and I have a home program.

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[Elipsis]

Awesome that you've seen the light with neuro. I'm a PGY-1; hopefully some guys that actually know what they're doing will chime in on your questions.

1. Neuro residents have to learn neurologic localization, which is basically the clinical application of neuroanatomy. Really learning this involves learning a lot of neuroanatomy but not really in the same way you studied it in your MS1 year. One of the differences between neurology and IM is that the integrity of many parts of the nervous system can be directly assessed by seeing how well it's functioning, i.e. by doing the neuro exam. Thus the exam and neuro anatomy are as crucial for neurologists as knowing what labs to get and how to interpret them in IM. A good book some of us look at to get going on this stuff is DeMyer's book on the exam. This is a fun book to take a look at if you're pretty interested in neuro and want to confirm your interest. It's like Dubin's EKG book or Felson's CXR book but for neuro.

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2. The job market is really good for us right now. Because of that there are postings for every kind of job in general neurology, including neurohospitalists, outpatient only with no call, and a mix of both. You can pretty much find whatever you're looking for. I'm a little leery of all these hospital employed positions opening up with high salaries. I feel like a lot of those places are looking to get someone in there and then change the deal once you've been there a few years and are committed to the location. Like any career you will have to be careful and business minded when you're looking for a position and seek a lot of help from more experienced people. That being said, the demand for neuro right now is very high, and if you're good you can expect to do well.