Need help deciding between peds or adult neuro

[kgamon8]

Hello everyone,

Super low step one (205), all Ps and one HP in clinicals, originally wanted to do obgyn or anesthesia. Did not love my peds rotation, but know that I will match. My school does not have a neuro rotation so I have very little exposure to the field. Would love to hear from some people who chose or didn't choose neuro

Peds
Pros: Easy to match, I like kids enough, the general peds clinic life does not seem stressful, every pediatrician seems to love their job and isn't burnt out. The biggest draw is probably the job satisfaction I see reported

Cons: Pay and having to only work in private practice to make 200k/ the business of that sounds kind of intimidating, I would never pursue fellowship due to not much increase in pay, all 3 years, most tied to academic, midlevels in NICU. Not being able to connect with the patient on the same level as an adult and little shared decision making. I feel that the medicine of gen peds is fairly boring.


Neuro
Pro: hopefully mastering a field that the everyday practioner does not understand and bringing a new perspective, more procedures, some imaging interpretation, diseases like MS are becoming treatable also migraines and seizures can be managed, avoiding primary care issues, discssuing goals of care with patients, a mix of clinic and inpatient, pay is better, opportunties for work in academic, community and private all with pay I'm happy with (200k)

Cons: feel that I was never drawn to neuro when I had opportunities to be such as my parent with MS or working with kids with developmental disabilities..worry that I will not be interested and not do a great job, depressing cases and unfixable situations, fellowship required for MS, burnout??

After my radiology elective, I realized I LOVED it. There is exposure to interesting diseases, some procedures, and I didn't miss patient interaction at all to be honest. It was so refreshing to just see someone do their job and not be bothered by social work, psych issues, or confusing labs. I am on my IM rotation and disliking rounds, clinic is fun but somehow these docs only see 8-10 patients a day?? I know I can't do radiology with my score so I guess I am looking for something that I can do without hating my life

---

Members don't see this ad.

 

[flapjack3d]

have you ruled out peds neuro? it's one of the least competitive specialties.
what about PM&R including peds PM&R? more procedures than neuro, similar population/diseases, longer relationships, much chiller residency, approx same compensation.

 

[kgamon8]

have you ruled out peds neuro?

I considered it, the outpatient side seems interesting but the inpatient peds neuro I saw was pretty disheartening. TBI, abuse, neonates with gentic diseases

 

[Dral]

I started med school either Neuro or IM. I was in the neurology interest group and such. Did my rotation and promptly ruled it out. While some things are treatable, it just didn't do it for me. 'Hey, I can figure out where the stroke lesion is, but I can't really help that much to get you/your loved one better'. No offense to neurologists. I still have much respect for the field, and I thought the problem solving part of it was super cool.

I would try to see if you can get any exposure to neuro at all before you make a decision.

 

[kgamon8]

I started med school either Neuro or IM. I was in the neurology interest group and such. Did my rotation and promptly ruled it out. While some things are treatable, it just didn't do it for me. 'Hey, I can figure out where the stroke lesion is, but I can't really help that much to get you/your loved one better'. No offense to neurologists. I still have much respect for the field, and I thought the problem solving part of it was super cool.

I would try to see if you can get any exposure to neuro at all before you make a decision.

That's a great point..on IM we have been consulted on stroke patients, and it was super hard to watch these patients not get better. I always loved EM becuase things are either fixable or sent away. So I can see this being tough for me. Especially seeing the course of MS first hand

 

[kgamon8]

Maybe pathology? If I can't do rads?

 

[Dral]

Pathology is a good thought. Just do your research and know the downsides. The job market is not the best (though it seems to be not AS bad here of late according to the path forum). There are FNAs, but other than that, you're not going to get the opportunities of procedures like you do in Rads.

If you're ok with not seeing patients (although you can see them for FNAs or also bloodbanking I think), want to avoid the social/psych issues with seeing patients, and want to see interesting pathology (literally), then path might work for you. There is the clinical path side (microbiology, laboratory, molecular etc) and that anatomic path side (what most of typically think of with pathology). There are lots of areas to sub-specialize in as well.

I always had an interest in Path and that was my first 4th year rotation. I didn't fall in love with it, but I liked it to the point that it's a large part of what I do now in a sense.

I'll echo my earlier advice. Schedule a path rotation before you make any major decisions. It aligns with Radiology in a lot of ways when compared to other specialties, but they are still very different fields.

Granted the following is not a typical path of a pathologist, but it's an interesting read:

Pathologist finds niche in blood banking, transfusion medicine

Melissa R. George, DO, of Pennsylvania dispels the myth that pathologists are chained to their microscopes and work only with the dead.

thedo.osteopathic.org

 

[kgamon8]

Pathology is a good thought. Just do your research and know the downsides. The job market is not the best (though it seems to be not AS bad here of late according to the path forum). There are FNAs, but other than that, you're not going to get the opportunities of procedures like you do in Rads.

If you're ok with not seeing patients (although you can see them for FNAs or also bloodbanking I think), want to avoid the social/psych issues with seeing patients, and want to see interesting pathology (literally), then path might work for you. There is the clinical path side (microbiology, laboratory, molecular etc) and that anatomic path side (what most of typically think of with pathology). There are lots of areas to sub-specialize in as well.

I always had an interest in Path and that was my first 4th year rotation. I didn't fall in love with it, but I liked it to the point that it's a large part of what I do now in a sense.

I'll echo my earlier advice. Schedule a path rotation before you make any major decisions. It aligns with Radiology in a lot of ways when compared to other specialties, but they are still very different fields.

Granted the following is not a typical path of a pathologist, but it's an interesting read:

Pathologist finds niche in blood banking, transfusion medicine

Melissa R. George, DO, of Pennsylvania dispels the myth that pathologists are chained to their microscopes and work only with the dead.

thedo.osteopathic.org

What do you do now?

Yes sort of worried about the job market also the isolation. I was surprised that the radiologist talked a bit with the ordering providers as well as the interaction with procedures. I am going to try to do a path or neuro elective. However, I can't do both becuase I am trying to take two months to study for Step 2

I worked in clinical heme/onc research between M1 and M2 year and actually really enjoyed the pace of clinic with positive follow-ups, delivering bad news, explaining chemo and bone marrow transplants, palliative discussions etc. There isn't as much social work with the specialties. But this would mean three years of IM and a chance I won't match heme/onc which is high if I end up in a community program.

 

[Dral]

Dermatology/Dermpath.

Heme/Onc seems to be a good field based on what I've seen around here. If you enjoy that subject material, Heme/blood bank may be good for you. You don't typically interact with patients in Heme (pathology heme that is), but depending on where you are (academics/hospital system), there is the opportunity to interact with clinicians at interdisciplinary conferences such as tumor boards.

 

[Mass Effect]

I wouldn't do a field you have no exposure to. You need a neuro rotation.