Neurality

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Hey guys, I recently switched my track from Emergency med to Neurology. Naturally, all of my previous research on residency was focused on EM. I am looking into neurology statistics now. That being said, can anyone comment on how competitive neuro residency is? Specifically a COMLEX CK 2 SCORE needed?

Stats:
OMS III USMLE 1: 222 COMLEX: 599
Strong LOR from my neurology preceptor +3 others
Straight passes in all classes
(Plus other extracurriculars geared towards EM)

-I know my personal statement will be important to explain why neurology now and not EM. Is there another way to show interest to prospective programs?


Thank you guys for any input!
 
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DO2015CA

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Neurology isn’t particularly competitive if you take USMLE. They like the USMLE so that’s good to took it. Plenty of people match with 210 step 1 which you passed. Just take step 2 and do similar as step 1 and you will be fine. You should do that well anyways. Most people increase from step 1 to 2 anyways
 

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Neurology isn’t particularly competitive if you take USMLE. They like the USMLE so that’s good to took it. Plenty of people match with 210 step 1 which you passed. Just take step 2 and do similar as step 1 and you will be fine. You should do that well anyways. Most people increase from step 1 to 2 anyways
I knew neuro wasnt competitive but damn 210?? lol thats pretty low. Hows lifestyle in neuro? i know pay is pretty good. Id assume outpatient in mostly any other neuro sub other than stroke would be not a bad lifestyle
 
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I knew neuro wasnt competitive but damn 210?? lol thats pretty low. Hows lifestyle in neuro? i know pay is pretty good. Id assume outpatient in mostly any other neuro sub other than stroke would be not a bad lifestyle
Neuro is a self selecting field. You’ll either love or hate neuro. There isn’t a ton of interest from American grads and a large portion of residents are IMG. With the looming residency crunch you may see it increase but for American grads it’s not crazy competitive if you show a true interest. Idk about lifestyle.
 

Cranjis McBasketball

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I knew neuro wasnt competitive but damn 210?? lol thats pretty low. Hows lifestyle in neuro? i know pay is pretty good. Id assume outpatient in mostly any other neuro sub other than stroke would be not a bad lifestyle
Not sure about after residency, but I have heard that residency, itself, is supposed to be one of the most demanding
 
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Neurality

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Ya one of my best friends is in a large university program. He is getting his d*** dragged through the dirt right now.
I have heard that neurology residency is pretty demanding. My guess was because of the size of most programs (smaller than IM/FM/EM) with the need to cover inpatient and outpatient. This, in addition to the increasing number of neuro consults. Thoughts?
 

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I have heard that neurology residency is pretty demanding. My guess was because of the size of most programs (smaller than IM/FM/EM) with the need to cover inpatient and outpatient. This, in addition to the increasing number of neuro consults. Thoughts?
Id say yes and the number of time intensive rotations you need is a lot more than EM and FM and maybe more than IM depending on the program.
 
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Neurality

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Id say yes and the number of time intensive rotations you need is a lot more than EM and FM and maybe more than IM depending on the program.
Can you define 'time intensive' rotations?
 

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Can you define 'time intensive' rotations?
70-80 hrs/wk, you know, the max.

Neuro residents out here work like dogs. We have plenty of rotations like that as well, but I swear they're on inpatient/ICU for like 2/3 of the year. Then as seniors instead of things getting a bit easier, it gets harder by covering stroke call and more 28s/overnights.
 
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DO2015CA

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Can you define 'time intensive' rotations?
Inpatient rotations, ICU, neuro ICU, etc. Without having experienced it, it’s hard to understand because although we know we work hard and the 12hr per day with call is expected. But a lot of residencies will alternate between a rotation working 70+ hours and an easy rotation to keep burn out down. But when you have such a high number of required inpatient ward rotations (not subspecialty rotations) it makes it hard to alternate. Takes Spectrum in Grand Rapids. In R2, they are required 7 inpatient neuro months. Out of 12. So what that means is you are doing 2-3 months at a time where you are at sign out for 6am and finishing sign out at 7pm. Repeat 5-6 days a week and sprinkling in 24h call shifts. Where as IM you will do one teaching service then a subspecialty then another service then subspecialty. It makes for better wellness and less burn out.
 
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Neurality

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Inpatient rotations, ICU, neuro ICU, etc. Without having experienced it, it’s hard to understand because although we know we work hard and the 12hr per day with call is expected. But a lot of residencies will alternate between a rotation working 70+ hours and an easy rotation to keep burn out down. But when you have such a high number of required inpatient ward rotations (not subspecialty rotations) it makes it hard to alternate. Takes Spectrum in Grand Rapids. In R2, they are required 7 inpatient neuro months. Out of 12. So what that means is you are doing 2-3 months at a time where you are at sign out for 6am and finishing sign out at 7pm. Repeat 5-6 days a week and sprinkling in 24h call shifts. Where as IM you will do one teaching service then a subspecialty then another service then subspecialty. It makes for better wellness and less burn out.
Sounds kinda rough. They'll know I'm committed, subbing EM residency schedule for neuro :laugh: .
Looks like program selection will be important. I will definitely be looking into programs' resident input about hours and schedule.
 

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Sounds kinda rough. They'll know I'm committed, subbing EM residency schedule for neuro :laugh: .
Looks like program selection will be important. I will definitely be looking into programs' resident input about hours and schedule.
ya EM is one of the easier residencies hours wise. A few of my friends brag about only having 15 shifts a month on their core ER rotations. As for neuro, ACGMe is strict so you really won’t have to worry about individual programs having way different rotations. Just find a program where you feel you would fit in with the residents. When you are working that much it’s vital. idk what I’d do on the long hospital months if I hated my coresidents
 
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ya EM is one of the easier residencies hours wise. A few of my friends brag about only having 15 shifts a month on their core ER rotations. As for neuro, ACGMe is strict so you really won’t have to worry about individual programs having way different rotations. Just find a program where you feel you would fit in with the residents. When you are working that much it’s vital. idk what I’d do on the long hospital months if I hated my coresidents
Its easier hours, but damn, thank God you guys like that kind of work. Not for me. A couple blocks in the ED with constantly rotating shifts were enough for me.
 
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DO2015CA

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Its easier hours, but damn, thank God you guys like that kind of work. Not for me. A couple blocks in the ED with constantly rotating shifts were enough for me.
I despise the ER in general. Even without the alternating shifts. I am a very rigid sleeping schedule man. I don’t mind working 70+ hours per week as long as my sleep schedule is the same time
 
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Neurality

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I despise the ER in general. Even without the alternating shifts. I am a very rigid sleeping schedule man. I don’t mind working 70+ hours per week as long as my sleep schedule is the same time
This is exactly me on EM rotation now. I loved working in the ED before medical school. Probably because I had a relatively consistent schedule.
 
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70-80 hrs/wk, you know, the max.

Neuro residents out here work like dogs. We have plenty of rotations like that as well, but I swear they're on inpatient/ICU for like 2/3 of the year. Then as seniors instead of things getting a bit easier, it gets harder by covering stroke call and more 28s/overnights.
That sounds like IM on steroid...
 

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Sorry for invading this thread, but How does one decide if they really like Neurology or not? I'm actually currently debating whether I would like Neurology better than IM, and I've been reading more and more about it online lately. I previously was focusing mainly on IM because of the variety and the many different options your career can take. But I know very little about what a career as a neurologist would be like. Mostly because I have very little exposure to it which is why I plan to use one of my electives next year for Neurology to see how it's like.
 
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anotherro

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So here is a question that I have. Will be starting DO school in the fall.

What does it mean when a Residency program has MD, IMG, and FMG residents, but not a single DO? I know there is bias against DOs, but is it so extreme that these programs take IMG and foreign grads but refuse to consider a DO?

Example: Harvard Neurology Residency Program, Current Residents

Class of 2020 for example
 

Quackery445

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So here is a question that I have. Will be starting DO school in the fall.

What does it mean when a Residency program has MD, IMG, and FMG residents, but not a single DO? I know there is bias against DOs, but is it so extreme that these programs take IMG and foreign grads but refuse to consider a DO?

Example: Harvard Neurology Residency Program, Current Residents

Class of 2020 for example
Yeah, don’t expect a non-FM Ivy League residency to accept DO’s. The DO degree is just too much tarnish for many of them it seems. Although, there are some very high end places that do. Mayo Clinic accepts quite a few DO’s for more than just FM, so does Cleveland clinic. We just have to be smart, realistic and picky come residency application time. The point is to match after all, not satisfy our vanity.
 

sab3156

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So here is a question that I have. Will be starting DO school in the fall.

What does it mean when a Residency program has MD, IMG, and FMG residents, but not a single DO? I know there is bias against DOs, but is it so extreme that these programs take IMG and foreign grads but refuse to consider a DO?

Example: Harvard Neurology Residency Program, Current Residents

Class of 2020 for example
Yes. Harvard and many other top programs will never touch a DO with a million mile pole... Harvard has taken DOs in programs that they struggle for top applicants in (Anesthesia and PM&R), but other than that most programs at places like Harvard will never bother with letting a DO make their residency roster look less competitive. Check out MGH's IM residents.

For a lot of top places, IMG/FMG might be acceptable, but DO is absolutely forbidden.
 

DrStephenStrange

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So here is a question that I have. Will be starting DO school in the fall.

What does it mean when a Residency program has MD, IMG, and FMG residents, but not a single DO? I know there is bias against DOs, but is it so extreme that these programs take IMG and foreign grads but refuse to consider a DO?

Example: Harvard Neurology Residency Program, Current Residents

Class of 2020 for example
Notice how none of them are from the Caribbean.

These are most likely FMGs rather than IMGs, and they're usually either from renowned international schools, have lots of research in the field, and/or super high USMLE scores. Yeah, some residency programs are so biased they would rather take a "superstar FMG" rather than a DO.

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anotherro

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Notice how none of them are from the Caribbean.

These are most likely FMGs rather than IMGs, and they're usually either from renowned international schools, have lots of research in the field, and/or super high USMLE scores. Yeah, some residency programs are so biased they would rather take a "superstar FMG" rather than a DO.

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OK - so this is kind of where I was going. Although, admittedly I unfortunately chose Harvard, which added another level of complexity. There are other programs where I have seen FMG and MD and no DO consistently through each of their years. And now I get it - there is no such thing as a "superstar DO" to some programs.

Thanks
 
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sab3156

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OK - so this is kind of where I was going. Although, admittedly I unfortunately chose Harvard, which added another level of complexity. There are other programs where I have seen FMG and MD and no DO consistently through each of their years. And now I get it - there is no such thing as a "superstar DO" to some programs.

Thanks
There are many programs that would rather have an MD from anywhere over a DO. Even Harvard's ophthalmology program has taken graduates of random no-name medical schools oversees, and I personally know them, and now they are faculty at Harvard. But they will never touch a DO ever. Hopkins ophthalmology program took a guy last year from a Pakistani medical school, but again they will never ever talk to a DO.
 
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DrStephenStrange

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OK - so this is kind of where I was going. Although, admittedly I unfortunately chose Harvard, which added another level of complexity. There are other programs where I have seen FMG and MD and no DO consistently through each of their years. And now I get it - there is no such thing as a "superstar DO" to some programs.

Thanks
To some programs (especially top programs), yes, there's no such thing as a superstar DO even if the DO was top of his class with 260 USMLE scores, lots of research and publications, and great letters of recommendation. Although, I'm probably exaggerating a bit with that example, but you get the idea. For them, having DOs will have immediate negative consequences to their programs, and they're absolutely right because future "competitive" USMD applicants might avoid them when they start thinking to themselves that they must have had a hard time finding competitive enough people to fill their program and resorted to accepting DOs. Basically the bias agianst DOs is a vicious circle between programs' pride and applicants' prejudices (or vice versa). Another thing these programs will do whenever they finally match a lucky DO is misrepresenting them by putting an MD behind their names so people don't notice.

We DOs are sometimes guilty of this as well. We're only human after all. Just like you're looking at residency rosters and noticing FMGs, we look at residency programs and if there's like a tad bit too many IMGs (usually from the Caribbean schools) in there, we immediately think that it must be an IMG malignant sweatshop. Whether this is true or not, who knows. So we actively try to avoid these programs if we can.

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FutureDoctor5000

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Yes. Harvard and many other top programs will never touch a DO with a million mile pole... Harvard has taken DOs in programs that they struggle for top applicants in (Anesthesia and PM&R), but other than that most programs at places like Harvard will never bother with letting a DO make their residency roster look less competitive. Check out MGH's IM residents.

For a lot of top places, IMG/FMG might be acceptable, but DO is absolutely forbidden.
Damnit I Knew it I should have gone to Ross over my DO school, could've matched Harvard Neuro
 

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Damnit I Knew it I should have gone to Ross over my DO school, could've matched Harvard Neuro
My intentions were never to feel out my chances w Harvard Neuro. I am admittedly a rookie (Happily DO class of 2024 and not looking back) and just trying to gauge my future. SUNY Downstate, which is not Harvard, is another example I believe. So it isn’t just the big names, if I am not mistaken

 

FutureDoctor5000

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My intentions were never to feel out my chances w Harvard Neuro. I am admittedly a rookie (Happily DO class of 2024 and not looking back) and just trying to gauge my future. SUNY Downstate, which is not Harvard, is another example I believe. So it isn’t just the big names, if I am not mistaken

LOL you need to relax, these just two programs that you have noticed. Maybe they did interview some DO's but they just happened to not match into the program. Neurology overall isn't a very competitive or desirable field for most USMD's and DO's and thus theres many IMG and especially FMG's in Neuro kind of similar to Pathology. Heres an example of UTSW(UT southwestern): Current Residents. Many DO's and few if any FMG's and IMG. Most programs are like this. Some Ivory tower places still have DO bias but overall your chances of matching anything especially Neurology even at a competitive program like UTSW or BCM in Houston i.e.. are much better as a DO then IMG/FMG.
 
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ananasmed

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There are something like ~100 DO students that apply for neurology each year, which is fewer than the number of FMGs applying. You should remember that when you look at programs and see very few or no DOs - there just aren't that many DOs going into neurology, in my opinion likely due to poor exposure to neurology. Certainly some programs (like Harvard) might not look at DOs, but who cares. You'll be a neurologist if you want to be one, and many excellent training programs across the country will consider your application.
 

FutureDoctor5000

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There are something like ~100 DO students that apply for neurology each year, which is fewer than the number of FMGs applying. You should remember that when you look at programs and see very few or no DOs - there just aren't that many DOs going into neurology, in my opinion likely due to poor exposure to neurology. Certainly some programs (like Harvard) might not look at DOs, but who cares. You'll be a neurologist if you want to be one, and many excellent training programs across the country will consider your application.
I wouldn't say poor exposure per say, we have 3 semesters worth of neuro/psych and neuroanatomy at my DO school taught by prominent faculty both DO and MD, we can also do a neuro elective in the third year(in place of IM-2 or Surgery-2 elective) as far as I know. I just think that neuro isn't a very popular field right now among both USMD and DO as it only attracts the niche students who really want to go into neuro and like neuro stuff and also due to the fact that you specialize early unlike something like IM etc where you can choose to specialize later, thus the field is pretty IMG and FMG friendly, kind of like Pathology.
 
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Neuro is not a competitive for some reason. Don't understand why TBH... Neurology is in the middle of the spectrum for lifestyle, salary and "prestige". A couple of my former classmates matched into good university programs with step 1/2 that are really low ( i mean barely passing), and the other part of their applications were not great either.
 

ananasmed

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I wouldn't say poor exposure per say, we have 3 semesters worth of neuro/psych and neuroanatomy at my DO school taught by prominent faculty both DO and MD, we can also do a neuro elective in the third year(in place of IM-2 or Surgery-2 elective) as far as I know. I just think that neuro isn't a very popular field right now among both USMD and DO as it only attracts the niche students who really want to go into neuro and like neuro stuff and also due to the fact that you specialize early unlike something like IM etc where you can choose to specialize later, thus the field is pretty IMG and FMG friendly, kind of like Pathology.
By poor exposure, I mean that many DO schools do not require a clinical rotation in neurology. Therefore some students will never rotate through neurology and may never realize they are interested before it's time to apply.
 

FutureDoctor5000

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By poor exposure, I mean that many DO schools do not require a clinical rotation in neurology. Therefore some students will never rotate through neurology and may never realize they are interested before it's time to apply.
MD schools have required clerkships in neurology? i see what you mean if thats the case lol
 
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Lmao, for real though, I highly doubt any MD would stop applying to Harvard just because there’s a bone wizard among them. They’ll probably know that person must have absolutely killed it to be there.

Anyway what’s the general ranking of residency intensity among Neuro/IM/FM/EM since we were talking about it above?
 

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Lmao, for real though, I highly doubt any MD would stop applying to Harvard just because there’s a bone wizard among them. They’ll probably know that person must have absolutely killed it to be there.

Anyway what’s the general ranking of residency intensity among Neuro/IM/FM/EM since we were talking about it above?
From what I’ve heard it’s exactly that order. With maybe EM moving up a slot.

But again, don’t decide what you’re going to do for 30+ years because 3-4 years of residency is easier
 
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sab3156

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Lmao, for real though, I highly doubt any MD would stop applying to Harvard just because there’s a bone wizard among them.
That is the way that many people think. I've discussed this in depth with ophthalmology faculty, program directors, and chiefs at top programs, including Harvard. They've been in this game for a very long time and understand how various factors impact the prestige and image of their programs. And this was actually discussed here not too long ago, with some people pointing out the horrendous things MD applicants were saying about Ortho programs like Cleveland Clinic that had DO residents.

Neuro is not a competitive for some reason. Don't understand why TBH... Neurology is in the middle of the spectrum for lifestyle, salary and "prestige". A couple of my former classmates matched into good university programs with step 1/2 that are really low ( i mean barely passing), and the other part of their applications were not great either.
Who knows. Neurology is a love/hate kind of specialty. Maybe it just comes down to that. Plus all the talk about how demanding the residency is.
 

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MD schools have required clerkships in neurology? i see what you mean if thats the case lol
Mine does. Except my class since we were a transitional year with a change in curriculum. Also two required sub-i’s as a fourth year, one being EM
 

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Im in a different situation, but i applied FM and I honestly wonder if I am at a disadvantage with a DO heavy progam as an MD. Especially when the PD is a DO.

But i feel bad when im all ehh on carib-heavy programs.
 

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That is the way that many people think. I've discussed this in depth with ophthalmology faculty, program directors, and chiefs at top programs, including Harvard. They've been in this game for a very long time and understand how various factors impact the prestige and image of their programs. And this was actually discussed here not too long ago, with some people pointing out the horrendous things MD applicants were saying about Ortho programs like Cleveland Clinic that had DO residents.
Lmao then those people would be even stupider than I thought if any of this is true. If none of them have ever taken bone wizards (or consistently), how would they even know the impact on prestige? Lol as if those same MD applicants wouldn't be ecstatic to match at Cleveland Clinic or Harvard if the latter took in 1-2 DOs.
 

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Lmao then those people would be even stupider than I thought if any of this is true. If none of them have ever taken bone wizards (or consistently), how would they even know the impact on prestige? Lol as if those same MD applicants wouldn't be ecstatic to match at Cleveland Clinic or Harvard if the latter took in 1-2 DOs.
Sorry, I forgot that your years of experience as a program director at an elite program has given you a vast amount of insight. My apologies.
 

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I'm a neurology PGY-2 resident. I'll give my $0.02.

1. Like said above, the hours, the stress, and the learning curve in neurology residency is higher than most specialties. Only surgical and OB residents work more hours than we do. When on days, expect to work 10-12hrs 6 days a week. When on nights, 12-15 6 nights a week. Some programs still have the traditional call system where you do a 28hr shift Q4-7 depending on the program, but from what I'm hearing, most programs are moving towards the nightfloat system. Most programs are front loaded; PGY-2 is nearly all spent inpatient pushing 80hrs/week. PGY-3 tends to be 50/50 inpatient/electives. PGY-4 is similar to 4th year med school; third of it is hard work and the rest is electives and "research".

2. Also like mentioned above, neurology is love or hate type of field. It's not one that you could stomach or easy your way into. You NEED to love it or you'll be miserable doing it. Therefore, it's very self-selective. It draws those who are fascinated by complexity and intrigued by ambiguity, not necessarily those who have urge to fix every patient they encounter.

3. Life after residency is significantly better. Even in inpatient heavy specialties like stroke and neurocritical care, everyone now does shift work where you cover the service 1-2 weeks in the month while having the rest of the month either off or chill clinic.

4. Money is good. Not cards or GI good but better than general IM or other nonprocedural IM specialties. Surveys have us towards the bottom third of the list in terms of salaries but this is skewed by a significantly large portion of neurologists who work academia or those who see less than 15 pts a day. Nowadays, starting salary for neurohospitalist is ~300k. Outpatient is 250K+ but much higher ceiling than neurohospitalist. Academic salaries are pathetic (high 100's-low 200's starting salary).

5. Similar to IM, the field is vast and has multiple subspecialties (Stroke, Epilepsy, NCC, Movement, Neuromuscular, MS, Neurodegenerative, Headache, Neurophys, etc...). Most neurologists subspecialize not because they have to, but again, most who go into neurology are genuinely in love with the field and want to become experts and contribute to a specific subfield.

6. Prestige is nice. We get tons of that from laypersons but not so much from our colleagues in other fields, haha.

7. Job market is great. There's shortage and it's growing. I don't think there will be issues finding a job anywhere in the country, at least not in the foreseeable future.

In regards to OP's question, neuro is not a competitive specialty. Your numbers look good. You are still a third year student have plenty of time to show interest in the field. Do a couple rotations, one being an away, and attend a conference.

IMO EM and neurology lay on the opposite ends of the spectrum: Doer vs thinker, generalist vs specialist, service vs brand. $/hr is better in EM no argument and EM is undoubtedly "sexier" than neurology. However, neurology is a more stable career and allows you the opportunity to advance and grow through it. You are an expert of an organ system and have "ownership" of your patients. Also, your shelf life as a neurologists is also longer than that of an EM physician.
 

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I'm a neurology PGY-2 resident. I'll give my $0.02.

1. Like said above, the hours, the stress, and the learning curve in neurology residency is higher than most specialties. Only surgical and OB residents work more hours than we do. When on days, expect to work 10-12hrs 6 days a week. When on nights, 12-15 6 nights a week. Some programs still have the traditional call system where you do a 28hr shift Q4-7 depending on the program, but from what I'm hearing, most programs are moving towards the nightfloat system. Most programs are front loaded; PGY-2 is nearly all spent inpatient pushing 80hrs/week. PGY-3 tends to be 50/50 inpatient/electives. PGY-4 is similar to 4th year med school; third of it is hard work and the rest is electives and "research".

2. Also like mentioned above, neurology is love or hate type of field. It's not one that you could stomach or easy your way into. You NEED to love it or you'll be miserable doing it. Therefore, it's very self-selective. It draws those who are fascinated by complexity and intrigued by ambiguity, not necessarily those who have urge to fix every patient they encounter.

3. Life after residency is significantly better. Even in inpatient heavy specialties like stroke and neurocritical care, everyone now does shift work where you cover the service 1-2 weeks in the month while having the rest of the month either off or chill clinic.

4. Money is good. Not cards or GI good but better than general IM or other nonprocedural IM specialties. Surveys have us towards the bottom third of the list in terms of salaries but this is skewed by a significantly large portion of neurologists who work academia or those who see less than 15 pts a day. Nowadays, starting salary for neurohospitalist is ~300k. Outpatient is 250K+ but much higher ceiling than neurohospitalist. Academic salaries are pathetic (high 100's-low 200's starting salary).

5. Similar to IM, the field is vast and has multiple subspecialties (Stroke, Epilepsy, NCC, Movement, Neuromuscular, MS, Neurodegenerative, Headache, Neurophys, etc...). Most neurologists subspecialize not because they have to, but again, most who go into neurology are genuinely in love with the field and want to become experts and contribute to a specific subfield.

6. Prestige is nice. We get tons of that from laypersons but not so much from our colleagues in other fields, haha.

7. Job market is great. There's shortage and it's growing. I don't think there will be issues finding a job anywhere in the country, at least not in the foreseeable future.

In regards to OP's question, neuro is not a competitive specialty. Your numbers look good. You are still a third year student have plenty of time to show interest in the field. Do a couple rotations, one being an away, and attend a conference.

IMO EM and neurology lay on the opposite ends of the spectrum: Doer vs thinker, generalist vs specialist, service vs brand. $/hr is better in EM no argument and EM is undoubtedly "sexier" than neurology. However, neurology is a more stable career and allows you the opportunity to advance and grow through it. You are an expert of an organ system and have "ownership" of your patients. Also, your shelf life as a neurologists is also longer than that of an EM physician.
I am slowly falling in love with Neurology this very second. I definitely need to speak to more people in the field and do a Neuro elective rotation next year. I hope I still like it by then.
 

Giovanotto

5+ Year Member
Jul 20, 2014
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Medical Student
I'm a neurology PGY-2 resident. I'll give my $0.02.

1. Like said above, the hours, the stress, and the learning curve in neurology residency is higher than most specialties. Only surgical and OB residents work more hours than we do. When on days, expect to work 10-12hrs 6 days a week. When on nights, 12-15 6 nights a week. Some programs still have the traditional call system where you do a 28hr shift Q4-7 depending on the program, but from what I'm hearing, most programs are moving towards the nightfloat system. Most programs are front loaded; PGY-2 is nearly all spent inpatient pushing 80hrs/week. PGY-3 tends to be 50/50 inpatient/electives. PGY-4 is similar to 4th year med school; third of it is hard work and the rest is electives and "research".

2. Also like mentioned above, neurology is love or hate type of field. It's not one that you could stomach or easy your way into. You NEED to love it or you'll be miserable doing it. Therefore, it's very self-selective. It draws those who are fascinated by complexity and intrigued by ambiguity, not necessarily those who have urge to fix every patient they encounter.

3. Life after residency is significantly better. Even in inpatient heavy specialties like stroke and neurocritical care, everyone now does shift work where you cover the service 1-2 weeks in the month while having the rest of the month either off or chill clinic.

4. Money is good. Not cards or GI good but better than general IM or other nonprocedural IM specialties. Surveys have us towards the bottom third of the list in terms of salaries but this is skewed by a significantly large portion of neurologists who work academia or those who see less than 15 pts a day. Nowadays, starting salary for neurohospitalist is ~300k. Outpatient is 250K+ but much higher ceiling than neurohospitalist. Academic salaries are pathetic (high 100's-low 200's starting salary).

5. Similar to IM, the field is vast and has multiple subspecialties (Stroke, Epilepsy, NCC, Movement, Neuromuscular, MS, Neurodegenerative, Headache, Neurophys, etc...). Most neurologists subspecialize not because they have to, but again, most who go into neurology are genuinely in love with the field and want to become experts and contribute to a specific subfield.

6. Prestige is nice. We get tons of that from laypersons but not so much from our colleagues in other fields, haha.

7. Job market is great. There's shortage and it's growing. I don't think there will be issues finding a job anywhere in the country, at least not in the foreseeable future.

In regards to OP's question, neuro is not a competitive specialty. Your numbers look good. You are still a third year student have plenty of time to show interest in the field. Do a couple rotations, one being an away, and attend a conference.

IMO EM and neurology lay on the opposite ends of the spectrum: Doer vs thinker, generalist vs specialist, service vs brand. $/hr is better in EM no argument and EM is undoubtedly "sexier" than neurology. However, neurology is a more stable career and allows you the opportunity to advance and grow through it. You are an expert of an organ system and have "ownership" of your patients. Also, your shelf life as a neurologists is also longer than that of an EM physician.
Damn it, man. I thought we were keeping neurology a secret.
 

Natural Killer Cell

Bone Wizard of COMwarts
2+ Year Member
Feb 17, 2017
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Medical Student (Accepted)
Sorry, I forgot that your years of experience as a program director at an elite program has given you a vast amount of insight. My apologies.
Is there sufficient sample size evidence of very elite programs in the past taking DOs consistently and over time losing their #prestige as a result? Like I said, it's not as if MDs are going to stop applying to Cleveland Clinic, or Harvard if the latter started taking bone wizards. Maybe I'm the stupid one here, but there doesn't seem to be much insight if they never take DOs because that supposedly lowers their rep, even though they have no proof of that happening....because they never have taken DOs. It's this type of archaic thinking that has prevented top-tier DO candidates in the past with higher scores, more research, better letters, etc., basically better than their MD counterpart in every way, from deservedly being at these places.
 
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Mar 14, 2018
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Interesting about Harvard: their medical school took a couple of DO students from UNECOM around 1980sish? Bc they wanted to focus on “holistic care” ( I know this bc my uncle was one of those DOs).
 
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Jan 2, 2019
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Is there sufficient sample size evidence of very elite programs in the past taking DOs consistently and over time losing their #prestige as a result? ike I said, it's not as if MDs are going to stop applying to Cleveland Clinic, or Harvard if the latter started taking bone wizards.
I think the point is that not many PDs want to be the one to test that out. Part of their job description is to build and maintain their "elite" programs with "elite" residents, and for them, it probably seems like easy risk management to avoid anything that they even suspect future residents (and others in academia) could question.
 

ciestar

All grown up! MS4!
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Sep 18, 2013
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I think the point is that not many PDs want to be the one to test that out. Part of their job description is to build and maintain their "elite" programs with "elite" residents, and for them, it probably seems like easy risk management to avoid anything that they even suspect future residents (and others in academia) could question.

This PD gave insight to this about a year ago
 
Jan 2, 2019
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This PD gave insight to this about a year ago
Yep, I remember reading that, it was pretty insightful
 
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Natural Killer Cell

Bone Wizard of COMwarts
2+ Year Member
Feb 17, 2017
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I think the point is that not many PDs want to be the one to test that out. Part of their job description is to build and maintain their "elite" programs with "elite" residents, and for them, it probably seems like easy risk management to avoid anything that they even suspect future residents (and others in academia) could question.
Yeah, dumber than I thought. Elite programs will continue to get elite applicants even if they take a DO every now and then. All it would take is for the top 10 programs to take in a few DOs, and whatever perception bias exists goes away. And those DOs that match there would have elite profiles. It’s backwards, outdated thinking honestly.
 

anotherro

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Jul 25, 2019
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This PD gave insight to this about a year ago
I mean, is this borderline inappropriate/unethical/illegal? If a student-physician applies w better board scores, publications, letters, and whatever else - and has their app thrown in the trash because of the school they went to - and you admit to participating in this systematic form of discrimination... I don’t know...

Not really my concern, if that’s their approach to shaping the future of medicine, then so be it, but it smells like somehow, esp after the merger, this could present itself as a future lawsuit if programs admit to it
 
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