Neuropsychology vs Neurology

[aaamyd123]

I've been doing a lot of research on clinical neuropsychology but I haven't been able to find specific answers to my questions or how exactly it differs from neurology. I was wondering if anyone could tell me about the day to day life of a clinical neuropsychologist and what role they play in patient care. I'm more interested in being involved with diagnosing a patient rather than mainly focusing on treatment. Would it be worth it to go to medical school if I'm only interested in working with the brain, or would it be better to pursue a career in clinical neuropsychology?

---

Members don't see this ad.

 

[Diirez]

I'll give a reply from my basic understanding. I encourage you to use the search bar to find more detailed and better responses.

Neuropsychology and neurology are fundamentally different. Neurology is a specialty of medicine that deals with the diagnosis and treatment of brain conditions. Neuropsychology is a specialty of clinical psychology that deals with diagnostic assessment of cognitive and brain functions.

They are pretty much different for a variety of reasons. A neurologist is probably more treatment and diagnosis than assessment (neurologists often refer to neuropsychologists for assessments). Whereas a neuropsychologist is more focused in assessment than treatment.

There's also obviously two main paths to get there. One is to do pre-med, take the MCAT, get into medical school, do 4 years of med school and then residency and specialization.

For neuropsychology, do psychology, take GREs, get into Clinical Psychology PhD (or PsyD), usually takes around 5-7 years (6 yrs average) to complete classes, dissertation and internship, then do a 2 - 3 year post-doc and get licensed.

They are usually around similar time frames. You might want to try to shadow a neuropsychologist and neurologist (I've had problems trying to shadow a neuropsychologist) and see what their day to day life is like. Neurologists get paid significantly more money than neuropsychologists, but they also accrue more debt from school (assuming you go down the PhD route).

 

[GDM210]

Salary: Both are very high paying and prestigious occupations. They are also both extremely difficult careers to attain. A Clinical Neuropsychologist makes roughly 120 K in the USA. However, if a CNP also works as a Part time professor, then that would be extra money. Not to mention, a CNP who has their own private clinic can make much more. A Neurologist, makes roughly on average 200 K/year in the USA. So while they make more money, the difference is not significant.

Work: Both are extremely important. However, the Neurologist has more freedom when it comes down to treating a patient. A Neurologist, can prescribe and diagnose. A CNP, uses many Psychometric evaluations in order to gain results, as well as a treatment plan. However, the CNP cannot diagnose nor prescribe medications.

 

[psych.meout]

Salary: Both are very high paying and prestigious occupations. They are also both extremely difficult careers to attain. A Clinical Neuropsychologist makes roughly 120 K in the USA. However, if a CNP also works as a Part time professor, then that would be extra money. Not to mention, a CNP who has their own private clinic can make much more. A Neurologist, makes roughly on average 200 K/year in the USA. So while they make more money, the difference is not significant.

Work: Both are extremely important. However, the Neurologist has more freedom when it comes down to treating a patient. A Neurologist, can prescribe and diagnose. A CNP, uses many Psychometric evaluations in order to gain results, as well as a treatment plan. However, the CNP cannot diagnose nor prescribe medications.

Well, I guess I better tell all my supervisors how they're practicing outside their scopes and need to issue retractions for all those reports we wrote.

 

[pediatric_psydoc]

Well, I guess I better tell all my supervisors how they're practicing outside their scopes and need to issue retractions for all those reports we wrote.

@psych.meout should I call back the pediatric neuropsychologist from the prestigious university with whom I consulted on Friday and tell him the same?

We’ll be making a lot of calls.

 

[AcronymAllergy]

A neuropsychologist can diagnose within their scope of practice, yes. They cannot prescribe medications in states without RxP for psychologists, and in those states, they would need a masters degree in psychopharmacology and the appropriate license.

I would personally say $120k vs. $200k is a significant income difference. Also, the mean for an early career neuropsychologist (1-5 years) is closer to 100k than 120k. But at the same time, I am happy with my income as a neurposychologist. In many instances, if a neuropsychologist (or other psychologist) chooses to work 60-80 hours/week, they could likely make $200k/year.

 

[Mad Jack]

A neuropsychologist can diagnose within their scope of practice, yes. They cannot prescribe medications in states without RxP for psychologists, and in those states, they would need a masters degree in psychopharmacology and the appropriate license.

I would personally say $120k vs. $200k is a significant income difference. Also, the mean for an early career neuropsychologist (1-5 years) is closer to 100k than 120k. But at the same time, I am happy with my income as a neurposychologist. In many instances, if a neuropsychologist (or other psychologist) chooses to work 60-80 hours/week, they could likely make $200k/year.

The average neurologist is making $267k, it's a substantial earnings difference. With regard to OP wanting to diagnose rather than treat, neurology is famously diagnosis-heavy, as there is little that can be done for most neurological conditions outside of the acute setting, save for epilepsy. For things like stroke, you diagnose acutely and treatment is largely a one time thing followed by a few follow up visits after which the PCP usually takes over

 

[PsyDr]

Neurology:
1) treats
2) sees SUBSTANTIALLY more patients per day.
3) See patient populations that would be atypical for most neuropsych to include: migraine, essential tremor, torcollis, etc.
4) Wears a lot of bow ties
5) The median income is more than double neuropsych
6) the demand is higher/higher mobility
7) they’re getting robot assisted stuff for telemedicine soon.
8) work can range from outpatient clinics with bankers hours to neurointensivist in a hospital with high hours/shift work.
9) can order labs, imaging, eegs

Neuropsych
1) diagnoses disorders that need one to quantify cognitive abilities (eg, dementia). OR to differentiate psych issues from neurological issues.
2) sees few patients per day, due to the need to test each one. You interview the patient, do some neuro exam stuff, then hand them off to the tester, and then write looooong ass reports. Seriously, there is a lot of writing here. If you look on sdn psychology, you’ll notice the neuropsychs are always on here because they’re sitting in front of a computer half the time anywa
3) patient populations are usually: cognitive complaints from psych patients, diagnosing different types of dementia, quantifying cognition before/after patients undergo a procedure for things like epilepsy surgery, etc.
4) work clothes are weirdly casual
5) bankers hours are standard. Outpatient is more standard.
6) relative lower mobility. People do not seem to move very often in this field.
7) Many supposed neuropsychs try to do psychotherapy.
8) there’s some oddballs in the field that do imaging and stuff, but it’s not super common.


You probably want to go to medical school. Be aware that ANY diagnostic job is going to be full of very common diagnoses. The rare things are, by definition, rare. In neuro anything, rare usually means very bad (ie, fatal, screws up functionality so bad death would be better, etc).

 

[Therapist4Chnge]

I would personally say $120k vs. $200k is a significant income difference. Also, the mean for an early career neuropsychologist (1-5 years) is closer to 100k than 120k. But at the same time, I am happy with my income as a neurposychologist. In many instances, if a neuropsychologist (or other psychologist) chooses to work 60-80 hours/week, they could likely make $200k/year.

I agree with most of the above, but not the bolded part. If a neuropsychologist incorporates some legal work into their clinical practice, they can earn $150k-$200k or more per year w/o having to work crazy hours. There may be some weeks that are 60hr (clinical work and then having to squeeze in record review, deposition, and/or court time), but that doesn't have to be the norm.

I keep bankers hours most weeks, with some weeks sprinkled in that suck. I also don't accept commercial insurance or Medicare/Medicaid, so I can earn a higher income without having to see a high volume of clinical patients.

 

[PsyDr]

In many instances, if a neuropsychologist (or other psychologist) chooses to work 60-80 hours/week, they could likely make $200k/year.

They could make significantly more.

 

[foreverbull]

Another training distinction: my understanding is that neuropsychologists attend clinical or counseling psychology doctoral programs (before doing a two-year Neuropsych postdoc) and provide both assessments AND psychotherapy in their training years, so coursework is in psychological assessment, research/statistics, and psychotherapy practice/theory. They are licensed psychologists who can diagnose and treat mental illness and also Neurocognitive-related disorders, etc. in the DSM-5 via assessments.

Neurology training does not include any psychotherapy training en route to practice (psychiatry will to some degree, but it is likely to be very brief training, from what I’ve heard). It is the standard medical school path with the specialization at the end, the end result being what others have posted above, but no capacity to treat mental illness.

 

[AbnormalPsych]

4) work clothes are weirdly casual

Haha, true.

 

[futureapppsy2]

One thing about neurology and treatment is that many of the conditions that you'll see can't be treated. A friend's wife has one of the rarer dementias, and the neurologist basically told him, "there's nothing you can do but provide good supportive care until she dies in a few years. We have no way to treat it or meaningfully stall the progression."

 

[AcronymAllergy]

I agree with most of the above, but not the bolded part. If a neuropsychologist incorporates some legal work into their clinical practice, they can earn $150k-$200k or more per year w/o having to work crazy hours. There may be some weeks that are 60hr (clinical work and then having to squeeze in record review, deposition, and/or court time), but that doesn't have to be the norm.

I keep bankers hours most weeks, with some weeks sprinkled in that suck. I also don't accept commercial insurance or Medicare/Medicaid, so I can earn a higher income without having to see a high volume of clinical patients.

(For this and PsyDr's reply)

Oh, I wasn't implying that a neuropsychologist would only make $200k working 60-80 hours. Just that if the goal is to make $200k, it's very possible, and one way to get there is just to work more hours.

All that being said, the path of least resistance to that level of income (and to easier portability) is neurology over neuropsychology.

 

[CatLover&PsychEnthusiast]

Anyone going into either field should at least care about treatment and have a solid understanding of what treatment entails otherwise they will be a poor clinician. Remember that brain is not simply a brain, it’s attached to a complex human.


Sent from my iPhone using SDN

 

[deleted1003601]

Salary: Both are very high paying and prestigious occupations. They are also both extremely difficult careers to attain. A Clinical Neuropsychologist makes roughly 120 K in the USA. However, if a CNP also works as a Part time professor, then that would be extra money. Not to mention, a CNP who has their own private clinic can make much more. A Neurologist, makes roughly on average 200 K/year in the USA. So while they make more money, the difference is not significant.

Work: Both are extremely important. However, the Neurologist has more freedom when it comes down to treating a patient. A Neurologist, can prescribe and diagnose. A CNP, uses many Psychometric evaluations in order to gain results, as well as a treatment plan. However, the CNP cannot diagnose nor prescribe medications.

So incredibly inaccurate and misleading.

 

[clausewitz2]

Both neurologists and neuropsychologists contribute to diagnosis and treatment planning.

Contrary to popular opinion, neurology actually does have a lot of treatment options. Some are very simple, Eg b12 deficiency can cause memory problems. B12 supplementation can fix it. Some more complicated....in conjunction with neurosurgery, deep brain stimulation to address symptoms of pd.

I find both fields quite interesting but the experience is different. I’ve been involved in training both and I’ve done some of the training elements for neurology (some med school classes [recommended for neuropsychology], going on neurology rounds, neuropath rounds, psychiatry rounds). I’ve also worked in medical schools for most of my career. Neurology, to me is an exciting field. There have been all sorts of interesting treatment developments of late (relatively speaking).

My career is only a small snippet clinical. My clinic sees a range of adult neurological/psychiatric questions. The types of questions that one helps address include things like etiology identification (Eg is this persons symptoms consistent with a stroke location or is there suggestion of another process), recovery prognosis from acute neurological injury, medication and treatment recommendations, psychiatric overlays, effort, legal, etc....

my perceived advantages to neurology

- pays way more on average and to level of skill. Sort of saying the same thing, but you can be a below average neurologist and still make a lot of money

- Job mobility. Demand is higher. Easier to call your shot where you want to be.

disadvantages

- call
- hours tend to creep up
- patient churn (high numbers)
- more exposure to gross stuff
- more direct exposure to death

Neurologists are definitely sometimes involved with DBS programming but they are not the ones putting these devices in (and just to make clear for people reading this thread very early in their exposure to healthcare) neurosurgery is a completely different training pathway post medical school. Psychiatrists in some centers are also involved with DBS programming for what it is worth but this is less common.

Neurologists do a lot of treatment these days, especially in epilepsy and movement disorders. Recent trials also suggest that they should be intervening endovascularly in stroke so they can in principle be the ones actually pushing a catheter into someone's brain and pulling out a clot. It is safe to say that there are not and should not be neuropsychologists doing this.

Neurology can legitimately cure people. They also have to deal with a wide range of disorders that have inevitably terrible prognoses or frequently catastrophic outcomes. The point about churn is legitimate. You will be working more hours as a neurologist for sure but there are definitely ways to structure your job so that your call obligations are minimal and "neurohospitalists" doing entirely shift work are an increasingly popular option in some places.

Neurologists are not psychiatrists of course but they have to get pretty comfortable with at least some psychotropic medications unless you are in an AMC lousy with shrinks because depression is suuuuuper common in neurology outpatients and frank psychosis is not that rare (peri-ictal, MS). Also, about 30-40% of people presenting to neurology clinics end up having functional neurological symptoms, so neurologists at least need to know how to respectfully and tactfully get these people to a therapist or psychiatrist and will definitely end up interacting with them regularly.

Neurologists also get to make patients do weird tricks with the full neurological exam and very few medical specialties so often have the experience of walking into a room, getting the patient to do two small tasks, and being able to confidently declare exactly what imaging findings will be on MRI with a high degree of specificity.

 

[clausewitz2]

Neurohospitalist actually seems like a cool option too. Infinite inpatient/call sounds terrible on the face of it, but they often have favorable schedules where they'll be on for a couple of weeks and completely off for a week. Pretty diverse case exposure too.

Neuropsychology often has a role in DBS as well, pre and post operative evaluations, contribute to deciding whether or not to do it. What you do depends on what role you want to play and costs/benefits to you for achieving that.

I know at least a few neuropsychologists who are involved in DBS placement during operations, testing awake patients every time the neurosurgeons advance the stereotactic probe to figure out precisely where the stimulator leads should be placed. Cool if you're into that kind of thing.

 

[WisNeuro]

I know at least a few neuropsychologists who are involved in DBS placement during operations, testing awake patients every time the neurosurgeons advance the stereotactic probe to figure out precisely where the stimulator leads should be placed. Cool if you're into that kind of thing.

Dave Sabsevitz actually helped to create a digitized set of tests to perform during certain neurosurgeries for these kinds of applications. Last I knew a year or so ago I think they were running some trials with several hospital systems, not sure where it's at now.

 

[SportsNeuroPsych]

I know at least a few neuropsychologists who are involved in DBS placement during operations, testing awake patients every time the neurosurgeons advance the stereotactic probe to figure out precisely where the stimulator leads should be placed. Cool if you're into that kind of thing.

Yup - 2 of my former supervisors during my graduate training did this, along with WADA's, quite regularly.