Random Neuro Questions

[postbacpremed87]

Advertisement - Members don't see this ad

What salary could one expect immediately out of residency as a general neurologist work 50 hr/wk in the South/Midwest? 230-240k?

Also how many hours per week do neurology residents work after intern year?

 

[typhoonegator]

The south and midwest are big places, so it depends on where. In underserved areas outside of academic institutions that's probably possible for an outpatient generalist, but might be reaching a bit for year 1.

Depends on the program. PGY 2 often work 80 hours per week, then decreasing from there in PGY 3 and 4.

 

[postbacpremed87]

The south and midwest are big places, so it depends on where. In underserved areas outside of academic institutions that's probably possible for an outpatient generalist, but might be reaching a bit for year 1.

Depends on the program. PGY 2 often work 80 hours per week, then decreasing from there in PGY 3 and 4.

Thanks Typhoon - I honestly do not want a surgical lifestyle and no other medical specialty appeals to me so I am definitely thinking neuro. A vascular or EMG fellowship would probably add 20-30k post fellowship, correct? Also, I meant places like OH or SC.

 

[typhoonegator]

Depends on how you bill and how your practice is structured, but EMG/NCS and reading vascular studies can increase revenue.

 

[Postictal Raiden]

Depends on how you bill and how your practice is structured, but EMG/NCS and reading vascular studies can increase revenue.

Typhoon,

I know you are a neurocritical care specialist, so could you please shed some light on the type of lifestyle and work hours of NCC? Do neurointensivists usually work a week on/a week off type of schedule (similar to that of medical hospitalists and intensivists)? What are the major differences between medical intensivists and neurointensivists? Also, do NCC specialists earn more general neurologists, enough to justify the extra two years of training and the more intense nature of the job?

 

[postbacpremed87]

Typhoon,

I know you are a neurocritical care specialist, so could you please shed some light on the type of lifestyle and work hours of NCC? Do neurointensivists usually work a week on/a week off type of schedule (similar to that of medical hospitalists and intensivists)? What are the major differences between medical intensivists and neurointensivists? Also, do NCC specialists earn more general neurologists, enough to justify the extra two years of training and the more intense nature of the job?

+1. I am going into medical school thinking neurology. Ask me again in two years to see if I changed my mind. I am thinking private practice with clinical neurophysiology fellowship, but neuroICU seems interesting.

 

[Postictal Raiden]

+1. I am going into medical school thinking neurology. Ask me again in two years to see if I changed my mind. I am thinking private practice with clinical neurophysiology fellowship, but neuroICU seems interesting.

I, too, am very drawn to surgery (especially neurosurgery) but I don't think I can tolerate the lifestyle. Neurology would be my other option, but I will want to pursue a procedural heavy fellowship to satisfy the "do-er" side of me. Therefore, NCC, or maybe pain medicine, are two subspecialities I may be interested in pursuing.

 

[postbacpremed87]

I, too, am very drawn to surgery (especially neurosurgery) but I don't think I can tolerate the lifestyle. Neurology would be my other option, but I will want to pursue a procedural heavy fellowship to satisfy the "do-er" side of me. Therefore, NCC, or maybe pain medicine, are two subspecialities I may be interested in pursuing.

Interventional Neuroradiology is a great option. Would you say that neurology self selects? One either loves or hates neuroscience.

 

[Postictal Raiden]

Interventional Neuroradiology is a great option. Would you say that neurology self selects? One either loves or hates neuroscience.

Yeah, I looked into interventional neuroradiology, and it seems a great field. However, the training is long. Neuro + NCC + INR that's 8 years.

I agree that neurology is a self-select field. Not many people can stomach neuroscience. Also, one aspect of neurology is that you get to manage conditions and treat patients that other specialists can't, so you often get dumped on. Combine that with having many unknowns and the lack of effective treatments to many neurological conditions. All these factors, in addition to being grossly underpaid for the amount of training and knowledge you have compared to other fields, make neurology not as appealing as other fields in medicine.

However, the challenges I mentioned above are the very reason that makes neurology an interesting field for me. While other people may see many unknowns and uncertainties, I see unlimited potential for creativity and innovation.

 

[postbacpremed87]

Yeah, I looked into interventional neuroradiology, and it seems a great field. However, the training is long. Neuro + NCC + INR that's 8 years.

I agree that neurology is a self-select field. Not many people can stomach neuroscience. Also, one aspect of neurology is that you get to manage conditions and treat patients that other specialists can't, so you often get dumped on. Combine that with having many unknowns and the lack of effective treatments to many neurological conditions. All these factors, in addition to being grossly underpaid for the amount of training and knowledge you have compared to other fields, make neurology not as appealing as other fields in medicine.

However, the challenges I mentioned above are the very reason that makes neurology an interesting field for me. While other people may see many unknowns and uncertainties, I see unlimited potential for creativity and innovation.

You can go through vascular and then it will be one less year. I think getting paid 250K+ mid-career to solve interesting puzzles about the most interesting organ in the body would be freaking amazing (coffee in hand while engaging in intellectually stimulating rounds ahhhh).

 

[AlbinoHawk DO]

You can go through vascular and then it will be one less year. I think getting paid 250K+ mid-career to solve interesting puzzles about the most interesting organ in the body would be freaking amazing (coffee in hand while engaging in intellectually stimulating rounds ahhhh).

You can get a 290k job right out of general neurology residency if you are willing to relocate. With a fellowship, you should be able to make at least 30-50k more.

 

[postbacpremed87]

I might change my mind, but I think I would like seeing a diverse patient population. Even still, I would do a clinical neurophys fellowship with the intent of doing a general neuro practice.

 

[typhoonegator]

NCC is a 24h a day job when you are on. I work less than 10 weeks a year, but I have a fully supported lab. Many jobs are for 16-18 weeks per year, because of burnout concerns if you work 50% or more, although there are definitely people who do that. In my academic practice, we request the weeks we want for each fiscal year, and can specify if we like doing more than one week at a time. We mostly do 7 day blocks. NCC tends to work more weekends than most neurologists.

The differences between Pulm/CC and NCC are mostly patient population, and the care model tends to be closer to SICU than MICU in many NCCUs because of the high proportion of neurosurgical patients, many of whom are post-op.

Pay is what you want it to be. Critical care time is usually billed in minutes per patient, and is much more RVU dense than office visits, although with office-based procedures and EEG and EMG and vascular reading it gets closer. But critical care people tend to do fewer weeks on service than many outpatient or hospital-based neurologists, again because you are on 24/7, and you aren't getting paid for all of those 3AM phone calls and the endless family meetings explaining why someone's husband won't get to watch their children grow up.

 

[Postictal Raiden]

NCC is a 24h a day job when you are on. I work less than 10 weeks a year, but I have a fully supported lab. Many jobs are for 16-18 weeks per year, because of burnout concerns if you work 50% or more, although there are definitely people who do that. In my academic practice, we request the weeks we want for each fiscal year, and can specify if we like doing more than one week at a time. We mostly do 7 day blocks. NCC tends to work more weekends than most neurologists.

The differences between Pulm/CC and NCC are mostly patient population, and the care model tends to be closer to SICU than MICU in many NCCUs because of the high proportion of neurosurgical patients, many of whom are post-op.

Pay is what you want it to be. Critical care time is usually billed in minutes per patient, and is much more RVU dense than office visits, although with office-based procedures and EEG and EMG and vascular reading it gets closer. But critical care people tend to do fewer weeks on service than many outpatient or hospital-based neurologists, again because you are on 24/7, and you aren't getting paid for all of those 3AM phone calls and the endless family meetings explaining why someone's husband won't get to watch their children grow up.

Thank you for the detailed response.

I understand that in academia, you could fill the rest of your year (42 weeks) with research, teaching, and administrative work. However, in PP, if you are working 18 weeks/year, what are you going to do with the other 34 weeks. I realize that you will need a week off after each week on, but that still leaves 16 weeks that are unaccounted for. Therefore, I'm wondering if there are models where NCCU coverage is divided between, let's say 4, partners where each one covers 13 weeks, takes 13 weeks off, and do outpatient neurology the other 26 weeks.

Thank you, again.

 

[typhoonegator]

Well, I don't know any NCC people that are in private practice. Most of us are in a hospital practice. The unit is usually divided among several practitioners, and in many units there are two attendings that split the ICU each week (each cover half of a large unit). If you're in a community hospital without teaching and without research, then a lot of intensivists are expected to do stroke work or hospitalist work, and there are administrative roles like quality assurance, directorships, etc. that need doing when you aren't on service. Your job fills the time. Very few NCC people are funded by the NIH, but many still do research projects or QA initiatives within their ICUs, which they manage when they aren't on service.

I don't get week off after each week on, I can assure you of that. I haven't taken a vacation in years.

 

[Postictal Raiden]

Well, I don't know any NCC people that are in private practice. Most of us are in a hospital practice. The unit is usually divided among several practitioners, and in many units there are two attendings that split the ICU each week (each cover half of a large unit). If you're in a community hospital without teaching and without research, then a lot of intensivists are expected to do stroke work or hospitalist work, and there are administrative roles like quality assurance, directorships, etc. that need doing when you aren't on service. Your job fills the time. Very few NCC people are funded by the NIH, but many still do research projects or QA initiatives within their ICUs, which they manage when they aren't on service.

I don't get week off after each week on, I can assure you of that. I haven't taken a vacation in years.

Thank you Typhoon for your informative response.

The "I haven't taken a vacation in years" is a little scary. However, if you are enjoying what do, then there's no point of taking a vacation, I guess.

 

[typhoonegator]

When you have babies, you will understand that taking vacation can be far more stressful than just working. And staycations are fake -- you just end up working.

 

[neurologist]

I haven't taken a vacation in years.

Seriously? You need to get a life, son. That's a prime recipe for burnout. Nobody is indispensible.

 

[typhoonegator]

Seriously? You need to get a life, son. That's a prime recipe for burnout. Nobody is indispensible.

Meh. I have a fast car and I garden on weekends.

 

[anbuitachi]

Hey Typhoon, when you say you work 24/7, and you work under 10 weeks, you mean 10 weeks of 24/7?? How does that work? Would you work 1 entire day, take a day off and do it over? I imagine you arne't working an entire week of 24/7... which would be no sleep for a week.

And do NCC make around the same as Pulm/CC (around 400k)

 

[postbacpremed87]

Hey Typhoon, when you say you work 24/7, and you work under 10 weeks, you mean 10 weeks of 24/7?? How does that work? Would you work 1 entire day, take a day off and do it over? I imagine you arne't working an entire week of 24/7... which would be no sleep for a week.

And do NCC make around the same as Pulm/CC (around 400k)

I have seen 350-400K+positions, but I am sure Typhoon can elaborate more than I can.

 

[typhoonegator]

I'm the attending 24/7 for the time allotted, usually 5-14 days. We have fellows in house 24 hours a day. I go home, but I'm always on call. And yes, sometimes that means that I'm awake for a long time, coming back to the hospital in the middle of the night and staying through the next day. There are no work hours for attendings. But it doesn't happen that often. Usually I get plenty of sleep.

One could make a lot of money in NCC, and some do. Most opt for sanity to prevent burnout. In academia, the money is substantially lower than private practice.

 

[Mattchiavelli]

Not to digress but RE: Original Post-

What salary could one expect immediately out of residency as a general neurologist work 50 hr/wk in the South/Midwest? 230-240k?

Yes, that's very doable. That's in the ballpark of some of the busier offers I've been getting from recruiters at this point, but TBH I'm not getting all that deep into them b/c I'm applying for a neurophysiology fellow position and have other stuff on my mind but that's in the range of some of those figures. That's what some of the faculty make where I'm at, though they are the lighter on the academic obligations- having some off service anesthesia residents help out with your inpatients is a bonus, but if you're deep into meetings and administration it doesn't pay as well despite the potential to be very fulfilling personally and professionally. Something you have to think about is call burden if you're not doing something hospitalist-esque where you have shift work- take more call, get paid more.

Specifically about south/midwest, it's in the "Stroke Belt" so there is an increased demand for Neurologists to match the increased workload.​

Also how many hours per week do neurology residents work after intern year?

As others have said it varies from program to program and rotation to rotation- I could have 40ish hours on a light outpatient or research elective, or 70ish on certain inpatient rotations. I'd say it's similar to IM where I am, except we stay in our call pool for outpatient rotations and they do not. Some places have graduated call schedules/home call and some don't. I can at least say that it's not as work-intensive as being a surgeon.​