The other issue is if it would even be financially worth it. I currently make right around 300K/year and the idea of dropping back down to resident salary for a few years would only be palatable if I thought I would make up for the loss of income. I'm 37 now and want to retire around 65. Any thoughts out there?
I'd argue that it's not going to be financially worth your time and effort. A neurology residency is 3 years, plus 1 year of internship (which you might be able to skip based on your credentials). Then you may even choose to complete a fellowship, which averages 1 year in our specialty.
Let's say that during those years as a trainee you'll make $40-50k per year (call it $45k for simplicity) then let's try some very rough math.
So at a minimum you're looking at 3 years' lost wages totalling around $900k ($300k x 3) - $135k (or 45k x 3) equals
$765k in lost money. Or you can say you'll be in training again for a maximum of 5 years (full 4 years of residency plus 1 year fellowship) and you get $1.5 million - $225k (or 45k x 5) equals
$1,275,000 lost income for that amount of time.
Then you can start practicing as a neurologist.
A starting neurologist in private practice might expect somewhere between $225 to 300k average, but even if you started at $350k per year as a neurologist you would still have to work something like 15 years after residency (based on our abovementioned
3 year minimum) before you would have earned approximately the same amount of money you would have had just by staying in your current position. Then you would make an extra 50k per year over FP baseline. Granted, your neurology salary could grow too, but...sheesh. And things obviosuly get meaner if we're talking 4 or 5 years lost ground or if you're starting salary as a neurologist is a more reasonable (and more likely) $250k.
And lest we forget, the ACA is slated to increase primary care salaries at the express expense of specialty pay. So the playing field would be tilted even further against you.
Ultimately you would very likely still make a bit more money in neurology, but it would take a minimum of around 16 years in private practice (after residency) earning $350k per year before you started to actually clear the difference. So 37 + 16 equals 53 (if you started as a neurologist today). So add in that 3-5 years of residency/fellowship and you'd actually be...56 to 58 years old. And you would be retiring in 7 to 9 years after that. Let's say as a neurologist you'd make $50k over your current base of 300k per year (or about $350) and you get a whopping $350k (7 years x 50) that you'd net as a neurologist instead of an FP when everything is said and done. And this is presuming you start right away...
And remember, this all assumes you're making
$350k per year as a neurologist. This is at the higher end. Lower the numbers to $250 or $300k in neuro and you would break even (at best), or (more likely) even
lose money by changing to neurology (at least at this point in your career).
One final caveat. All this brainstorming presumes the numbers will all hold roughly the same (which we all know they won't) and that you would start neurology immediately (which you likely won't).
Now I am without a doubt the worst person in math on this entire forum but even by my rough calculations you can see that this is a bit dicey. Factor in the headache of being a junior resident again and all of the call nights and it's...just...not...worth...it. Unless of course, you are truly passionate about neurology and would do this no matter the financial implications. But I'm guessing you wouldn't have posed the question the way you did if the money didn't matter to you.
My advice? Stay where you are and have fun with the neurology cases you get in primary care. Plenty of neurology can be managed alone or in close concert if you're a great PCP interested in the subject matter.
Whatever you decide...good luck.
