Think I Want to Do Neuro But...

[Dekkard]

I have questions. Lots of them. I've searched the forums and found some answers. I've talked to some faculty and residents, but given the weight of the decision it is to decide your given field, I want to solicit as much input as possible.

Throughout medical school, neuroscience was the one topic that just grabbed me. I enjoyed my neuro clerkship even more. My concern is can I actually make enough money as a neurologist to pay off my loans live comfortably. I hear stories of residents leaving for 250k to 300k jobs but is this actually the norm, or am I going to get paid like family medicine (180k range). No it's not all about money but money is an issue.

Also what kind of practice structure is most common these days? I know that neuro hospitalist is kind of a hot new beast, but do purely clinic gigs exist anymore?

I know a lot of the questions have been asked before, and I've read those threads but many are quite old. I just love neuroscience, and neurology from what I've seen. If I have to be working when I'm 70 keeping up with current literature I can think of no more a fascinating field. I just worry I will be sacrificing the ability to live a fun, happy life with my family to do so. So before you chastise me for another of "those" threads, just remember you were or were all a scared M3 at one point in your life.

Thankful and grateful for any and all input!

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[TUGM]

Neurology is an excellent field. Job market is great and you can generally get a job at a location of your choosing. You also really have the option of tailoring your practice to your liking. So yes, there are jobs that are purely outpatient. Doing some inpatient work alongside outpatient will definitely help the salary issue though. The average neurology salaries are probably 225-250K range a few years into practice, but depending on how hard you work and the amount of of procedures (EEGs, EMGs, sleep studies, botox) in your practice, it is not uncommon for some private gigs to get you into the 300+ range (you will be busy). Some fellowships remain pretty profitable (aka interventional pain) while not completely compromising lifestyle concerns that you have. Academic practice pays lower, but you'll have residents and fellows and protected teaching/research time that will make lifestyle better.

Neurology is fascinating, but it is not a high paying field. There's just no way around it at this point in time. The general principle: the more you work, the more you make.

There are a few other neuroscience related fields I would urge you to explore. You've had some exposure to neurology. Another you should explore is neuroradiology. The diagnostic aspect that makes neurology fun is also present, albeit, in a different way. Lifestyle and pay are good, and generally higher than neurology jobs. I would say if salary is a concern, you should pursue neurosurgery --> spine, but during residency your lifestyle would have to be significantly sacrificed.

Let me know if you have any other specific questions, and I will do my best to find some answers for you. Overall, I would urge you to pursue something you really find interesting and feel passion for. Loans are an issue, sure, but even making 180K/year, you can pay off your loans relatively quickly if you live below your means and will be able to enjoy a comfortable life - depends on your definition of comfort, I suppose.

 

[Achillees]

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[typhoonegator]

Day to day neurology doesn't always have a whole lot to do with neuroscience, just as day to day electrical engineering doesn't always have a whole lot to do with quantum physics. So make sure you're OK with the more mundane aspects of the field. This is true for any specialty, but pretty much everyone thinks neuroscience is pretty cool at some level, so I think the gee-whiz nature of people starting to explore our field is a bit more than most. I have a huge amount of student loans, and I can guarantee that even if your neurology salary gets translated into Harvard dollars, you can still live reasonably and make your payments (don't ask me how I know that).

Purely clinical gigs absolutely exist, in fact, they remain the norm for the majority of neurologists. You get way too much exposure to the academic style during training, even though they make up a small proportion of the practicing population. Neurohospitalist work is growing these days, but you can be primarily outpatient with minimal admitting call as well if that is your desire.

The only salary sacrifice (as you say) you'll be making is one of small degrees. Sure, you probably won't be making as much as some ortho spine docs (at least for now, and it's hard to predict how these things change), but you will be making more than lots of other people who live self-reported very comfortable lives. From my experience, salary is like Creatinine. The difference in lifestyle per unit salary between $100K and $150K is much larger than the difference between $250K and $300K, and you'll be on the good side of the equation no matter what you do (unless your other career option is GP pediatrics in Los Angeles or something).

Picking jobs based on expected salary (or giving that issue undue weight in decisions among specialties) is a dangerous proposition. There are plenty of young radiologists out there who can testify to that. Who knows? In 20 years neurology could be doing better than most specialties, or worse. We all want to make more money, that's perfectly natural. But you're going to be doing this gig a long time and there are going to be unpredictable fluctuations to things like reimbursement schedules. So pick something you really like. Unless you want to buy a racing team in your 30s, you'll have enough liquidity to pay down your loans and live a comfortable life.

 

[Dekkard]

These reply are awesome. I really appreciate you taking the time to do so. I really think neurology is the field for me, I just needed some panicky, sometimes hard to ask, questions answered. I was able to talk to a few recent grads of my home residency program and they all expressed similar sentiments to the ones above.

Thanks again!