What is the salary and lifestyle of Neurology life after residency? How is it different from general IM?

[studentdocmember]

Just wondering about the salary and lifestyle of neurologists... and how its different from general IM?
I hear neurologists make generally 300k starting vs 220k general IM and the lifestyle is ok?

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[scoopdaboop]

IMO, fields work similarly in the sense that you can work as a hospitalist (stroke fellowship docs I think) to make more money, or outpatient to make less with better lifestyle. But, difference is in neurology, 400k outpatient is pretty attainable, while in IM that would be hard to come by. Also, neurohospitalists can easily cross 500 reaching even 7.

 

[Neurogeneral]

compensation and lifestyle can be very variable. Obviously very academic jobs will pay less but in the community setting you can make much more. I think anything less than $300k is on the lower end of the median compensation in the community setting. It also depends on the locale and how hard you are willing to work.

In terms of lifestyle, this is also variable but the general trend I see for new residents looking for work is them wanting a good lifestyle AND also wanting to get paid. I got bamboozled into a q2 job at my health system a few years back. I am still there, doing the work, and not complaining to my superiors. The new fresh ones now being interviewed are outright refusing to do any hospital call/coverage without any hesitation. Those inclined towards inpatient want 7 days on/off and refuse to do any outpatient. It appears that the traditional model of neurology is fading IMO. People either want their weekends off or want their full 2 weeks per month. As to how many patients you will see when you are, it is usually 15 patients a day in either setting but obviously that can vary as well.

 

[deathmerchant]

Just wondering about the salary and lifestyle of neurologists... and how its different from general IM?
I hear neurologists make generally 300k starting vs 220k general IM and the lifestyle is ok?

This topic has been discussed ad nauseam in this forum and in IM forums. You make relatively similar money doing similar amount of work as both a neurologist and IM. Currently neurohospitalists are getting paid a little more than market value due to shortage. And that's why you can also develop a busy outpatient practice pretty fast in neuro. You can also do some procedures, do locums/tele work and take additional stroke calls as well to make more money. Salary will range from 250-350k on average. With a SD of 100k depending on many factors. There are some people making over 500k.

IM hospitalists on an average get 220-250k but they can also take extra shifts and nocturnists are paid lot more. In addition, many small town hospitalists round at nearby Rehab centers and nursing homes. Some even own/direct Nursing homes. Similar to neuro there are Hospitalists making over 500k. And obviously you can do Cards/GI and make way more money.

Focus on what kind of work you will enjoy doing more. Reimbursement after taxes is not significantly life changing.

 

[GuillainMollaret]

300 to 350k is fairly typical for a full time, outpatient neurologist. Anything less than 275k would be considered low imo. 350 to 400k and beyond is doable but you'll be busy.

Call is going to vary depending on where you work, but outpatient neurologists doing inpatient work or stroke call is quickly becoming a thing of the past, particularly with larger groups that have neurohospitalist support.

Residency is brutal, but outpatient neurology once you're an attending can offer a good combination of lifestyle and compenstation.

 

[Postictal Raiden]

What pays better, inpatient or outpatient?

I’m a PGY4, so I’m trying to figure out what I want to do. I enjoy both environments. At the same times, I find certain aspects about both to be equally annoying. The neurohospitalist path provides more time off, but when you’re on, you’re working hard. Outpatient provides the opportunity to have nights and weekends off.

Therefore, I’m conflicted. I can see myself thriving in either setting.

Of note, I’ll be doing a year of mixed neurophysiology training after residency to augment my diagnostic skills.

 

[Telamir]

Whatever you like doing most pays better.

 

[scoopdaboop]

Of note, I’ll be doing a year of mixed neurophysiology training after residency to augment my diagnostic skills.

So not fellowship? How you doing that?

 

[Postictal Raiden]

So not fellowship? How you doing that?

I am. Neurophysiology.

 

[xenotype]

Do neurology because you like the field, the patient population, and the pathophysiology. Don't do it because you might make $50k more than an IM hospitalist and you heard someone was making $600k taking no vacations and on call every night... money can always change

Reasons to like neuro-
1) primarily a consultant- not responsible for every problem a patient has
2) able to pick a patient population you like seeing- eg younger for headache/MS or older for movement
3) wide variety of ways to practice from inpatient to outpatient
4) decent short and long term expected demand for neurologists but this can always change with midlevels and increasing residency spots
5) wider ways to practice than one might expect from infusions, EMG, interventional and neurocritical care procedures to ability to work full time entirely from home- telestroke/EEG

most importantly- you need to have passion for neurological diseases and the patient population.

 

[deathmerchant]

What pays better, inpatient or outpatient?

I’m a PGY4, so I’m trying to figure out what I want to do. I enjoy both environments. At the same times, I find certain aspects about both to be equally annoying. The neurohospitalist path provides more time off, but when you’re on, you’re working hard. Outpatient provides the opportunity to have nights and weekends off.

Therefore, I’m conflicted. I can see myself thriving in either setting.

Of note, I’ll be doing a year of mixed neurophysiology training after residency to augment my diagnostic skills.

Employed inpatient pays more at low patient volumes with a lower ceiling (unless doing extra locums/tele etc).
Outpatient pays more with higher patient volumes and has a higher ceiling.

 

[Drhappyface]

Employed inpatient pays more at low patient volumes with a lower ceiling (unless doing extra locums/tele etc).
Outpatient pays more with higher patient volumes and has a higher ceiling.

I've heard generally outpatient is less pay due to a better lifestyle than being a neurohospitalist. Are you referring to this high ceiling in a private group setting?

 

[deathmerchant]

I've heard generally outpatient is less pay due to a better lifestyle than being a neurohospitalist. Are you referring to this high ceiling in a private group setting?

Hospitalist (7-7) jobs come in a wide range- from super cushy (like round on 2-3 new and 2-3 f/u anytime of day and go home in 2-3 hours and then get called maybe couple times from hospital/ICU!) to super busy (like 7-8 new and 7-8 f/u everyday and stay 8-12 hours in house and attend to code stroke in ER etc). Even though your RVUs in the former job are not much, salary difference in the above examples might not be a lot AND its not in your control how many patients you see- hence the lower ceiling.

Outpatient has a predictable 8-9 hour schedule that you can control. You can see as many patients as you want and do procedures. You could see >20 patients a day and do some procedures and make way more RVUs and hence lot more money. Esp if you do private practice or better a multigroup practice.