What made you choose neurology?

[bigamygdala]

Honestly.

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[GuillainMollaret]

I wasn't interested in any of the surgical subspecialties.

I liked IM but found neurology to be intrinsically more interesting than the vast majority of the medicine subspecialties and something I really enjoyed learning about.

Lifestyle and pay are fairly middle of the road compared to other specialties which was okay with me.

I liked how diverse the field is and the option to do primarily inpatient or outpatient work.

Not something that factored into my decision to choose neurology back then, but it has become one of the most in demand specialties which is obviously great when looking for jobs and does put some upward pressure on salaries. And this may prove to be even more important in the post-covid era.

 

[Telamir]

The many many threads in which this question was asked and answered to varying degrees.

 

[dodobirddh]

the landscape of neurology is changing..

1. Many diseases hitherto untreatable are eminently treatable now... eg stroke, multiple sclerosis, dystrophies

2. The cognitive challenge to reach a diagnosis is unlike many other specialities.

3. Mobile apps are changing the way we learn and interact with new developments in neurology... some notable ones are listed below..

UpToDate - for current literature

Neurology Pro - for quick list of differential diagnosis

Software tools on mobile eg OKN strip

Calculators eg NIHSS

 

[DrSatan]

Neurology Pro is sort of pricey. Is it actually worth the purchase?

 

[dodobirddh]

Neurology Pro is sort of pricey. Is it actually worth the purchase?

I agree... its pricey. I was initially reluctant to use it precisely for that reason. A friend of mine who was using it regularly convinced me to try it out. They offer a 14 days free trial in case one opts for yearly subscription. I have been using it for more than a year now. It has its pluses and minuses. The biggest plus is the instant generation of differentials in a given clinical scenario. This has helped me more than once in not missing a critical diagnosis while drawing a list of DDs. Another plus is the relevant reference link outs to reputed journals like NEJM, JAMA, Lancet, Neurology, UpToDate etc... The biggest minus of course is the price. I found that the yearly subscription is available for half the price of monthly subscription. Wish it was cheaper. After using it for a year, I sheepishly went ahead and renewed my yearly subscription. In the end, the value it offers for the price may vary from person to person. My two cents...

 

[vancoremed]

the landscape of neurology is changing..

1. Many diseases hitherto untreatable are eminently treatable now... eg stroke, multiple sclerosis, dystrophies

2. The cognitive challenge to reach a diagnosis is unlike many other specialities.

3. Mobile apps are changing the way we learn and interact with new developments in neurology... some notable ones are listed below..

UpToDate - for current literature

Neurology Pro - for quick list of differential diagnosis

Software tools on mobile eg OKN strip

Calculators eg NIHSS

What is the new way that neurologists are treating stroke/ms?

 

[Thama]

Stroke has thrombectomy in addition to thrombolysis that became evidence-based about 5-6 years ago.

MS has new drugs coming out all the time, but the real game changer is likely to be bone marrow transplant which has started to be used at some centers.

Muscular dystrophies and triplicate repeat disorders (e.g. SMA, Huntington's, etc) are first in line for ASO-based genetic therapies which are proven for SMA and in very late stage trials for other disorders.

 

[neglect]

Honestly.

I was fascinated by the brain, by neuroscience, even liked neuroanatomy. Then it just clicked for me. It is a great fit for my brain: big picture stuff, complex data sets boil down to single diagnoses, a few axioms get you very far. I also loved that neurology didn't have great treatments, I thought that I could be part of helping develop treatments in these horrible diseases. As it happened, the ONLY trial I ever saw while in medical school was in a stroke patient who received an experimental drug or placebo. That was awesome. Some of the recent drugs and interventions have been developed with my help, such a great feeling.

I was also repulsed by many other fields of medicine, sometimes literally like surgery. I just hated it. While I respect anyone who does surgery, OB, gyn, anesthesia, it was very much not for me. I found radiology boring and to my immature mind it seemed like just a test. Not a good fit with my brain that seeks to consolidate and reduce problems to their core - radiology counts every little detail that's right or wrong.

I'm grateful to have found neuro. Hasn't been an easy road, but I'm now extremely privileged.

 

[dodobirddh]

What is the new way that neurologists are treating stroke/ms?

Here is the latest on stroke .... published in NEJM

Endovascular Thrombectomy with or without Intravenous Alteplase in Acute Stroke | NEJM
Stroke Rx : Endovascular therapy +/- thrombolysis

 

[Jimmy B]

Because it's the best!

On a more serious note-I loved the nervous system after the first year of med school. I did think about Internal Medicine but felt that it was too broad for my taste. I wanted to be more focused and specialized which is where Neurology fit really well. The wide range of lifestyle options was another attractive option compared to other specialties where you can't quite get that.

 

[dodobirddh]

the landscape of neurology is changing..

1. Many diseases hitherto untreatable are eminently treatable now... eg stroke, multiple sclerosis, dystrophies

2. The cognitive challenge to reach a diagnosis is unlike many other specialities.

3. Mobile apps are changing the way we learn and interact with new developments in neurology... some notable ones are listed below..

UpToDate - for current literature

Neurology Pro - for quick list of differential diagnosis

Software tools on mobile eg OKN strip

Calculators eg NIHSS

Another new tool in the offing... detecting papilledema with AI
Detect papilledema with AI - NEJM

 

[Postictal Raiden]

Another new tool in the offing... detecting papilledema with AI
Detect papilledema with AI - NEJM

Cool innovation. Hardly AI though. It’s merely a pattern recognition.

 

[Splenda88]

I am not in neuro but I considered it during med school

1) The subject matter is interesting and there is still a lot we don't know about the brain

2) You are a specialist in 4 yrs

3) Middle of the road in term of lifestyle

4) 300k+/yr salary for a relatively short residency

5) No one can even attempt to do what neuro docs do without a formal training (aka no midlevel encroachment).

 

[dodobirddh]

Neurology Compensation: Does survey help?
https://journals.lww.com/neurotodayonline/fulltext/2017/10190/Practice_Matters__How_Much_Money_Should_You_Ask.6.aspx

 

[Postictal Raiden]

the 2020 MGMA data (based on 2019 survey) says the median is 302-342k based on the region

 

[Peace of Mind]

Interesting
Someone asked a similar question on Reddit the other day and it was all about Oliver Sacks.
Here we have more nuanced responses based on real life considerations.

 

[Alcmaeon of Croton]

The intellectual component is probably the most attractive to me. Neurological systems are the most complex biological systems when it comes to an organism. Also, neurology or neural sciences in general intersect with psychiatry/psychology and humanities including religion; all interesting to me. I also didn't want to be a surgeon because, although super exciting, I can't live on adrenaline rush for the rest of my life and the intellectual part is minimal in comparison. Neurology is the most "exciting" non-surgical specialty with hematology and rheumatology coming in second/third place by a mile. Unfortunately, neurological diseases are similar (in number) to all other specialties combined owing to the complexity of the nervous system and the number of neural sciences is getting higher and higher to the point of making neurology and neuroscience huge umbrellas that will eventually, if not already to some extent, get fragmented.

 

[Splenda88]

the 2020 MGMA data (based on 2019 survey) says the median is 302-342k based on the region

That is a pretty good salary given that neurology lifestyle does not seem to be bad...

 

[bigamygdala]

the 2020 MGMA data (based on 2019 survey) says the median is 302-342k based on the region

is that number considered as net income or the basic income with add-ons not included usually? I saw posts of senior neuro attendings here earning 500k, is that possible?

 

[Telamir]

500 is possible but it really depends on where you work and how much you work. I know a few people making that much but it's usually doing things I personally wouldn't. Nothing wrong with it, just not my cup of tea. Mid 300's is certainly doable and I personally don't think I'd work for less than 300 unless it's an extremely chill job.

 

[bigamygdala]

500 is possible but it really depends on where you work and how much you work. I know a few people making that much but it's usually doing things I personally wouldn't.

things such as?