when was neuro "competitive"?

[cyanocobalamin]

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Almost everything in "early" SF Match is pretty darn competitive; someone told me neuro used to be competitive and that's why it's in the early match, when was this so? and how did things change? and when will things become competitive again?

 

[BigTree]

I think someone told me it was in the 70s or early 80s that neurology was competitive; the reason being that they made a ton of money back then. Now that procedures receive the largest reimbursements, neurology is no longer competitive. I think it might slowly turn around though as new developments start to come around, but its very hard to predict. I've heard that neurology has become slightly more competitive over the last few years but I don't know how true that is or not.

 

[cliff]

When was the path switched from 3 years of medicine and then neurology residency (like other internal medicine specialties) ?

Was it when Neuro hitched up with the SF Match?

How many years did it used to be - (Medicine (3) + Neuro (?))?

thanks

 

[syrinx]

Was it when Neuro hitched up with the SF Match?

thanks

The Neurology Matching Program was founded in 1979. You can read a little about the history at the following link.

http://www.aupn.org/index.php?submenu=About&src=gendocs&link=AUPN_History&category=About AUPN

 

[GopherBrain]

While I agree with what people have posted so far, I don't think that the OP's link between the SF Match and competitiveness of of a specialty is significant. The common link between the various SF Match specialties is that they were formerly thought of as subspecialties in another field (surgery for most, medicine for neurology) and commonly still require a PGY1 year in that area. It just so happens that most surgical subspecialties are historically competitive, making the SF Match seem like a competitive match.

Let's face it. Three factors make specialties competitive - lifestyle, money, and prestige. You need to have at least two out of the three. Derm, for example, has money and lifestyle, whereas neurosurgery has money and prestige. You can play this game with most any specialty. Neurology retains moderate-to-high prestige (if you think being considered a brainy geek is a good thing anyhow), but only average lifestyle and money (I'm speaking in generalities, I know exceptions exist). Before neurology becomes competitive again, it will need a major cash infusion, which seems unlikely...

Personally, I'm happy that neurology is a non-competitive specialty. The low barrier to entry and the relative lack of gunners mean that your future colleagues made their specialty decision out of a real interest in the field, and they will comprise a broad group - not just the resume gods of derm...

 

[Bonobo]

Let's face it. Three factors make specialties competitive - lifestyle, money, and prestige. You need to have at least two out of the three. Derm, for example, has money and lifestyle, whereas neurosurgery has money and prestige. You can play this game with most any specialty. Neurology retains moderate-to-high prestige (if you think being considered a brainy geek is a good thing anyhow), but only average lifestyle and money (I'm speaking in generalities, I know exceptions exist). Before neurology becomes competitive again, it will need a major cash infusion, which seems unlikely...

I think it is great that you have such high opinion about neurology, but neurology does not get the prestige you believe it should. Compared to most specialties out there, except at the very top institutions, neurology probably only has low-to-moderate prestige. Until neurologists begin to focus on developing procedures that make dramatic changes in patients' lives, this won't change.

I also think your analysis of what makes a specialty competitive is wrong. Prestige has very little to do with it. Money is a requirement. The second is the number of spots available. And third is lifestyle. Neurosurgery would not be competitive if more spots were available. Anesthesiology is not very competitive despite the lifestyle and money simply because of the spots available. Cardiothoracic surgery, a very prestigious, money soaked field if not the most in both cases, is having a tough time recruiting candidates from general surgery because of lack of lifestyle and a relatively decent number of spots.

I think it is unfortunate that neurology is not more competitive. I would want people in the field who are driven to push neurology to advance like cardiology and GI, rather than a glut of neurologists who simply love the field as it is--an easy outpatient lifestyle with a basic science lab on the side.

B

 

[Rolandicfissure]

from sfmatch.org:

"In the 1940s, the lack of an appropriate appointment system for medical internships had led to a chaotic situation. In 1951, the decision was made to institute a centralized matching system. This system evolved into what is now the NRMP. In the 1970s, a similar situation had evolved for specialties starting at the PGY-2 level. At that time, the NRMP could not process such appointments. This led to the establishment of the Ophthalmology Matching program. The first Ophthalmology Match took place in 1978. Later, Ophthalmology was joined by Otolaryngology, Neurology, Neurosurgery and Plastic Surgery. In the 1980s, the service was expanded to include Fellowship Matches, first for various sub-specialties in Ophthalmology and later for several other specialties.

Thanks to the matching system, appointment dates, which initially had moved to April of the junior year or earlier, to January of the senior year. This gives applicants the chance to firm up their choices during various rotations, and can provide programs with more recent references. The system allows an orderly interview period during which both parties can explore their options without pressure for early decision making.

Over time, the services of our office have been expanded to other aspects of the application and selection process. In the 1980s, we developed a Vacancy Information System on which programs can list unexpected vacancies on our Web Site. This system has now been expanded to the World Wide Web. Our Web site also provides links to detailed information about individual programs so that applicants can better target their applications.

Completing many different application forms for different programs used to be an onerous and time-consuming task. For Ophthalmology, Otolaryngology, Neurosurgery, and Neurology, our office provides a Central Application Service. For applicants this means that they need to provide only one standardized application and one set of support documents; our office handles the distribution. For the training programs it has the advantage that they receive only complete files and that all files are in the same format."

 

[GopherBrain]

Bonobo - some of your points are well-taken, and perhaps I am willfully underestimating the role of $$$ in making specialty decisions, but I think that you are WAY off base with the comment:

I think it is unfortunate that neurology is not more competitive. I would want people in the field who are driven to push neurology to advance like cardiology and GI, rather than a glut of neurologists who simply love the field as it is--an easy outpatient lifestyle with a basic science lab on the side.

You are inappropriately equating the type of performance that allows someone to become a medical school "resume god" with the drive and innovation that allows a mature clinician to push his/her field forward. If this was the case, wouldn't derm be the most dynamic and excitingly new field in medicine, rather than the realm of steroid cream and punch biopsy? (Note, I am being somewhat sarcastic, please nobody PM me defending derm - that isn't the point).

Neurology is poised to advance more in the next 30 years than most any other field. Who will drive it forward? The unimpressive "glut" of current students and residents who are fascinated with the nervous system and choose to study it rather than chasing the almightly dollar...

 

[usmleed]

Bonobo - some of your points are well-taken, and perhaps I am willfully underestimating the role of $$$ in making specialty decisions, but I think that you are WAY off base with the comment:



You are inappropriately equating the type of performance that allows someone to become a medical school "resume god" with the drive and innovation that allows a mature clinician to push his/her field forward. If this was the case, wouldn't derm be the most dynamic and excitingly new field in medicine, rather than the realm of steroid cream and punch biopsy? (Note, I am being somewhat sarcastic, please nobody PM me defending derm - that isn't the point).

Neurology is poised to advance more in the next 30 years than most any other field. Who will drive it forward? The unimpressive "glut" of current students and residents who are fascinated with the nervous system and choose to study it rather than chasing the almightly dollar...

beautiful answer and i fully agree with you. i too am a neurology aspirant and sincerely wish to take this feild further, expand knowledge through research and, find ways to cure the incurable. I might be dreaming but thats where reality starts. best of luck to us

 

[als]

Neurology is poised to advance more in the next 30 years than most any other field. Who will drive it forward? The unimpressive "glut" of current students and residents who are fascinated with the nervous system and choose to study it rather than chasing the almightly dollar...[/QUOTE]

I hope to work with people who are think along the same lines... it's the only way to move forward...

 

[JudoKing01]

I am just starting med school and I really didn't have a clue as to what I wanted to do, and I'm sure I will probably have other ideas later on, but after reading more about neurology, stroke care, headache, sleep medicine, etc, I'm very excited to go to med school so I can learn more about it and hopefully go into a neurology residency. I'm pretty excited to see where interventional neurology goes with stroke management/prevention...etc.

 

[snowman8]

beautiful answer and i fully agree with you. i too am a neurology aspirant and sincerely wish to take this feild further, expand knowledge through research and, find ways to cure the incurable. I might be dreaming but thats where reality starts. best of luck to us

people choose to go into derm b/c of the lifestyle and money, and possibly b/c they find it interesting. This is what drives the "resume gods" alluded to earlier. And as far as breakthroughs in Neurology, what breakthroughs ? Neurosurgery is the only neurological field capable of actually treating CNS disorders. Oh wait, there is tpa.. that is the highlight of your training. How pathetic.

 

[Rite]

people choose to go into derm b/c of the lifestyle and money, and possibly b/c they find it interesting. This is what drives the "resume gods" alluded to earlier. And as far as breakthroughs in Neurology, what breakthroughs ? Neurosurgery is the only neurological field capable of actually treating CNS disorders. Oh wait, there is tpa.. that is the highlight of your training. How pathetic.

For someone who is just a 4th year who just matched into anethesia and probably has done at most 1 month of neurology, those are pretty big words. Dude, I would learn how to respect those collegues you will work with when you go start your internship in Baltimore. As a resident going into neurocritical care and neurointerventional, I have done rotations in neurosurgery, neuroanethesia, and neuroradiology. One has to learn how to work with all the different specialties for each has something unique to offer to the patients. I think you may think differently when you actually become a resident in anethesia.

 

[Methyldopa]

Neurosurgery is the only neurological field capable of actually treating CNS disorders. Oh wait, there is tpa.. that is the highlight of your training. How pathetic.

Spoken like a true surgeon. "If there is a problem, let me cut it out!"

Well along those lines, may I suggest a frontal Lobatomy for your evident personality woes!

Maybe that will make you play nice and respect other fields of medicine.

But why stop at your frontal lobes, let's include your amygdala for good measure.