10+ Year Member
- May 1, 2007
What were the main factors in you choosing neurology? What other specialties did you consider? Specifically, did many (any) of you consider psychiatry?
May I ask what you would have done differently had you had the chance?I liked the logic of neuroanatomy. I thought the presentation of many neurologic conditions was interesting. I saw that there was more ability to treat neurologic conditions than most people realized. There were several subfields of neurology that I found particularly fascinating and fun to deal with (neurophysiology, epilepsy). Unfortunately, what I didn't realize until it was too late was that most of general neurology consists of chronic pain management. I have been trying to distance myself from that aspect of things ever since, with limited success.
May I ask what you would have done differently had you had the chance?
Say, pursue a fellowship perhaps? Do you think that would have made a lot of difference? Do most neurology practices tend to allow their subspecialists to focus on their particular area? Or do most tend to "share the load" of the chronic pain management folks?
Keep in mind that there is a very broad range of what constitutes "academic medicine." Some programs are very large, others relatively small. Now maybe at the bigger programs, you can have more opportunity to subspecialize, but as I mentioned in the original post, we all make our compromises with regard to other factors relating to employment.Ever think about academic medicine?
That is understandable. I'm not even sure there is a thing as a "perfect" job. There will always have to be sacrifices/compromises, just a matter of finding which priorities you need to sacrifice the least number of (location, work hours, location, benefits, cost of living, proximity to family/friends...etc.) I just figured that "academic medicine" would give you your best shot at practicing solely within your subspecialty.Keep in mind that there is a very broad range of what constitutes "academic medicine." Some programs are very large, others relatively small. Now maybe at the bigger programs, you can have more opportunity to subspecialize, but as I mentioned in the original post, we all make our compromises with regard to other factors relating to employment.
You nailed it. Fix 'em up, and let 'em loose. Thats my motto.I think you'd be happiest in neurorads, especially if there is an interventional component. I get the sense you are not entirely keen on direct, ongoing patient care, and that's pretty much the whole game in neuro and peds, even in subspecialties. Even a small rads program can get you into a fellowship if you do well. On the flip side, interventional fellowships remain pretty hard for neurologists to get at this time and that's going to remain an ongoing battle. As for peds, . . . bleh. Sure the kids are cute, but I had the same reaction as you did -- dealing with the parents sucks.
No kiddin."Patient care interferes with practicing medicine."
There are 9 of us, plus a couple of PAs. Two of the MDs (one is the chief and one has been here forever, so they get to do pretty much whatever they want) seem to do almost 100% subspecialty work. The other MDs all do about 50% subspecialty work and 50% general neuro. Unfortunately, we don't have anyone with specific pain/headache interest/training, or anyone doing 100% catch-all "general neuro" in our group, so those patient populations (which are large) have to get split up between everyone.I'm curious if you wouldn't mind mentioning how large your practice is? Don't most of your partners refer to you the patients that fit under your subspecialty training?
Well, it's really a matter of preference. Honestly, some people love it, God bless them.aubreytex said:Thanks for the insight Neurologist! What makes dealing with chronic pain patients so bad?
Hey TerpskinsYou nailed it. Fix 'em up, and let 'em loose. Thats my motto.
It seems like everyone (including many folks in radiology) feels that interventional neuro will inevitably go the route of interventional cards (it might as well... not too many radiologists want anything to do with INR anyhow). But the general consensus I'm getting is that we're at least another 10 years or so before it catches on. Its all politics.