Why does neurology have a bad rap?

[rae_97]

As a pre-med, I'm doing some research on different specialties that interest me (I know specialties shouldn't be my main focus right now but I enjoy looking into different future career possibilities) and one field that I keep going back to is neurology. Neurology seems like a fascinating area, correct me if I'm wrong but, depending on your area of expertise, aren't neurologists able to do a lot of different things such as help brain trauma patients, look into neuroendocrine issues, as well as help neurological disorders and even some mental disorders?

I guess my question is, do neurologists get to do all these things and why does neurology seem to have a bad reputation? I keep reading that the field is low-paying, exhausting as far as work hours and that neurologists don't perform many procedures.

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[NYCdude]

Patients have miserable conditions that you can't do anything about besides manage their symptoms (maybe.)

Neuro ICU was pretty cool though I thought.

 

[Donald Juan]

I don't think neurology has a bad reputation at all, at least not anymore than any other specialty outside of derm. It's not competitive because it doesn't pay as much as some specialties, but it certainly isn't the lowest and has a high ceiling depending on your practice. The work hours are not exhausting unless you want them to be, it is certainly not considered a tough specialty as far as work hours or residency go (keep in mind, most physicians in general work more than 40 hours a week so this is relative). It's not considered a procedure heavy field, which may or may not be a good thing for an individual. Depending on what niche you try to fill with your ultimate practice you could be doing a decent amount of procedures, but you're not gonna be operating 2-3 days a week like a surgeon or anything like that.

 

[VA Hopeful Dr]

Patients have miserable conditions that you can't do anything about besides manage their symptoms (maybe.)

Neuro ICU was pretty cool though I thought.

Thankfully that's much less true than it was 10 years ago. But stereotypes take a while to catch up.

 

[mistafab]

I really don’t think neuro has a bad rap at all. It is a unique field that only attracts people interested in neurology - a recipe for a good thing.

The only miserable neurologist I’ve ever met was an MD-PHD (n=20). He was more miserable that he wasted 5 years doing a PhD than anything else really, poor dude. An MD PhD would be miserable if you didn’t need your PhD. He loved neuro though lol.

 

[kb1900]

what makes up the ‘bread and butter’ of neuro? Is it consult full neuro exams? What kind of procedural stuff do neurologists do?

 

[Cognovi]

what makes up the ‘bread and butter’ of neuro? Is it consult full neuro exams? What kind of procedural stuff do neurologists do?

lumbar puncture

 

[Teppil]

what makes up the ‘bread and butter’ of neuro? Is it consult full neuro exams? What kind of procedural stuff do neurologists do?

Neurologist bread and butter is pretty much the most common neuro diseases, as you would expect. Strokes, dementia (Alzheimers), Parkinsons, headaches, and many developmental and later onset genetic disorders. One thing I didn't realize before starting medical school was neurologists are also the muscular experts in medicine (nerves and muscle go hand in hand), so they run clinics for to test a patients muscle electrophysiology.

It's a huge field, way larger than I realized (as is pretty common nowadays in every field). You don't do many procedures, but being a master of the traditional history and physical is key to diagnosing most problems, and can be really satisfying if you are really good in these areas. I worked with some neurologists before medical school and they did a lot of consults because any neuro symptom seen in an admit, medicine will consult them on (syncope, TIA, stroke follow up, dementia).

Things are rapidly changing in neurology, new treatments are coming out and the fields future looks really bright. Personally it's not my top choice (psych), but its a close second or third atm.

 

[Donald Juan]

What kind of procedural stuff do neurologists do?

EMGs, EEGs, lumbar punctures

 

[trobinsonmd]

I don't think it has a bad reputation at all... the pay is not that great, but that shouldn't mean it is worthy of a bad reputation... if you are interested in neuro but want to do more procedures, you can do an interventional neuro fellowship I think and you will be able to do some very cool procedures.

 

[eseemesiete]

Neurologist bread and butter is pretty much the most common neuro diseases, as you would expect. Strokes, dementia (Alzheimers), Parkinsons, headaches, and many developmental and later onset genetic disorders. One thing I didn't realize before starting medical school was neurologists are also the muscular experts in medicine (nerves and muscle go hand in hand), so they run clinics for to test a patients muscle electrophysiology.

It's a huge field, way larger than I realized (as is pretty common nowadays in every field). You don't do many procedures, but being a master of the traditional history and physical is key to diagnosing most problems, and can be really satisfying if you are really good in these areas. I worked with some neurologists before medical school and they did a lot of consults because any neuro symptom seen in an admit, medicine will consult them on (syncope, TIA, stroke follow up, dementia).

Things are rapidly changing in neurology, new treatments are coming out and the fields future looks really bright. Personally it's not my top choice (psych), but its a close second or third atm.

I have had a similar experience to yours during med school, and have had similar struggles choosing psych over neuro. Would you care to elaborate what made you favour psych?

 

[cutari]

Neuro's a specialty I've been interested in for a long time. I don't know why it's not more sought after!

 

[Treebeard]

I think it sounds great. Definitely high on my list.

Many people who aren't neurologists say there is nothing you can actually do for the patients besides diagnose them with something awful and then leave. Actual neurologists insist this is not true. My admittedly limited experience in neurology (just an M2 but I've done a lot of shadowing with them) tells me that it really depends on the field. Parkinsons, Epilepsy, MS, Migraine are definitely treatable or meaningfully manageable conditions. Stroke, Neuro-ID and N-ICU are are just downright cool. Things like ALS or glioblastoma are obviously more dire and less treatable, but if you're a research person that might draw you in those directions.

 

[VacheronConstantin]

Neurology = slow paced, boring, no money and no prestige.

 

[The Knife & Gun Club]

I was a neuro major in college and did neuro research during my gap year - the field is definitly fascinating and very broad.

My thoughts on why it has a bad rap: the bread & butter (Alzheimer’s, strokes, genetic disorders, brain injuries, seizure, Parkinson’s) cases are often very sad an not very treatable. Other than seizure & PD Most of the cases have a poor prognosis and few treatment options.

It’s terribly depressing to have to be the one to tell a family their son may never walk again or that grandma isn’t going to be able to talk anymore.

 

[LizzyM]

Treatment changes with time. What was untreatable in one decade becomes treatable in the next. Neurology is about to have some big breakthroughs. Prompt treatment for stroke is saving lives and function.

I've not known neurologists to have much to do with Alzheimer's disease. That is more often the task of internists and family medicine docs (and fellowship trained geriatric specialists within those specialties), and neuropsychologists with referral to geriatric psychiatry for behavioral issues such as depression and anxiety.

One thing I find remarkable about neurologists is their amazing powers of observation. They begin collecting clues when they call the patient from the waiting room and watch them rise from the chair and walk to the exam room. Once, at a wedding, I spoke with a neurologist about a fellow classmate who had a yet undiagosed muscle wasting problem. The neurologist watched him from the other end of the banquet hall and made a tentative diagnosis, an obscure degenerative neurological condition. (Twenty years later, our friend is somewhat disabled but still living independently.)

 

[VacheronConstantin]

Treatment changes with time. What was untreatable in one decade becomes treatable in the next. Neurology is about to have some big breakthroughs. Prompt treatment for stroke is saving lives and function.

I've not known neurologists to have much to do with Alzheimer's disease. That is more often the task of internists and family medicine docs (and fellowship trained geriatric specialists within those specialties), and neuropsychologists with referral to geriatric psychiatry for behavioral issues such as depression and anxiety.

One thing I find remarkable about neurologists is their amazing powers of observation. They begin collecting clues when they call the patient from the waiting room and watch them rise from the chair and walk to the exam room. Once, at a wedding, I spoke with a neurologist about a fellow classmate who had a yet undiagosed muscle wasting problem. The neurologist watched him from the other end of the banquet hall and made a tentative diagnosis, an obscure degenerative neurological condition. (Twenty years later, our friend is somewhat disabled but still living independently.)

See the flaw with this is that this "observation" is very time consuming, when coupled with Neurologist's inability to do procedures, translates to little income and prestige.

 

[LizzyM]

See the flaw with this is that this "observation" is very time consuming, when coupled with Neurologist's inability to do procedures, translates to little income and prestige.

Well, if you are going into medicine for income and prestige, you may be disappointed. If you enjoy diagnositic puzzles and a growing armentarium of drugs to treat neurological diseases, you may be challenged and satisfied.