Why don't more people choose NEUROLOGY?

[bigfrank]

Hello all,

I have talked to several PDs that state that "any score a US-MD brings to the table is 'strong'." Spots seem somewhat limited (~ same as Ophtho) but there is never too much competition for them.

Neurologists seem to make a very decent salary ($160K to start, $200-250K in practice) with a decent lifestyle (q4 of not too busy call). So what gives?

Is there a shortage of jobs, treatment options, a difficult patient population, or ???

Any insight would be greatly appreciated.

And, I am thinking of going into either Neurology or PM & R (outpatient). Is there a difference? IF so, can you expound?

Thanks, bigfrank

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[Winged Scapula]

Poor pay compared to procedural specialties, few procedures, caring for patients without any hope of a cure, few effective treatments, lack of prestige/glamour factor (ie, they're the pocket protector crowd of medicine), etc...

 

[bigfrank]

I would tend to disagree.

Their salary tends to be up to par with several of the 4-year residencies (and definitely higher than IM, FP, Psych, and even some IM subspecialties--Rheumatology, Endocrinology, etc.), and even some General Surgeons.

They tend to be respected by the public in my opinion. Eveyone I tell that I'm considering neurology seems to be extremely impressed.

???????

 

[Guitarzan the Jungle Man]

How could you spend your life studying patients you cannot help? that would be VERY difficult for me.

 

[ApacheIndian]

I've read that Neurologists are considered to be some of the most "cerebral" of all specialists. I also like this quote I've read:

Neurosurgeons know nothing but do everything.
Neurologists know everything but do nothing.
Psychiatrists know nothing and do nothing.

IMHO, you already answered your own question...

"Neurologists tend to make 200-250K, with q4 call..."

And this sounds "good" to you?

 

[Careofme]

Cuts,

haha...I'm stealing that quote once and for all. I saw that earlier then forgot how it went exactly and now I'm taking it!!!

Thanks!

 

[Goofy]

•••quote:•••Originally posted by Kimberli Cox:
•Poor pay compared to procedural specialties, few procedures, caring for patients without any hope of a cure, few effective treatments, lack of prestige/glamour factor (ie, they're the pocket protector crowd of medicine), etc...•••••While mainstream Neurology certainly lacks procedures, there is plenty of hands on for those who desire it. Neurologists can do fellowship in EMG or Pain for example. The latter offers as many procedures as any discipline.

I would debate the argument that Neurology lacks prestige. At least where I am from they are held in very high regard. These are exceptionally bright and well educated members of the team, that understand a lot more about the nervous system than I could ever hope to.

In terms of cure, you are correct in that the field has little in the way of meaningful cure at the moment. Again, I would debate the argument that it lacks 'hope' of cure, as Neurology is the front line of cutting edge research. Simply put, because there is so little that can be done today, there is so much that can be done tomorrow. It is a real frontier that will explode once even one mainstream treatment emerges.

Neurology salaries are highly variable, and I wouldn't put much stock into what is posted on these boards. However, it can be said that while some do exceptionally well, on average, they are more poorly compensated than their peers. There are ample opportunities to supplement income for those interested however.

 

[medstud721]

Neurology is being flooded with FMGs. More are less, they are the geeks of medicine with no prestige. In the world of medicine today, they aren't respected by other MDs. They are on par with psych/family practice.

 

[Ligament]

oh come on and be a little more respectful of this important field. This negative comments are immature.

 

[Vince]

not to sound too dreconian, but.......... <img border="0" alt="[Laughy]" title="" src="graemlins/laughy.gif" />

 

[bigfrank]

Dr. Cuts,

q4 call is usually taken from home and, from what I understand, is NOT that busy.

So yes, I do think that q4 home call and $250K/year is really good.

Compare that salary with Orthos and even some Anesthesiologists and it's looking pretty good, considering the hours and all.

 

[Goofy]

Hi Bigfrank,

I'm afraid the compensation you are quoting is not typical. There is a lot to like about Neurology, but the compensation certainly isn't the part I would highlight. While Neurologists can earn what you are quoting, the 'average' salary is much lower.

 

[bigfrank]

Dear Klebsiella,

Sorry, I may be quoting salaries from my neck of the woods. I am in the midwest and would like to end up in a small, family-oriented town in the midwest (fairly small, &lt; 50,000). That said, $250K in-practice is a number that is extremely feasible for me, assuming I choose Neurology and do enough EMGs, EPs, EEGs, etc.

Thanks for all you help, though.

 

[RainaNoelle]

I originally thought about neurology, but have since decided that it is not the field for me, even though in principle it is a very interesting field. I believe that watching people suffer from chronic diseases and conditions would begin to wear my mental state down after a while. Like stroke victims who can no longer communicate what their still-active brains are thinking; diseases where entire control of your body is stripped away slowly over time.

There will always be some good outcomes, but so many of your patients are chronic and the only treatments currently available for most are to make them somewhat more comfortable. I tip my hat to the doctor who can overlook this and make a difference in these people's lives...but I don't think that person is me. An unhappy doc wouldn't do anyone any good.

Fyi, my husband has multiple sclerosis, so I will never escape neurology entirely. Having seen the emotional toll the "low" times can wreak, I know I don't want to live any more "low" times than I have to. Luckily for us, he made a full recovery from the last relapse and has been relapse-free for more than 1-1/2 years! &lt;knocks on wood&gt;

Best wishes in your search for a specialty!

 

[Winged Scapula]

•••quote:•••Originally posted by bigfrank:
•I would tend to disagree.

Their salary tends to be up to par with several of the 4-year residencies (and definitely higher than IM, FP, Psych, and even some IM subspecialties--Rheumatology, Endocrinology, etc.), and even some General Surgeons.

They tend to be respected by the public in my opinion. Eveyone I tell that I'm considering neurology seems to be extremely impressed.

???????•••••They may be "up to par" but their potential for making much more than any of the procedural specialties is frankly very low. I'm not sure where the quote of $250,000 comes from but I would argue that this is NOT the average for most neurologists. You can do further training in Pain and EMG which will give you more money, but again not substantially more - if everyone will read my original comment you'll see I wasn't comparing the salary to other medical specialties, but rather to procedural ones.

My point was not whether they are respected by the general public (who tend to respect most specialties) but that among medical professionals they are not seen as glamorous. Yes, Neurologists are considered intelligent and amongst the most cerebral of the medical specialties; however, being regarded for your intelligence does not translate into prestige or glamour. Truth is, many who go into medicine want something that will bring them more monetary and personal/social rewards.

I am not trying to be negative as has been suggested. Rather it has been asked why people don't go into Neuro - all of the above are reasons given by AMGs for not going into Neurology - these are not my opinion but that of your colleagues. The influx of IMGs into the specialty likely deters *some* AMGs but I find it hard to believe that someone really interested in the field would really care about that. Most I talk to mention all of the above and include their personal distaste for "not helping people" and "dealing with a lot of death and intractable illness".

So please calm down natives - since I once considered Neuro as my field and spent nearly 5 years doing Neurodegenerative disease research I am hardly the enemy here.

 

[gatormed]

All of these comments seem to be taken to the extreme. Very few patients with cerebrovascular disease end up with Locked In Syndrome. Neurologists also handle outpatient management of relatively healthy patients. Anyone who doesn't want to treat chronic disease with no "cure" should stay out of the medical fields. A patient slowly dying of COPD, complications of diabetes, cancer, are just as bad or worse than anything that neuro has to offer.

With regards to the respect of other doctors. Medical doctors seem to respect neurologists since they sure don't know anything about the nervous system. Surgeons don't respect neurologists because they don't respect any medical specialty. Neurology is definately disrespected among medical students who currently want a hands on field with great pay and short hours (they should look into dentistry).

Now, glamour. The glamourous specialty in my neck of the woods is Ortho. The ortho residents are into body building and dating strippers. That may be glamourous but I sure wouldn't want to base my career on something like that. I save that stuff for my personal life.

 

[halothane]

=neuro, psych, fp ( very depressing)

= ortho, dermat

= radio, optho, ent

=anesth

= IM and subspecialities

= surgeons

 

[RainaNoelle]

I just wanted to clarify a bit.

There's a difference between not wanting to treat ANY chronic patients and not wanting to treat almost EXCLUSIVELY chronic patients with slim to no chance for improvement. I have no problem with patients with chronic and/or terminal illnesses, but do not want that to be my "bread-and-butter." And my examples were just that...examples. I wasn't trying to say that you'd see exactly those cases every day. Thank goodness not everyone wants to do the same thing though!! It would really suck if everyone wanted only one specialty!

Best wishes

 

[ApacheIndian]

•••quote:•••Originally posted by halothane:
• =neuro, psych, fp ( very depressing)

= ortho, dermat

= radio, optho, ent

=anesth

= IM and subspecialities

= surgeons•••••LOL! I think that about says it all folks. HAHA!

 

[ApacheIndian]

If I may...

:wink: - OB-Gyn

perverts all of them lol

 

[ApacheIndian]

•••quote:•••Originally posted by Careofme:
•Cuts,
haha...I'm stealing that quote once and for all. I saw that earlier then forgot how it went exactly and now I'm taking it!!!
Thanks! •••••lol sure Careofme but give me credit every time you utter it to ANYONE!

 

[analu]

halothane & Dr.Cuts, you guys crack me up!!! Funniest thing I've seen in a long time....

The derm guy looks a little TOO tanned, however!!!ha ha ha!

 

[bigfrank]

I have been speaking with Neurology placement firms.

FYI, "Neurologists who choose to practice in rural areas (&lt;50,000 people) are receiving 'fresh out-of-residency' offers of $160-$180K/year." This is the "income guarantee" and does NOT include production bonuses, etc.

Partners are easily making $250K/year. This does NOT go for large cities like SF, KC, St. Louis, LA, etc., but general surgeons do NOT make that much in such large metropolitan areas either.

 

[Winged Scapula]

•••quote:•••Originally posted by gatormed:
•All of these comments seem to be taken to the extreme. Very few patients with cerebrovascular disease end up with Locked In Syndrome. Neurologists also handle outpatient management of relatively healthy patients. Anyone who doesn't want to treat chronic disease with no "cure" should stay out of the medical fields. A patient slowly dying of COPD, complications of diabetes, cancer, are just as bad or worse than anything that neuro has to offer.

With regards to the respect of other doctors. Medical doctors seem to respect neurologists since they sure don't know anything about the nervous system. Surgeons don't respect neurologists because they don't respect any medical specialty. Neurology is definately disrespected among medical students who currently want a hands on field with great pay and short hours (they should look into dentistry).

Now, glamour. The glamourous specialty in my neck of the woods is Ortho. The ortho residents are into body building and dating strippers. That may be glamourous but I sure wouldn't want to base my career on something like that. I save that stuff for my personal life.•••••As another has noted, we aren't speaking of extreme examples - while much of IM is dealing with chronic problems, most of Neuro is.

I'll take exception to your generalization that Surgeons don't respect any medical specialists - while there may be personal exceptions, I see nothing farther from the truth. We work very closely with a number of specialists, whose advice we rely heavily on for our surgical patients: nephrologists, heme-oncologists, cardiologists, gastroenterologists, etc. Nearly every surgeon I've spoken to admits that they know little about general medical problems and need the assistance of medical specialists to solve complex medical issues in our patients.

 

[Neurogirl]

I'm not sure why some of you feel the need to ignorantly dispute the posted salaries (you obviously haven't researched the topic), but the numbers posted by BigFrank are indeed correct. Average starting salaries in the midwest (private practice) generally range from $150,000-180,000 base, plus production bonuses that usually add another 25-50%. Soooooo, that means that a newly minted neurologist can expect to make $187,500-270,000 the first year (not including signing bonuses and relocation), with more to follow after partnership. This info comes from fellow residents, attendings and recruiters. But don't take my word for it (that would be asking too much), take a look at the following site <a href="http://www.neurologyjobsonline.com" target="_blank">www.neurologyjobsonline.com</a> .

As for why more people don't choose neurology, in MY opinion (anecdotal evidence), some consider it too difficult a specialty to master, and never really investigate it as a specialty choice. Think about it...how many in YOUR med school class LOVED freshman neuro and how many just wanted to pass and get it over with? Others aren't aware of the many good treatments now available for a number of illnesses (BTW, I have no desire to post a dissertation defending this statement, as I have discussed this issue at length in previous posts...if you're interested...just do a search).

Finally, I would tend to disagree with the issue of "prestige". We may be seen as the "pocket protector group", but, in general, the folks I know are very highly regarded. Also, please remember that MANY physicians enjoy slinging smack at other specialty groups. More often than not though, it's the people in surgical specialties. They tend to have egomaniacal personalities which preclude them from viewing ANY other group as socially equal.

 

[Winged Scapula]

•••quote:•••Originally posted by Neurogirl:
•
Finally, I would tend to disagree with the issue of "prestige". We may be seen as the "pocket protector group", but, in general, the folks I know are very highly regarded. Also, please remember that MANY physicians enjoy slinging smack at other specialty groups. More often than not though, it's the surgical specialties. They tend to have egomaniacal personalities which preclude them from seeing ANY other group as socially equal. •••••Let's settle this once and for all. MY basis for the salary disputes is based on the average salaries for academic neurologists (which is much lower) and for those in large cities (which is much lower than those quoted).

While there have been advances in treatment, including new medications which can help slow the rate of DAT in the mildly demented, there still exists no effective treatment for many of the diseases seen in academia: ALS, PSP, CVA, Huntington's, MS and other muscle disorders (although again, progress is being made), etc. Its this that students see and feel frustrated by.

Its not necessary to bash other specialties in order to defend your own. My original statement was meant to point out the reasons students often give for not going into Neurology. As for it being "perceived as too difficult" I don't know of any who gave this reason, although I know some found it so during school but perhaps only because they weren't interested in it and didn't devote the time to studying the neural pathways. But your defense is understandable - I feel the same way when someone posts something nasty about surgeons (by way of example, one of the threads that says all General Surgery residents are dumb as stumps. Really now.).

Perhaps I misused the term prestige. As I stated in a later message, I believe neurologists are widely-regarded as very cerebral and intelligent. I have yet to hear another specialist, surgeon or not, disagree with this. My intent was not to say that neurologists are not well regarded as intelligent or hard workers but that the field is not considered a glamorous one - I shouldn't have used the term prestige to convey a similar feeling. I think you will agree that Neuro is not seen as a glamour field.

I'll bow out from this discussion as it seems to be getting a bit too heated, what with terms like "egomaniacal" thrown around (you might be interested in seeing my other post in which I admit that surgeons are viewed as the LEAST desirable socially. Even amongst surgeons! :wink: ).

 

[Dr Sardonicus]

What do you mean by "pocket protector" set? They are all geeks?

Also, I would be interested to find out what medical specialties people consider "glamorous."

 

[HanSolo]

•••quote:••• Also, I would be interested to find out what medical specialties people consider "glamorous." ••••Hmm...this one is easy :wink: It has to be NeuroSurgery

 

[Mercury]

I remember on of my senior professors discussing a newly diagnosed young patient with Motor neuron disease "Unfortunately all I can offer him is the diagnosis"
That pretty much summed it up for me while deciding against this branch.

 

[bigfrank]

Dr. Neurogirl,

thanks so much for your input and help. You're been a great friend over the last few months.

I appreciate you and the face that I can always receive honest and unbiased advice.

Best wishes!!!

 

[Goofy]

•••quote:••• Let's settle this once and for all. MY basis for the salary disputes is based on the average salaries for academic neurologists (which is much lower) and for those in large cities (which is much lower than those quoted).
••••I believe your numbers. My sources come mainly from those who recently signed contracts and journal listings all over the country. The former is perhaps the absolute best source. The exuberance of the above posters, citing fringe Neurology job sites, lends little credence to the average salary of a starting Neurologist. Further, those sites do more harm against the wild and atypical salaries claimed on this thread. Again, money can be made in this field. However, it remains one of the more poorly compensated specialties. Most medical students realize this quite early in their education. I believe this, in large part, sways would be Neurologists into more lucretive disciplines.

•••quote:•••While there have been advances in treatment, including new medications which can help slow the rate of DAT in the mildly demented, there still exists no effective treatment for many of the diseases seen in academia: ALS, PSP, CVA, Huntington's, MS and other muscle disorders (although again, progress is being made), etc. Its this that students see and feel frustrated by ••••Agreed. But at the same time, one man's garbage is another's gold. I think it's terribly misleading for other posters to parade the field around as one with meaningful treatments and cures. It isn't. That doesn't make it a bad choice, and I hope others who so readily 'defend' neurology can see this 'criticism' for what it is. Certainly other fields have tons of chronic treatment and poor outcomes. But Neurology remains a field with exceptionally little in the way of meaningful treatment for an array of debilitating pathology.

•••quote:••• My intent was not to say that neurologists are not well regarded as intelligent or hard workers but that the field is not considered a glamorous one - I shouldn't have used the term prestige to convey a similar feeling. I think you will agree that Neuro is not seen as a glamour field.••••I'm not certain any of the medical disciplines are really all that 'glamorous' to be honest with you. Frankly, I could care less how others pereive my chosen specialty, as long as I found it rewarding. This is precisely why I don't respond when posters attack my chosen profession, because I feel no need whatsoever to defend it.

 

[Goofy]

BigFrank said to Neurogirl:

I appreciate you and the face that I can always receive honest and unbiased advice.

I hope you see the fallacy in this rather comical observation. :wink:

 

[bigfrank]

Wow, another ridiculously ignorant comment.

I was referring to the FACT that neurogirl is basing her UNBIASED opinion on the FACT that she has talked to residents, PDs, recruiters, etc. when she makes her statements.

SHE has no vendetta against the field of neurology as many other apparently do.

 

[Goofy]

•••quote:•••Originally posted by bigfrank:
•Wow, another ridiculously ignorant comment.

I was referring to the FACT that neurogirl is basing her UNBIASED opinion on the FACT that she has talked to residents, PDs, recruiters, etc. when she makes her statements.

SHE has no vendetta against the field of neurology as many other apparently do.•••••Lets get this straight. You claim a self proclaimed neurology resident's opinions are unbiased fact!?!

I'm afraid in your madness, you have come to some rather absurd conclusions. You are entitled to absurdity. Enjoy

 

[Neurogirl]

Klebsiella,

Where to begin...? First of all, am I biased? Of course. Am I a liar? I think not! Secondly, a question. Correct me if I'm wrong, but aren't you a 4th year student/recent grad/soon to be grad? Are you so "knowledgeable" about ALL specialties or is neuro a special interest? Just how many recent neuro grads have you talked to?

Regarding the "fringe" web site I posted, you might want to peruse the main site <a href="http://www.physicianrecruiting.com" target="_blank">www.physicianrecruiting.com</a> . I would hardly call it "fringe". But while we're talking "fringe", might I recommend another site? It's called the American Medical Association. In a report from 1997 (sorry, but I didn't have the time or interest to find a more recent article), they site the MEDIAN (not mean) income for neurologists to be $175,000. In keeping with the definition of MEDIAN, this quote would certainly account for the lower incomes of academic and salaried specialists as well as the much higher incomes of private practice neurologists, especially those in the midwest, which is the geographic location quoted by both myself and BigFrank.

As far as type of practice is concerned, the bread and butter of neurology is stroke, TIA, migraine, seizure, tremor, MS, GB, pain mgmt, peripheral neuropathy, vertigo, parkinsons, encephalopathy, etc. For the most part, all of these conditions have effective treatments and/or management strategies. The zebras of neuro are ALWAYS used as evidence of the morbid nature of the specialty, but in reality, they are not encountered on an every day basis.

In closing, I don't pretent to be an expert in all specialties...just my own. It would behoove you to do the same.

 

[Goofy]

Hi Neurogirl,

You said:

•••quote:••• First of all, am I biased? Of course. ••••And this point is well understood. My above reply simply mocked another poster who stated your thoughts as 'unbiased fact.' This is ludicrous, but that doesn't take anything away from your well informed opinions. It just means that 'bigfrank' takes him/herself a bit too seriously.

•••quote:•••Am I a liar? I think not! ••••I never said as much. In fact, our dispute notwithstanding, I largely consider you to be one of the finer posters on this board. I'm sure that this will make you feel all warm and fuzzy inside. (choke)

•••quote:••• Are you so "knowledgeable" about ALL specialties or is neuro a special interest? ••••Careful, you are becoming almost as cynical as myself. I'm obviously someone who is not afraid to share opinions if I feel I have something to contribute. I have commented on a variety of fields because I have experience in a variety of fields. Is that enough license for you? Or perhaps having several close friends as well as family members passes muster? While you may feel your opinions are de facto law because you are training in Neurology, this simply isn't so. I know a lot about the field, have close contacts and family in it, and have in fact done quite a bit of research. I would venture to guess I have published more extensively in Neurology journals than some of the self proclaimed experts on this board.

Does that make me an expert? No. Does that make me someone with intimate knowledge and something worth contributing? You be the judge.

•••quote:•••Just how many recent neuro grads have you talked to? ••••Quite a few. I beseech you to do the same. This is the absolute best source of compensation packages, as well as snares that employers commonly use on sites that you cited. This applies to all fields. Neurology isn't special in that regard.

•••quote:••• I would hardly call it "fringe". But while we're talking "fringe", might I recommend another site? It's called the American Medical Association. In a report from 1997 (sorry, but I didn't have the time or interest to find a more recent article), they site the MEDIAN (not mean) income for neurologists to be $175,000. In keeping with the definition of MEDIAN, this quote would certainly account for the lower incomes of academic and salaried specialists as well as the much higher incomes of private practice neurologists, especially those in the midwest, which is the geographic location quoted by both myself and BigFrank. ••••Mode, median, mean. Statistics are a bunch of bull in my opinion. I'm certain you have read 'how to lie with statistics.' Once you do any meaningful amount of research, you will fully appreciate the nuances of my comments.

There are about 12 different national surveys of medical salaries. The differences are wild and incongruent. Notice how I tried to stay away from specific numbers, as they are exceptionally hard to peg down. Unfortunately, a generalization is all I'm willing to committ to. If you want to invest your confidence in overinflated, shallow quotes from a fringe web site, thats your business. You should be aware that many of those quotes were well below your stated 'median.' Some in the 120' and 130's.

The fact remains that as a whole, Neurology is one of the poorer compensated fields in medicine. That doesn't mean you cant make money, even a lot of money in the field. If you read my comments above, you will see that I elucidated this point quite well.

•••quote:••• stroke, TIA, migraine, seizure, tremor, MS, GB, pain mgmt, peripheral neuropathy, vertigo, parkinsons, encephalopathy, etc.••••I know we have debated this ad nauseum in other threads. If you find treating Neurological disorders meaningful and gratifying, more power to you. You certainly don't need my stamp of approval.

I have rotated through these services, worked in Neurology clinics, published numerous papers and didn't have the same experience. Neurology simply isn't for everyone. I'm certainly glad that bright, motivated people still want to enter the field. Don't take personal afront because others here find the field empty of meaningful treatment/cure.

•••quote:••• In closing, I don't pretent to be an expert in all specialties...just my own. It would behoove you to do the same. ••••This is a rather dangerous statement, wouldn't you say? Again you are setting the meter for discourse on this forum at expert. If you thought about it for a couple minutes, I doubt you would even pass that test. You are still early in training, no?

I don't profess to be an expert, that's something that takes years and years of training. I still have a wealth of experience and knowledge that I will share without reservation. I hope this imposition isn't too burdensom for you.

 

[droliver]

•••quote:•••Originally posted by halothane:
• =neuro, psych, fp ( very depressing)

= ortho, dermat

= radio, optho, ent

=anesth

= IM and subspecialities

= surgeons•••••<img border="0" alt="[Pity]" title="" src="graemlins/pity.gif" /> = Klebsiella
= Kimberli Cox

 

[Neurogirl]

Klebsiella,

Perhaps we should just agree to disagree. BTW, I do have a rather good foundation in statistics as my MPH is in epidemiology. For the most part, I must admit that I also view you as one of the more knowledgeable posters on this board (you and Kimberly) (hope you're feeling all warm and fuzzy too) . Do take a moment to look at the aforementioned web site...tell me what you think.

Hugs and kisses!

Neurogirl DO, MPH

 

[Goofy]

Hi Neurogirl,

I have actually seen that site before. I paged through a couple of specialties, and all of em had a wide range of compensation. Most slots didn't offer any kind of salary information. This is sometimes a rather sinister omen.

Anesthesia has a web site specifically for the discipline. Here you will find a higher tier of jobs, and certainly more of em. Again, the quality of these jobs is usually subpar, but many medical students get excited when they see the salary information. I always take information like this to peers/friends/family looking for employment in that discipline beforing relying on it too heavily.

It's hard to appreciate this until you actually start looking for gainful employment. I used to rely on web based service information until a couple of my buddies pointed out that 'only the crappy jobs' get posted there. While I don't think this is necessarily a rule to live by, it does seem that the better jobs are posted in more reputable places, like journals, and more importantly, word of mouth. I'm certain that your chief resident must receive enumerable postings, but these are likely to be academic slots.

One really neet thing about Neurology, in my view, is that the sheer dearth of specialists, makes it rather easy for ya to set up your own practice literally anywhere! (I have a business background, and entrepreneurial energy running in my blood )You don't need to rely on lucretive practices in remote locations to get paid well. Just a little business sense. It is truly one of the few professions left where you can hang a sign, and people will start coming. Think about it.

Here's a great big smooch right back at ya!

K.P.

 

[Vader]

I think many of the posters have oversimplified the field of neurology and the oversimplifications lead to misconceptions and misunderstanding.

It is true that many medical students find the field is not for them. However, there are quite a few misconceptions that are popularly thrown around by both medical and non-medical folks.

Admittedly, it is very difficult to deal with patients who have serious neurological disorders that affect the very essence of their humanity--the ability to move, sense, think, reason, and perform life's daily activities. For some diseases, there is no cure and there are not very good treatments. Yet for others there are excellent treatments.

The type of neurology that you will practice depends upon many factors, including location (i.e. urban vs. rural), patient population (socioeconomic, racial, etc), and whether you are in private practice or at an academic medical center. There are also considerable differences in how neurologists arrange their time. Some do purely outpatient clinical practice. Others serve primarily as inpatient attendings. Some incorporate clinical research, others basic science. Within the field, there are a vast array of subspecialties available, making it very easy to find your niche. Also, remember there is a whole field of child neurology, which involves a set of patients with unique problems.

I would be highly skeptical of anyone who talks trash about another specialty. We all do it at some point or another, but it should always be taken with a grain of salt. Historically, neurology has been seen as a very cerebral field, has been closely associated with neurosurgery, and has had intimate connections with the sciences. The great neurologists have left their mark on medicine and surgery. Names like Broca, Wernicke, Geschwind, etc, still resonate and inspire us to understand the organ system that gives us our unique personalities and individuality, allowing us to find our place in the world (whether it be neurology or any other profession).

 

[wake up sir your surgery is over]

Dear Neurogirl:

You are right about he neuro salaries. People like Cuts and ether just don't want to believe that people other than the high and mighty anesthesia and radiologists can make a ton of money out there. Althogh they are an integral, valuable, and highly skilled part of the medical world, they are the only one's on here harping about how much money they will make and showing disrespect and condescendence (sp?) to other specialties because the real reward for anesthesia for these people seems to be cash, whereas the real reward for other specialties might actually include helping heal a sick patient.

As for respect, I've never heard a neurologist referred to as a "pimple popper"

I guess more people don't want to go into neurology because it is mentally challenging and you might actually have to drive your BMW back to the hospital to see a sick patient once a week on call.

"Wake up Mr. Smith,, your surgery is over"
just my piece

 

[A-Phi-A]

One of the positions posted on neurologyjobs.com indicated that a person would have to see 60 patients a day. WTF!!!!

 

[gasdoc]

•••quote:•••Originally posted by wake up sir, your surgery is over:
•Dear Neurogirl:

You are right about he neuro salaries. People like Cuts and ether just don't want to believe that people other than the high and mighty anesthesia and radiologists can make a ton of money out there. Althogh they are an integral, valuable, and highly skilled part of the medical world, they are the only one's on here harping about how much money they will make and showing disrespect and condescendence (sp?) to other specialties because the real reward for anesthesia for these people seems to be cash, whereas the real reward for other specialties might actually include helping heal a sick patient.

As for respect, I've never heard a neurologist referred to as a "pimple popper"

I guess more people don't want to go into neurology because it is mentally challenging and you might actually have to drive your BMW back to the hospital to see a sick patient once a week on call.

"Wake up Mr. Smith,, your surgery is over"
just my piece•••••Dear Mr. "Wake up..."

Please do not use so much generalization about other specialties, particularly anesthesiology. Anesthesiologists and anesthesia residents, I doubt, condescend to other specialties and just think about money all the time. As you said yourself, we are an "intergral part" of the health team like all other members. If anything, our biggest fight is w/ the CRNAs. And, if anything else, we need the help of other physicians and surgeons to combat this constant threat of anesthesia and safety issue brought on by overzealous and overly vocal CRNAs who want independence.

I myself have the greatest respect for both surgeons and medicine people, including neurologists. If anything, I would consider the good anesthesiologist to be an internist at heart. After all, what we care most about the surgical patient is their cardiovascular, pulmonary, renal functions in the OR. Finding a way to effectively monitor CNS function is perhaps one of the many holy grills of anesthesia, in fact.

So, in summary, I will be one anesthesia doc who will have the utmost respect for the neurologist.

 

[dkwyler94]

OK, I have read a little in this site and seen some of the arguments that get passed around.

My position is I am just about done with my 1st year(year-round school ). The way my school does the 3rd and 4th year is you pick from 15 different regions across the country. I would prefer to have at least a rough idea of what I might be interested in before choosing my region to hopefully find a place with some residencies in the local area.

I did work on a rehabilitation floor of a hospital, so I got to work with some neurologists. Right now I think I would want a mentally challenging field where I can take the facts that are presented to come to a conclusion. Something that presents cases that are not always obvious and which I would have to research. I would also want a career where I felt I was helping people return to good health. Positive outcomes would be important to me(something that seems disputed on this list).

As far as the nerd part, I do consider myself a nerd, but my definition is anyone who would go to medical school is a nerd.

David

 

[gherelin]

I was very close to choosing neurology but was turned off by my 4thyear rotation. I had some expereince in my former life, as well as much much earlier when an undergraduate, so was already, I thought, fascinated by the field. During my rotation, however, which might just have been my school, I found that there was a lot of interest in salaries, and in pissing contests about who was better at neuroanatomy, neuroradiology, and quick diagnosing, but very little interest in the whole patient, his/her experience of the disease (one of the most interesting parts of neurology in my view), or the many theoretical and philosophical issues about language and mind and brain that are or should be stimulated by neurology. I also found that patients with odd symptoms (common in neuro) were often dismissed as conversion disorder just because no one could not understand the possible mechanism.

 

[geezer]

As a UK student, its interesting and bemusing to read all the comments and counter comments that have been bandied around about neurology. The arguments have gotten far too heated and many view quoted are too generalised and subjective.

The chronic nature of conditions and the perceived "lack of treatment" line of argument is often used against neurology however in reality, a large proportio of medical (as opposed to surgical) problems that patients present with in the western world are chronic in nature regardless of specialty. I think what people tend to forget is that as medics, what we generally tend to do is administer medication to relieve symptoms rather than "cure" pathologies. I do accept that the situation may be a little more polarised in neurology however with respect to research, the 90's was the "decade of the brain" and the potential for symptomatic therapies for neurological diseases is continually improving.

I myself do not intend to special in neurology but I am do find the field very fascinating, if a little cerebrally challenging. Here in the UK, neurology is a very respected field and it is extremely competitive to obtain a training post in. Infact, foreign graduates have almost no chance in obtaining a training post in neurology in the UK. Neurology in the UK has a lot of prestige (even though I think anyone who relies on prestige/kudos/respect etc to choose their specialty is very shallow). The funny thing is that specialties such as radiology and anaesthesia from which I gather from this forum, are highly sought fields after in the US have huge recruitment problems over here.

Anyway, to cut a long story story short, we should all stop getting protective about our own specialties and appreciate what other fields offer. After all, I do seriously hope that the reason most of us chose to enter this venerable profession of ours is to provide a good service to the sick whilst doing something we find challenging, fascinating and most importantly, stimulating and rewarding. All specialties have a role to play!!!

 

[paean]

As I am only entering medical school, I can't comment from the same types of experiences referenced by the previos posters. However, as a patient all I have to say is the cerebral nature of neurology, and being refered to a neurologist who actually thought about the symptoms I was presenting, instead of following the most common treatment guidelines for the illness I was labeled with, made an enormous difference in my "chronic" condition.

I'm now expecting to have no more trouble with the rigors of medical school than anyone else, something totally inconceivable before she suggested I try the med I'm on.

Am I cured? No. However, my life is close to what it was before the onset of my illness. The difference between being cured and feeling well is an odd and mostly irrelevant one in my everyday life. The only measurable difference would be a "cure" would mean I would no longer occasionally worry about the FDA pulling approval for my med, and my pocketbook would be $3/day heavier. I know that this is purely anecdotal, but not every patient a neurologist sees (and I wasn't a one time refferal) is going to be depressing and make the neurologist feel like they can't do enough.