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I heard that you do pretty much two intern years? Is this why?
Is it tougher than IM residency?
Is it tougher than IM residency?
MD & DO Why is neurology residency considered so tough?
- Thread starter taeyeonlover
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The first intern year is a prelim year with mostly IM they complete with their IM colleagues. The second year is informally your Neuro “intern” year since you now need to learn Neuro.
In many ways it’s harder, in some ways it’s easier. Neurology residencies are harder than IM because you will actually carry some responsibility of providing answers that have to be accurate. With IM you can consult.
Neurology is easier in that they don’t need the breadth of knowledge IM does and don’t need to have to deal with as much care coordination.
In terms of hours worked and stress levels, it’s highly dependent on the individual programs. For neuro, I have heard stroke call can be difficult but q4 call and night admitting or night ICU can be tough for medicine float too.
In many ways it’s harder, in some ways it’s easier. Neurology residencies are harder than IM because you will actually carry some responsibility of providing answers that have to be accurate. With IM you can consult.
Neurology is easier in that they don’t need the breadth of knowledge IM does and don’t need to have to deal with as much care coordination.
In terms of hours worked and stress levels, it’s highly dependent on the individual programs. For neuro, I have heard stroke call can be difficult but q4 call and night admitting or night ICU can be tough for medicine float too.
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Stroke call is brutal
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2 inpatient heavy intern years and definitely tougher than IM residency where I was.
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As a resident I remember seeing the neuro team still rounding mid afternoon when we had already wrapped up rounding on our inpatients and seen all new admits/consults.
I felt so bad for the psych resident on the team!
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Why is it brutal? I just have no idea as an MS4.
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Code stroke activations are becoming increasingly more common, especially as hospitals go through the steps of getting primary and comprehensive stroke certification. Code strokes can be activated anywhere and require timely response/evaluation, so you can be running all over the hospital all day.
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This. Simultaneous code strokes are the worst, especially if they're floors apart.
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Same, our neuro team essentially rounded all day because the consults just never stopped coming.
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Variety of reasons:
1) You do two "intern years," with the first one (medicine) usually being much more inpatient-heavy than the medicine categoricals
2) Often much higher patient acuity and constant volume. Constant ED consults, constant stroke alerts, etc. No one can wait. Our consult service sees probably 25-30 new patients and 30-40 follow-ups a day.
3) Very high patient volumes on primary service, more in line with surgical services. Neurology services typically don't have a "cap" like medicine services, so the stroke service may have 30 patients, half of which are ICU-level, with 2-3 residents.
4) Call is often brutal (and often a 24-28 hour shift). My personal record as a resident was seeing 34 patients in a 24-hour period, which is far from my program's record.
5) You have specialty knowledge about a field no one else in the hospital knows literally anything about, and so will constantly get called either about meaningless things, or questions to which no resident could possibly know the answer. Unfortunately, neurology knowledge bases are typically very limited even among other physicians, let alone nurses/APPs, so you get called ALL the time with questions.
6) This is institution-dependent, but many non-neurologists consider neurology to be a "subspecialty" of medicine and that neurology residents = medicine residents. This means you can't reject a patient for medical complexity (something any other service in the hospital can do), generally can't get much help from medicine consultants, and have more disposition fights than any other service. That patient in DKA with a sodium of 120 who looks septic, but also had a 10-second seizure? Guess who's going to get asked to admit the patient? This sounds like a minor issue, but can be very frustrating.
7) Also institutional-dependent, and becoming less of a thing these days, but due to all the reasons above, duty hour violations used to be a big issue at many places.
1) You do two "intern years," with the first one (medicine) usually being much more inpatient-heavy than the medicine categoricals
2) Often much higher patient acuity and constant volume. Constant ED consults, constant stroke alerts, etc. No one can wait. Our consult service sees probably 25-30 new patients and 30-40 follow-ups a day.
3) Very high patient volumes on primary service, more in line with surgical services. Neurology services typically don't have a "cap" like medicine services, so the stroke service may have 30 patients, half of which are ICU-level, with 2-3 residents.
4) Call is often brutal (and often a 24-28 hour shift). My personal record as a resident was seeing 34 patients in a 24-hour period, which is far from my program's record.
5) You have specialty knowledge about a field no one else in the hospital knows literally anything about, and so will constantly get called either about meaningless things, or questions to which no resident could possibly know the answer. Unfortunately, neurology knowledge bases are typically very limited even among other physicians, let alone nurses/APPs, so you get called ALL the time with questions.
6) This is institution-dependent, but many non-neurologists consider neurology to be a "subspecialty" of medicine and that neurology residents = medicine residents. This means you can't reject a patient for medical complexity (something any other service in the hospital can do), generally can't get much help from medicine consultants, and have more disposition fights than any other service. That patient in DKA with a sodium of 120 who looks septic, but also had a 10-second seizure? Guess who's going to get asked to admit the patient? This sounds like a minor issue, but can be very frustrating.
7) Also institutional-dependent, and becoming less of a thing these days, but due to all the reasons above, duty hour violations used to be a big issue at many places.
