Best/worst things about neurology?

[afugazzi]

I am starting med school in the fall and I'm interested in neurology. If you can forgive the intrusion by a not-yet-med-student, what are some of your favorite and least-favorite things about neurology? Also, what would you recommend for a new med student who is interested? I've shadowed a neurologist a couple of times and done some research with a neurosurgeon. I'm guessing just more shadowing and maybe some research in neurology? I have an interest in academic medicine, probably doing computational research or clinical research (love programming, hate wet lab research).

---

Members don't see this ad.

 

[Mattchiavelli]

I'll start off I guess and say that as a med student, the most off-putting thing was the neurological exam. It is the most involved exam of any organ system and it also requires a high degree of interaction to do a full exam (you will be pushing/pulling patients, sticking things in their mouth, doing verbal interview type things, walking them, having them do complex movements of their limbs, etc). I think being the typical perfectionist med student made it very frustrating for me at the beginning, coupled with the fact that being new to clinical medicine I wasn't super comfortable interacting with patients yet. It is also awkward to do the exam and record results at first but it's getting better.

I've started appreciating it more as I've gotten more comfortable with both the exam and patient interaction. There is also a personal style aspect to it that is appealing, since different neurologists will use different techniques of examination and every now and then someone you're working with will say "hey- have you tried this?" and all of a sudden you have a new weapon in your personal arsenal.

 

[danielmd06]

Welcome to the neurology forum!

My advice for someone considering neuro in your stage of the game is to relax and have fun. Work hard in your general med classes. If you want some serious neuro work then continue with research like you seem to have already started.

My favorite part of neurology is its focus on intricate anatomy and the plethora of fascinating presentations.

Least favorite would be the (sometimes heavy) psychiatric overtones to many of the neurological diseases that must be navigated with patients. I was never much of a fan of subjective complaints. I like hard data in medicine, and save subjectivity for art, music, and literature.

 

[typhoonegator]

Neurologists take care of the only organ system you can talk to. You will come to learn that this is both a good thing and a bad thing. Others have already said this in one form or another. I chose a subspecialty where most of my patients have tubes down their throats, so you know which end of the spectrum I came down on. That said, this is an incredibly nuanced field, where you can really look like a wizard to the uninitiated and a real healer to your patients.

Personally, I like it because it is a high-risk, high-reward specialty. You can give people their lives back, from carpal tunnel to sleep disorders to acute stroke. With that comes the risk that outcomes can be ludicrously bad (although hopefully not from carpal tunnel). If your goal as a physician is to bear witness to humanity at its best and worst, neurology will certainly give you that opportunity.

Welcome to the forum. Questions from the interested will never be unwelcome here.

 

[afugazzi]

Thank you all for your helpful responses I'm excited to start school and beginning exploring this and other parts of medicine!

 

[95439]

Thank you all for your helpful responses I'm excited to start school and beginning exploring this and other parts of medicine!

To add on to the above: I think the worst thing about neurology is 'learning the language' aka 'neuroscience'. If you enjoy learning all the fasciculi and tracts, you're destined to be a neurologist. If you tolerate them and understand they're a means toward an end, then you'll be fine as well. I know some people who actually hated neuroscience, but still enjoyed clinical neurology enough to want to join the profession (although I wouldn't want them as my neurologist lol).
The best thing about Neurology is everything else. It's the 'final frontier of medicine', there's so much going on in the field. Moreso than any other field of medicine that I know of right now. Genetic research in neuromuscular disease, functional modalities for interpreting and treating strokes. This field, if populated by educated, dedicated people, should experience growth like no other over the next several decades!!

 

[sarcoid]

To add on to the above: I think the worst thing about neurology is 'learning the language' aka 'neuroscience'. If you enjoy learning all the fasciculi and tracts, you're destined to be a neurologist. If you tolerate them and understand they're a means toward an end, then you'll be fine as well. I know some people who actually hated neuroscience, but still enjoyed clinical neurology enough to want to join the profession (although I wouldn't want them as my neurologist lol).
The best thing about Neurology is everything else. It's the 'final frontier of medicine', there's so much going on in the field. Moreso than any other field of medicine that I know of right now. Genetic research in neuromuscular disease, functional modalities for interpreting and treating strokes. This field, if populated by educated, dedicated people, should experience growth like no other over the next several decades!!

Interesting point... Going off of that, I'm looking for some good feedback/constructive criticism from attendings or residents for the following:

I am drawn towards Neurology because i am FASCINATED with the brain! Absolutely LOVED neuroscience in 1st yr. I got a high grade and it was the only subject that was 'fun' to learn. It was the one class during the past two years that seemed to come naturally to me.

That spurred me to get a little research experience, not much, but did a chart review for a large PP neurology firm which does clinical research (still unpublished, awaiting more data).

Here's my dilemma: I have shadowed Neurologists, anesthesiologists, surgeons, ER doc's, FP's & pediatricians. Definitely drawn towards procedure-based, acute treatment practices, which Neurology unfortunately is not.

I am wondering if I do choose neurology, if I might end up enjoying it with more time put into it.

 

[typhoonegator]

Here's my dilemma: I have shadowed Neurologists, anesthesiologists, surgeons, ER doc's, FP's & pediatricians. Definitely drawn towards procedure-based, acute treatment practices, which Neurology unfortunately is not.

Neurocritical Care. Procedure-based, hyperacute. Or consider neurosurgery.

 

[sarcoid]

Neurocritical Care. Procedure-based, hyperacute. Or consider neurosurgery.

Thanks for the tip! I might try a rotation in this, I'm also thinking I might find gen neuro practice more appealing as I get older. I mean in anesthesia, EM, & SURG, i can see a much easier burnout. And it seems as if I could enjoy neuro forever bc of such less strain on the lifestyle as those others do (EM working knights, weekends & holidays clear into my 50's... Plain sucks). Still have a year to decide...

 

[FictionalGirl]

Sarcoid,
I think burnout strongly depends on the person. I know a lot of bitter docs in neuro, EM, surgery, Optho, ENT, even Derm (wouldn't have believed it till I saw it.) So much depends on how flexible you are and willing to adjust your time commitments/salary to achieve the kind of life you want. My roommate and I just applied in two very different fields (i went neuro, she went er) and we're both planning on fellowships that give us the opportunity to work in a hospital or a clinic , solo or group, etc. It's the docs who get saddled with lifestyle debt and commitments that keep them from adjusting their work life who become unhappy. My friend doing ER is into both integrative medicine and interventional pain management. Lots of groups DON"T have you working nights when you're in your fifties. Some neuro groups have you working weekends. ER lets you work 5 days a month for a pretty good salary, neuro.... doesn't. Neuro doesn't make you work, in private practice, on Saturday at 10pm or new years eve. Trades trades trades. Well, it might, in some subspec's. I'm interested in stroke, research and neuromuscular. Both of us love things now that probably won't be as easy to pull off when we're fifty. Then we'll change it up a little. But that's just our natural inclination. Also, try to figure out what it is you like. My roomie REALLLLLLLLY resented call and got super cranky when she was on medicine, but was magically able to pull a bunch of random night shifts on no notice and less sleep when she was in the ER. Coffee consumption was pretty much the same

Figure out what yours is and choose the path that will keep you happiest. Catch is, it's hard to see the future of a specialty or of your personal life Good luck!

Thanks for the tip! I might try a rotation in this, I'm also thinking I might find gen neuro practice more appealing as I get older. I mean in anesthesia, EM, & SURG, i can see a much easier burnout. And it seems as if I could enjoy neuro forever bc of such less strain on the lifestyle as those others do (EM working knights, weekends & holidays clear into my 50's... Plain sucks). Still have a year to decide...

 

[neurologist]

Worst part, hands down: The chronic pain patients.

Best part: I'm not an internist.

 

[95439]

Best part: I'm not an internist.

 

[Acherona]

Worst part: touching feet
Best part: the only body fluid I have to deal with is clear and odorless