- Joined
- Mar 16, 2016
- Messages
- 269
- Reaction score
- 143
Attendings and residents, are you happy in neurology? Would you choose neurology again if you could go back? Would you recommend your specialty to current medical students? Why or why not?
Happy in neurology?
- Thread starter painballer27
- Start date
- Joined
- Feb 27, 2013
- Messages
- 391
- Reaction score
- 381
My answer depends on the day. Some days Neurology is the best- can't believe how lucky I am to be doing this- helping people, solving puzzles and mysteries and making good money and respect!! Other days I want to pull my hair out after the third syncope consult. Or when I see a Derm midlevel making more money with better lifestyle than me.
Yeah I agree it's definitely a day to day thing. I love being a specialist and having the final word/being the expert. The workload can be daunting but managable depending on what you want your lifestyle to be.
Some days I feel helpless like there's not much I can do for my patient locked in with a BAO or ALS patient who is teetering on intubation. The GOC conversations can be taxing especially on the inpatient side.
Overall I feel like it's the most stimulating and interesting field especially with all the emerging research/pathologies. I would choose it again for sure.
Some days I feel helpless like there's not much I can do for my patient locked in with a BAO or ALS patient who is teetering on intubation. The GOC conversations can be taxing especially on the inpatient side.
Overall I feel like it's the most stimulating and interesting field especially with all the emerging research/pathologies. I would choose it again for sure.
- Joined
- May 27, 2021
- Messages
- 52
- Reaction score
- 56
Bump! Anyone else able to contribute?
I certainly wouldn't pick any other specialty, I'll put it that way. I also think after one survives residency which can genuinely be a miserable experience there are enough different ways to practice neurology that most people could be happy, find some niche that works for them.
Neurocrit
Full Member
- Joined
- Jul 17, 2022
- Messages
- 21
- Reaction score
- 26
Im happy in neuro ICU but I would not have been happy as another type of neurologist. I chose neurology with the known end point of neuro ICU rather than choosing neurology and then discovering neuro ICU. I was pretty miserable in residency and often wondered if I should have taken the anesthesia path to neuro ICU.
Whenever I felt like I shouldn't have done neurology I tried to take a step back and ask whether the consults or patients with real neurological problems were the problem. The answer was usually no. Neurologists have the burden of sorting out what is and what isn't neurological and due to that we spend the majority of our time dealing with non neurological complaints. It may be different in the community but in residency I also felt the neurologists opinion was demanded stat for everything but didn't come with much respect or appreciation. Probably because many of our consults are non neurological and the diagnosis of "toxic-metabolic" and recommending continued treatment of whatever the underlying pathology is (i.e. septic shock) is not very satisfying to the consulting team.
Whenever I felt like I shouldn't have done neurology I tried to take a step back and ask whether the consults or patients with real neurological problems were the problem. The answer was usually no. Neurologists have the burden of sorting out what is and what isn't neurological and due to that we spend the majority of our time dealing with non neurological complaints. It may be different in the community but in residency I also felt the neurologists opinion was demanded stat for everything but didn't come with much respect or appreciation. Probably because many of our consults are non neurological and the diagnosis of "toxic-metabolic" and recommending continued treatment of whatever the underlying pathology is (i.e. septic shock) is not very satisfying to the consulting team.
Last edited:
I agree whole heartedly with this. There is always this sense of urgency from people to get us to see a patient even sometimes as a condition for discharge which makes me feel like my time is wasted and I'm only there to diffuse liability. Recently I was urgently called to bedside because of a pupillary asymmetry that was noted on a patient only to have it be a surgical pupil, for example. Unreactive pupil that end up being prosthetic eye, asterixis in liver patient, etc.
Every single internist or E.R. doc you will meet has a passing familiarity with cardiology, GI, pulm, endo, I.D., rheum, etc. None of them are comfortable with even the most basic of neurological issues, which can be a drag. This interestingly leads to people calling us when they don't need to or not calling us when they should.
Am I happy in neurology? Eh. It's alright. It pays the bills and I don't hate it. Every now and then I get to see some really interesting pathology and make a difference in someone's life. Being (essentially at times) the only neuroscience expert in the hospital is frustrating however, especially when you try to advocate for a patient and you get strange looks from all other services.
- Joined
- May 27, 2021
- Messages
- 52
- Reaction score
- 56
A major theme of disillusionment from neurologists seems to be that there's too many non-neurological patients that they have to wade through before they see patients with genuine neuropathology. Is the number of patients with genuine neurological disease pretty small then? Or is it similar in volume to something like patients with genuine cardiac disease but there are few biomarkers that non-specialists can order to truly delineate between non-neurological vs neurological disease so neurologists get a disproportionate number of referrals for non-neurological disease so both the bull****:real-disease ratio and the overall consult volume is much higher for neurologists compared to other specialties?
I am in residency currently, and I do think some neuropathology and MRI findings are interesting. But, as a whole, I feel apathetic and indifferent to the field of neurology, and I am not excited about practicing neurology as an attending besides hoping that the workload would be less, I would have more free time, and I would make a bit more money.
- Joined
- May 27, 2021
- Messages
- 52
- Reaction score
- 56
Which year of residency are you in?
- Joined
- Feb 27, 2013
- Messages
- 391
- Reaction score
- 381
Yes that's true that we don't have a quick marker to rule out/rule in a non neurological disorder. One of my attendings used to say- You can never rule out anything in neurology (obviously hyperbolic)- but it has some truth to it. Also pretty much everything in the body is eventually controlled/connected by/to the nervous system.
That being said, what people mentioned above is not what every neurologist feels- Not to sound too idealistic because Clinical neurology has its issues like every field; I personally Love seeing weird/mysterious/functional patients that others don't know how to approach or handle. I Love being one of the few people that understand the nervous system and its disorders. I Love finding Zebras. I Love going into a patient room and being anxious because it could be so many different things, unlike most other fields where the differential can be counted on one hand. I don't know if the anisocoria consult will be a benign congenital/surgical/pharmacological issue or an aneurysm or increased ICP or others!!
In regards to residency, I don't know many people who were happy in neuro residency. I know many people who love being a practicing neurologist.
- Joined
- Mar 25, 2014
- Messages
- 109
- Reaction score
- 184
I think this definitely happens to other fields. The ratio of every non cardiac chest pain evaluation to real pathology for cardiologies is probably high.
