Job Outlook for Neurology?

[Alakazam123]

Hello everyone, I understand that there have been previous questions about neurology that were similar, but the last one that was posted was nearly 5 years ago. So I was wondering, to those who are involved in neurology, what the job outlook looks like? I find neurology to be very interesting, and personally suffer from a peripheral nerve disorder (which sparked my interest), but have found out that it is a low paying specialty. Apparently most neurologists make around 250,000/year which is less than the median value for medical specialties.

I am a little worried, that following my passion would end up meaning accepting a sub-par salary. Is it true hospitals won't pay most neurologists above 150,000/year? Why so?

I am sorry if I sound greedy. I understand that medicine shouldn't be done primarily for the money. But I also would like a good compensation. Is there any way to increase your compensation when working for a hospital? Or does one have to enter a private practice?

Two other questions:

1) Can you do two subspecialties in neurology? Like neuromuscular and stroke?
2) While doing residency, can you spend extra time with the Attendings beyond what is required to learn additional skills and make yourself more marketable?

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[Spinothalamic]

“I am a little worried, that following my passion would end up meaning accepting a sub-par salary“

-Yeah, at the end of the day, it’s a personal decision whether you want to spend your life doing something for which you have passion or to spend your life doing something just to make more money. Although neurologists don’t make as much as many other specialties on average, they typically make more than primary care specialties. For me, there are gradual diminishing returns with any additional salary after 200k but again it’s a personal matter. Unless you have hugeee amounts of loans (500k+) or stuck with an irresponsibly high mortgage or have other personal reasons, you should be more than fine with 200-250k annual salary.


“Is it true hospitals won't pay most neurologists above 150,000/year?”


-No. In fact, neurohospitalists are currently in demand and can find good salaries, 350k+, if willing to compromise on practice location, call schedule, etc


“Can you do two subspecialties in neurology? Like neuromuscular and stroke?”


-Yes. But whether or not you will use both specialties’ training and scope of practice maximally is less likely, especially if you are inclined to pursue academics which lends towards further subspecialization. But there are many people that you will come across within neurology who have done two different fellowships with a large variety of combinations


“While doing residency, can you spend extra time with the Attendings beyond what is required to learn additional skills and make yourself more marketable?”


-Yes. Reading EEG with extra time, spending time in EMG, Botox for migraines/dystonia, nerve blocks, reading vascular ultrasound can all lead to billable procedures/additional qualifications that could be useful when looking for a job

 

[Alakazam123]

“I am a little worried, that following my passion would end up meaning accepting a sub-par salary“

-Yeah, at the end of the day, it’s a personal decision whether you want to spend your life doing something for which you have passion or to spend your life doing something just to make more money. Although neurologists don’t make as much as many other specialties on average, they typically make more than primary care specialties. For me, there are gradual diminishing returns with any additional salary after 200k but again it’s a personal matter. Unless you have hugeee amounts of loans (500k+) or stuck with an irresponsibly high mortgage or have other personal reasons, you should be more than fine with 200-250k annual salary.


“Is it true hospitals won't pay most neurologists above 150,000/year?”


-No. In fact, neurohospitalists are currently in demand and can find good salaries, 350k+, if willing to compromise on practice location, call schedule, etc


“Can you do two subspecialties in neurology? Like neuromuscular and stroke?”


-Yes. But whether or not you will use both specialties’ training and scope of practice maximally is less likely, especially if you are inclined to pursue academics which lends towards further subspecialization. But there are many people that you will come across within neurology who have done two different fellowships with a large variety of combinations


“While doing residency, can you spend extra time with the Attendings beyond what is required to learn additional skills and make yourself more marketable?”


-Yes. Reading EEG with extra time, spending time in EMG, Botox for migraines/dystonia, nerve blocks, reading vascular ultrasound can all lead to billable procedures/additional qualifications that could be useful when looking for a job

Speaking of location, which locations usually offer the highest salaries in hospitals? Do you have to go to small-town areas, or can you make a good salary in the big city places? Furthermore, what do you think the future of neurology looks like (I know it's hard to predict 100%), but are salaries expected to increase at all w/i the next 10 years?

 

[deathmerchant]

Hello everyone, I understand that there have been previous questions about neurology that were similar, but the last one that was posted was nearly 5 years ago. So I was wondering, to those who are involved in neurology, what the job outlook looks like? I find neurology to be very interesting, and personally suffer from a peripheral nerve disorder (which sparked my interest), but have found out that it is a low paying specialty. Apparently most neurologists make around 250,000/year which is less than the median value for medical specialties.

I am a little worried, that following my passion would end up meaning accepting a sub-par salary. Is it true hospitals won't pay most neurologists above 150,000/year? Why so?

I am sorry if I sound greedy. I understand that medicine shouldn't be done primarily for the money. But I also would like a good compensation. Is there any way to increase your compensation when working for a hospital? Or does one have to enter a private practice?

Two other questions:

1) Can you do two subspecialties in neurology? Like neuromuscular and stroke?
2) While doing residency, can you spend extra time with the Attendings beyond what is required to learn additional skills and make yourself more marketable?

You are almost right about salaries- Academia in big cities(nyc/sf)- 150-180, small cities- (200-250). neurohospitalist in big cities(200-250), small cities(300-400). 'Successful' Private practice in big cities( 200-500), 'Successful' private practice in small cities(250-750). There are always other ways to add 50-100k to your income by doing extra calls, teleneuro, adding some procedures/EEG/EMG, clinical trials, representing drug companies etc.
But you are almost wrong about looking at it numerically. It is a much more complex decision. I assure you it won't matter if u are clocking 70 hours a week in a specialty you don't like and making 400k. After 250k what you gain in tax free salary, is usually not worth it in those situations.

Also future of neurology and medicine in general is very unpredictable, I wouldn't count on neurologists' salaries going up dramatically compared to other specialties.

 

[Alakazam123]

You are almost right about salaries- Academia in big cities(nyc/sf)- 150-180, small cities- (200-250). neurohospitalist in big cities(200-250), small cities(300-400). 'Successful' Private practice in big cities( 200-500), 'Successful' private practice in small cities(250-750). There are always other ways to add 50-100k to your income by doing extra calls, teleneuro, adding some procedures/EEG/EMG, clinical trials, representing drug companies etc.
But you are almost wrong about looking at it numerically. It is a much more complex decision. I assure you it won't matter if u are clocking 70 hours a week in a specialty you don't like and making 400k. After 250k what you gain in tax free salary, is usually not worth it in those situations.

Also future of neurology and medicine in general is very unpredictable, I wouldn't count on neurologists' salaries going up dramatically compared to other specialties.

How about Interventional Neuroradiology? I tried looking around for some programs, and found a handful (about 10-12) in which neurology background people are also accepted into the program. Does it sound practical to do 1 year Neuromuscular fellowship and the 2 year IR fellowship after residency?

Also what is the difference between vascular neurology and endovascular neurology? What are the career prospects for those things?

 

[Alakazam123]

“I am a little worried, that following my passion would end up meaning accepting a sub-par salary“

-Yeah, at the end of the day, it’s a personal decision whether you want to spend your life doing something for which you have passion or to spend your life doing something just to make more money. Although neurologists don’t make as much as many other specialties on average, they typically make more than primary care specialties. For me, there are gradual diminishing returns with any additional salary after 200k but again it’s a personal matter. Unless you have hugeee amounts of loans (500k+) or stuck with an irresponsibly high mortgage or have other personal reasons, you should be more than fine with 200-250k annual salary.


“Is it true hospitals won't pay most neurologists above 150,000/year?”


-No. In fact, neurohospitalists are currently in demand and can find good salaries, 350k+, if willing to compromise on practice location, call schedule, etc


“Can you do two subspecialties in neurology? Like neuromuscular and stroke?”


-Yes. But whether or not you will use both specialties’ training and scope of practice maximally is less likely, especially if you are inclined to pursue academics which lends towards further subspecialization. But there are many people that you will come across within neurology who have done two different fellowships with a large variety of combinations


“While doing residency, can you spend extra time with the Attendings beyond what is required to learn additional skills and make yourself more marketable?”

-Yes. Reading EEG with extra time, spending time in EMG, Botox for migraines/dystonia, nerve blocks, reading vascular ultrasound can all lead to billable procedures/additional qualifications that could be useful when looking for a job

Can you split your time between the two subspecialties? Like ask to do M,W,F in Neuromuscular, and Tu, Th, and Weekend in Stroke? or something like that?

 

[OurFord]

How about Interventional Neuroradiology? I tried looking around for some programs, and found a handful (about 10-12) in which neurology background people are also accepted into the program. Does it sound practical to do 1 year Neuromuscular fellowship and the 2 year IR fellowship after residency?

Also what is the difference between vascular neurology and endovascular neurology? What are the career prospects for those things?

Others more in the know please correct me if I am wrong but...
You must complete either a Neurocritical Care or Vascular Neurology/Stroke fellowship before you can complete an IR fellowship. Neuro IR is incredible but it is very competitive to get in and it seems to be extremely demanding as a career.

 

[Alakazam123]

Others more in the know please correct me if I am wrong but...
You must complete either a Neurocritical Care or Vascular Neurology/Stroke fellowship before you can complete an IR fellowship. Neuro IR is incredible but it is very competitive to get in and it seems to be extremely demanding as a career.

Damn it!! There go my dreams So with all my ambitions in mind, I'd end up doing, 4 years of Neuro Residency + 1 yr Neuromuscular + 1 yr Vascular/Stroke + 2 yrs Neuro IR (if I get in), so about 8 years in total. Dang, that's more lengthy than I thought.

 

[deathmerchant]

Damn it!! There go my dreams So with all my ambitions in mind, I'd end up doing, 4 years of Neuro Residency + 1 yr Neuromuscular + 1 yr Vascular/Stroke + 2 yrs Neuro IR (if I get in), so about 8 years in total. Dang, that's more lengthy than I thought.

Actually you don't need Vascular neurology( aka stroke) or neuromuscular or EEG or movement or any fellowship really to practice these fields. You can TRY to learn them in residency- esp programs with no fellowships. Most general neurologists take stroke call and manage stroke and even neuro ICU in small cities. A lot of people read their own EEGs and do their EMGs without formal fellowships. That won't be possible in big academic centers but elsewhere it should be fine.
Endovascular (aka Neuro IR) is a different story, you do need 3 years after residency.

That being said, if you want to be good at any of these(go to big names or academic centers) - you will find it next to impossible to stay on top of each field. Even in these fellowships, people end up focusing on individual pathologies.

 

[Alakazam123]

Actually you don't need Vascular neurology( aka stroke) or neuromuscular or EEG or movement or any fellowship really to practice these fields. You can TRY to learn them in residency- esp programs with no fellowships. Most general neurologists take stroke call and manage stroke and even neuro ICU in small cities. A lot of people read their own EEGs and do their EMGs without formal fellowships. That won't be possible in big academic centers but elsewhere it should be fine.
Endovascular (aka Neuro IR) is a different story, you do need 3 years after residency.

That being said, if you want to be good at any of these(go to big names or academic centers) - you will find it next to impossible to stay on top of each field. Even in these fellowships, people end up focusing on individual pathologies.

Splendid!! How do you spend time learning these extra skills, without seeming like a job "glutton," who's trying to steal from other students? Do you warm up to the attending, or speak to the Program Director?

So, then in academic institutions, no matter how many recommendations you have from your former attendings saying "Hey, this guy knows how to do EEG, and Stroke!!," they won't take you as seriously as a fellowship person?

And, based on your response, I am assuming that you are going to be allowed to split your time between two different sub-specialties in the hospital?

Also, I'm hearing of some programs that are taking in Neurology residents into an IR fellowship (not neuro IR). How common is this?

 

[deathmerchant]

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[deathmerchant]

Splendid!! How do you spend time learning these extra skills, without seeming like a job "glutton," who's trying to steal from other students? Do you warm up to the attending, or speak to the Program Director?

So, then in academic institutions, no matter how many recommendations you have from your former attendings saying "Hey, this guy knows how to do EEG, and Stroke!!," they won't take you as seriously as a fellowship person?

And, based on your response, I am assuming that you are going to be allowed to split your time between two different sub-specialties in the hospital?

Also, I'm hearing of some programs that are taking in Neurology residents into an IR fellowship (not neuro IR). How common is this?

You can learn these skills in your elective time. EEG, EMG, Stroke and other procedures are all part of residency training. EEG should be ok as you can just read as many EEGs and ask questions, but for EMG, Botox etc you might have to compete with fellows. It depends on individual programs really. I don't think you have to warm up or anything, just show genuine interest. Although I must say most residency programs are very busy, everyone is already working like a 'glutton'.


-No I don't think you will get into academic positions without fellowships. May be stroke or headache. For non academic you should be able to do whatever. Needless to say, like I mentioned before- It IS true that you won't be as good as a fellowship trained person in more than 1 field. It is too vast and things are changing too fast. Heck I can't keep up with 1 sub-specialty.


-Yes you can negotiate your contract like that. Once you get into the system, doesn't sound like a good idea in regards to Time:Money:Expertise. Best you can do is pick up Neurophys (EEG+ EMG) and take stroke and/or inpatient neuro calls. (if u want to practice multiple specialties).
Doing Neurophys fellowship+ IR or even Stroke fellowship does not make sense on so many levels, I honestly don't have the energy to write why.


-Yes, that is true. There are a few. I don't know how many. It is still a 3 year program though.[/QUOTE]

 

[Postictal Raiden]

You can learn these skills in your elective time. EEG, EMG, Stroke and other procedures are all part of residency training. EEG should be ok as you can just read as many EEGs and ask questions, but for EMG, Botox etc you might have to compete with fellows. It depends on individual programs really. I don't think you have to warm up or anything, just show genuine interest. Although I must say most residency programs are very busy, everyone is already working like a 'glutton'.


-No I don't think you will get into academic positions without fellowships. May be stroke or headache. For non academic you should be able to do whatever. Needless to say, like I mentioned before- It IS true that you won't be as good as a fellowship trained person in more than 1 field. It is too vast and things are changing too fast. Heck I can't keep up with 1 sub-specialty.


-Yes you can negotiate your contract like that. Once you get into the system, doesn't sound like a good idea in regards to Time:Money:Expertise. Best you can do is pick up Neurophys (EEG+ EMG) and take stroke and/or inpatient neuro calls. (if u want to practice multiple specialties).
Doing Neurophys fellowship+ IR or even Stroke fellowship does not make sense on so many levels, I honestly don't have the energy to write why.


-Yes, that is true. There are a few. I don't know how many. It is still a 3 year program though.

[/QUOTE]


I just want to clarify something. Are you saying that some Interventional Radiology programs (not neurointerventional) take neurology-trained applicants?

Thanks

 

[deathmerchant]

I just want to clarify something. Are you saying that some Interventional Radiology programs (not neurointerventional) take neurology-trained applicants?

Thanks[/QUOTE]

No, sorry. I probably read the question wrong.Obviously not IR. Neurointervention only.

 

[Postictal Raiden]

I just want to clarify something. Are you saying that some Interventional Radiology programs (not neurointerventional) take neurology-trained applicants?

Thanks

No, sorry. I probably read the question wrong.Obviously not IR. Neurointervention only.[/QUOTE]
Oh I see. Makes sense. Thanks

 

[NeuroNerd25]

How about Interventional Neuroradiology? I tried looking around for some programs, and found a handful (about 10-12) in which neurology background people are also accepted into the program.

Hey, just joining in on this thread. I'm applying for match 2019, also interested in neuro IR. would you mind sharing/PMing the list of residency programs that also offer Interventional Neuroradiology fellowships? Would be much appreciated.
Thanks in advance!

 

[Thama]

Hey, just joining in on this thread. I'm applying for match 2019, also interested in neuro IR. would you mind sharing/PMing the list of residency programs that also offer Interventional Neuroradiology fellowships? Would be much appreciated.
Thanks in advance!

Not every program that has a program accepts applicants from neurologists, and not every program that accepts applications from neurologists takes them seriously. Mamy programs, for reasons passing understanding, seem to prefer a candidate who has spent their entire residency in a dark room looking at pictures of patients over one who has spent large portions of their residency in hands on acute care of patients with vascular neurological problems for a program entirely dedicated to the hands on treatment of vascular neurologic problems.

 

[jd1031]

Hello everyone, I understand that there have been previous questions about neurology that were similar, but the last one that was posted was nearly 5 years ago. So I was wondering, to those who are involved in neurology, what the job outlook looks like? I find neurology to be very interesting, and personally suffer from a peripheral nerve disorder (which sparked my interest), but have found out that it is a low paying specialty. Apparently most neurologists make around 250,000/year which is less than the median value for medical specialties.

I am a little worried, that following my passion would end up meaning accepting a sub-par salary. Is it true hospitals won't pay most neurologists above 150,000/year? Why so?

I am sorry if I sound greedy. I understand that medicine shouldn't be done primarily for the money. But I also would like a good compensation. Is there any way to increase your compensation when working for a hospital? Or does one have to enter a private practice?

Two other questions:

1) Can you do two subspecialties in neurology? Like neuromuscular and stroke?
2) While doing residency, can you spend extra time with the Attendings beyond what is required to learn additional skills and make yourself more marketable?

Overall, the job outlook looks pretty good. However, the job outlook really depends on your subspecialty, work setting, geographic flexibility, and preferred work load/lifestyle. Someone looking for an academic cognitive/behavioral neurology position is going to have a vastly different experience than someone looking for a 100% inpatient community /neurohospitalist job, which is different than someone looking for a a 50/50 neuromuscular/general neurology mostly outpatient position with some stroke call.

No one in community neurology is gonna accept a full time position that only pays 150k. Most of the offers I've seen have been 250k - 300k, with some being as high as 350-450k in more "geographically undesirable" areas (I wonder what their call schedule is like). For neurocritical care, 350k seems to be common. Academics have been 150-180k, as someone posted above. Again, this all depends on things like billable procedures (EMG, EEG, botox, etc), local demand for your subspecialty, etc.

Also, in general, more procedures = more compensation.

To answer those last questions:
1) Yes, you can do 2 fellowships. I know someone who just did a movement disorders fellowship and is going to do a neurophys/EMG fellowship. Keep in mind the length of training, and the fellowships should be complimentary. IMO stroke + neuromuscular doesn't make sense.
2) Yes, and actually I think it's a great idea to gain extra skills during your elective time.