neuro - what clinched it for you

[bonvivant]

I'm a new fan to neurology and now an seriously considering it after finishing a neuro rotation just last month. Previously, I was thinking of IM. I am still not sure which path to take especially since I'm such a neuro newcomer and my board scores suck. I'm still waiting on Step 2 but my step 1 was around a 210. I can get decent letters for a neuro residency. The neurologist I was working with came from Cleveland Clinic. Passed third year just fine but no honors. So I guess I am qualified for less competitive neuro programs? The biggest issue though - I am still undecided what I want to do with the rest of my life. I'm currently doing a medicine sub-I right which is going OK. Some people have been trying to talk me out of neuro because patients don't get better in neuro. I'm not as pessimistic and saw a lot of neuro dz that improved while doing my neuro rotation. C'mon, how many people got better at your local internists' office in terms of their htn or dm?

Overall, I'm concerned because I'm not sure about neuro yet, don't have any neuro research under my belt, and competitiveness is somewhat lacking.

What helped you decide on neuro?

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[ectopic_thought]

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[Faebinder]

Research intensive field.

I love playing where is the lesion.

 

[neurosign]

Neurology is a rapidly evolving field with advances in diagnostic/therapeutic modalities. Especially with interventional neurology that will allow future neurologists to perform diagnostic angiographies, stenting, embolizations, and stroke treatments. Most neuroradiology programs have already been training neurologists and this will become more common. There was also a recent creation of Society for Vascular and Interventional Neurology which will lay the groundwork for training neurology residents in INR (interventional neuroradiology). A nice article can be found on training guidelines in the January 2005 issue of Neurology.

Other areas include, movement disorders with deep brain stimulation becoming an effective treatment for moderate to sever Parkinson's disease.

Epilepsy- newer AEDs and anti-seizure 'pacemaker' working in the thalamus; also intra-operative monitoring in neurosurgical cases has been expanding

Headache/pain- much overlap with internvetional pain programs run by anesthesiology, but a push to make it multidisciplinary since neurologists have more clinical knowledge to effectively treat acute/chronic pain; most pain programs will take neurology residents even now. Also, new headache fellowship established last year.

Sleep- lots of research going into this field, and already multidisciplinary with pulmonary and ENT providing their expertise but most programs run by neurology depts; numerous diagnostic modalities

Neuromuscular- a popular field for many residents due to diagnostic strategies with EMG/NCV, etc. Many programs offer combined clinical neurophysiology fellowships with training in EEG/EMG/NCV/polysmonography.

Hope that helps!

 

[llogg]

Neuro has a lot of chronic illnesses that allows for long term patient relationships to be built. Not a ton of acute hospital middle of the night stuff, which allows for a little better lifestyle. You're a specialist with an opportunity to subspecialize in several fascinating fields.

 

[bustbones26]

I'm a new fan to neurology and now an seriously considering it after finishing a neuro rotation just last month. Previously, I was thinking of IM. I am still not sure which path to take especially since I'm such a neuro newcomer and my board scores suck. I'm still waiting on Step 2 but my step 1 was around a 210. I can get decent letters for a neuro residency. The neurologist I was working with came from Cleveland Clinic. Passed third year just fine but no honors. So I guess I am qualified for less competitive neuro programs? The biggest issue though - I am still undecided what I want to do with the rest of my life. I'm currently doing a medicine sub-I right which is going OK. Some people have been trying to talk me out of neuro because patients don't get better in neuro. I'm not as pessimistic and saw a lot of neuro dz that improved while doing my neuro rotation. C'mon, how many people got better at your local internists' office in terms of their htn or dm?

Overall, I'm concerned because I'm not sure about neuro yet, don't have any neuro research under my belt, and competitiveness is somewhat lacking.

What helped you decide on neuro?

I too thought of IM, but realized later I just wanted to be a specialist and be good at one thing only. In my internship year when I had to do IM call, I quickly remembered why I chose neurology over IM. No, its not a competitive field, yet, and I stress the word yet. As neuro becomes a field where there are more procedures to do rather than playing find the lesion (i.e. more money to make), it will slowly become more competitive.

I do like that inpatient neuro keeps you on your toes. Yes, in outpatient neuro you will see the same headaches, MS, Parkinsons, etc. but on the inpatient service, you get to see some really cool stuff that is always new and fascinating.

So this is what I have come to like about neuro. I feel that if I did surgery, it would be cool to a lap chole or appy, the first 10 times I did it at least, after about 100, it would get boring. If I did medicine, after I told about the 100th obese person whose diet consisted of pizza and hamburgers that they need to get their cholesterol and blood sugar under control, it would find it boring. If I did OB/GYN, after delivering my 100th baby, it would get boring.

In neuro, there are plently of weird things that help break the boredom. One plus of the field.

 

[tec]

When I was deciding between IM and neuro, someone told me that you need to enjoy the bread-and-butter of the specialty. The thought of seeing CHF, COPD, HTN and DM over-and-over again was not appealing to me. But even in neuro, when you see multiple strokes, they are unique in their own ways. The rest of the bread-and-butter of neuro is intellectually stimulating. In neuro you can also build those long-term relationships that I found appealing in primary care.

 

[Methyldopa]

For me, it was all about the subject matter. What organ is as interesting/complex as the brain? Going through med school, I loved neuroanatomy and always read articles about neurology with great interest.

And to discover the mechanics of how the brain works is what drove me to neurology.