Neurology as a specialty

[hye345]

Compared to all the other specialties, where does neurology rank in terms of lifestyle, pay, and the difficulty of both admissions into the residency program and the residency itself? Thanks a lot in advance.

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[neurotrancer]

competitiveness - as a US MD, you will get into neurology if you want it, last year less than 100 US MD's matched into neuro program spots.

as for lifestyle, I'm under the impression that it can be really hard with less $ or it can be easy with good money (e.g. if you do an EMG or EEG or sleep fellowship, you should be able to make >200k working 40 - 50 hours / week).

peace!

 

[71263]

competitiveness - as a US MD, you will get into neurology if you want it, last year less than 100 US MD's matched into neuro program spots.

as for lifestyle, I'm under the impression that it can be really hard with less $ or it can be easy with good money (e.g. if you do an EMG or EEG or sleep fellowship, you should be able to make >200k working 40 - 50 hours / week).

peace!

Wait, less than 100 people matched?? Damn, that sounds pretty tough. And I had thought that neuro was one of the less competitive fields.

 

[hye345]

So did I...

I understand that it is more competitive than internist and a little less competitive than general surgery. Am I right or wrong?

 

[neurotrancer]

less than 100 matched because less than 100 applied. pretty crazy if you ask me.

 

[2muchplanning]

Any ideas why so few people were interested (aside from the stereotype that "Neurologists don't treat but only diagnose")?

Any red flags against the specialty?

 

[nobrainer]

Less than 100 matched probably because you are looking at the NRMP match statistics from last year when neurology was part of the early match. DUH!

 

[hye345]

Less than 100 matched probably because you are looking at the NRMP match statistics from last year when neurology was part of the early match. DUH!

Oh yeah! I read about that. Neurology is supposed to be integrated into the regular match system starting in 2006, though.

 

[salmonella]

Oh yeah! I read about that. Neurology is supposed to be integrated into the regular match system starting in 2006, though.

The neurology job market in desirable cities is very very tough. I know a few graduating fellows (with training in EMG) who could not find jobs. They had to send solicitation letters out to neurologists in the area, begging for positions. General neurology jobs are hard to come by as well, with starting salary in the range of $120000. There are more than 10 applicants for each of such spot.

The more lucrative areas are stroke, neuro-critical care and interventional neurology. But these are stressful and demanding subspecialties that many people shy away from. If you want to be a rich neurologist, open your own headache center, or do a pain management fellowship.

Jobs in less desirable areas are very abundant, especially in Ohio, Nebraska, Missouri, Illinois, and the Southern states. Anyone that's willing to live there will be able to make good living.

 

[USIMGgrad]

Compared to all the other specialties, where does neurology rank in terms of lifestyle, pay, and the difficulty of both admissions into the residency program and the residency itself? Thanks a lot in advance.

Here is some data from the internet.
http://www.emedhire.com/neurologist_corner.asp

NEUROLOGY COMPENSATION SURVEY

Note: this is averages of working neurologists. It does not give an idea of the high end or low end of each region. Starting compensation ranges from as low as $110,000 to as high as $340,000. Factors contributing to highs and lows are community need (oversupply or undersupply of specialists), sense of urgency, managed care penetration / level of reimbursements, and / or liability costs.

MedHIRE Survey
Residents / Fellows: Starting compensation ranges from $150,000-$185,000.
Practicing Neurologists: Starting compensation ranges from $180,000-$225,000.
Please note that this is starting compensation, thus it does not indicate the earning potential at a practice.

AMA Survey
All Neurologists: $201,241
Starting Neurologists: $151,960
East Coast Neurologists: $180,882
West Coast Neurologists: $199,614
Northern Neurologists: $201,241
Southern Neurologists: $204,000

Other Surveys
NB: Response rate to these surveys ranges around 10%.
NAPR/MGMA Survey (target group – mid-sized SSGs/MSGs): $239,511
AMGA Survey (target group – large SSGs/MSGs): $213,300
Sullivan Survey (target group: teaching hospitals, HMO's, large MSGs): $194,614
Hay Survey: $189,100
Warren Survey: $185,708
HHCS Survey: $171,298



FELLOWSHIPS

Here are some issues to keep in mind when considering whether to do a fellowship, and which fellowships to choose. Ultimately, this is a personal decision and the greatest factor will be what you love to do.



What factors should I consider when deciding whether to do a fellowship?

* The majority of practices that are seeking a general neurologist do not give preference to candidates who have done a fellowship over a candidate who has done residency only.
* By far, the greatest demand in neurology positions is for General Neurologists. If you do a fellowship, it does not guarantee that you will be able to find a position where you can devote a large percentage of your practice to your subspecialty.
* Starting compensation does not increase for candidates who have done an additional year of training. The only factor that will increase starting compensation is practice experience.
* If you select a subspecialty that is not in demand, your choice of subspecialty may limit your choice of location. In other words, if you are dead-set on a specific area of the country in which to locate, then doing an uncommon subspecialty will make your criteria too narrow to find a job.



Which subspecialties are in demand?

Currently, our practices are requesting the following subspecialties (in descending order). (We will update this list from now on to give a more accurate picture of demand, but this is pretty typical.)



1. General (Most expect proficiency in EMG and EEG)
2. EMG (Neurophysiology or Neuromuscular)
3. Sleep (The majority are not 100% sleep)
4. Stroke
5. Epilepsy
6. Pediatric
7. Movement Disorders
8. Headache/Pain
9. MS
10. Neurointensivist
11. Neurorehab
12. Neurobehavioral/Dementia
13. Neuropsychiatry
14. Neuro-imaging
15. Neuro-opthalmology

 

[hye345]

The neurology job market in desirable cities is very very tough. I know a few graduating fellows (with training in EMG) who could not find jobs. They had to send solicitation letters out to neurologists in the area, begging for positions. General neurology jobs are hard to come by as well, with starting salary in the range of $120000. There are more than 10 applicants for each of such spot.

And I was under the impression that neurology was a relatively non-competitive field...

 

[71263]

And I was under the impression that neurology was a relatively non-competitive field...

It seems that getting a neuro residency out of medical school isnt terribly bad. But yes, for a fully trained neuro fellow, finding a job does sound pretty tough...

 

[neurotrancer]

It sounds to me like if you want to be a neurologist in LA making mad loot$, that won't happen so readily.

If you are in an area where there is no neurologist for miles, you can expect to do pretty well.

Here, one of the more popular neurology groups has a wait time of 3 months, and I live in a small/medium sized city. I can't imagine that in such a place there wouldn't be room for more neurologists.

I don't completely trust these online salary reporting sites because #1 you don't have necessarily a full range of practitioners reporting so as to guarantee a representative sample and #2, they are salaries. If you are partner in a successful practice, doesn't it make sense you'd be making more than 180,000 - 200,000 (the national average as reported by some of these sites).

 

[hye345]

BTW,

I understand that for primary care physicians such as pediatrist, family doc, internist, etc..., you almost always have to accept medicare, and you are at the eye of the storm when reimburstment levels drop.

On the other side of the spectrum, specialists such as dermatologists, oncologists, and radiologists have the freedom (relatively speaking) to drop their insurance carriers if the reimburstments drop too low (how one turns away a terminal cancer patient and/or charges them an arm and a leg for a given procedure is a topic for another day).

Im curious: where does neurology rank in this scale?

 

[neurologist]

BTW,

I understand that for primary care physicians such as pediatrist, family doc, internist, etc..., you almost always have to accept medicare, and you are at the eye of the storm when reimburstment levels drop.

On the other side of the spectrum, specialists such as dermatologists, oncologists, and radiologists have the freedom (relatively speaking) to drop their insurance carriers if the reimburstments drop too low (how one turns away a terminal cancer patient and/or changes them an arm and a leg for a given procedure is a topic for another day).

Im curious: where does neurology rank in this scale?

Not great. A vast # of neuro patients are elderly or disabled and therefore not making much money or working for places that offer great private insurance. Many are on medicare/medicaid.

I guess that you could be a "boutique neurologist" running a cash-only clinic for well-heeled and crazy headache and chronic pain patients.

Most neuro practices are kept in the black by procedures: EMG/EEG/sleep.

 

[Nerdoscience]

I don't know where these people who say that it's really hard to get a job as a Neurologist. I am an intern, and am already getting job offers. Many of our fourth years got hired with signing bonuses during their third years, and our fellows are having no problem finding jobs.

Maybe it's location-dependent. If you are dead set on working in a specific city, then maybe.

 

[neurologist]

I don't know where these people who say that it's really hard to get a job as a Neurologist. I am an intern, and am already getting job offers. Many of our fourth years got hired with signing bonuses during their third years, and our fellows are having no problem finding jobs.

Maybe it's location-dependent. If you are dead set on working in a specific city, then maybe.

Amen to that. No doctor will ever be unemployed. You will always be able to find a job. But if that job involves $300-400K in New York/Boston/San Fran/LA, well, yeah, lots of luck. I think many folks have rather unrealistic expectations about the real world.

 

[hye345]

Most neuro practices are kept in the black by procedures: EMG/EEG/sleep.

What do you mean by "kept in the dark"?

 

[neurologist]

What do you mean by "kept in the dark"?

That's "Kept in the BLACK," not "Dark."

It means "kept profitable."

 

[salmonella]

I don't know where these people who say that it's really hard to get a job as a Neurologist. I am an intern, and am already getting job offers. Many of our fourth years got hired with signing bonuses during their third years, and our fellows are having no problem finding jobs.

Maybe it's location-dependent. If you are dead set on working in a specific city, then maybe.

Overall there is a huge shortage of neurologists in this country; the neuro workforce is just poorly distributed. The coasts are over-saturated, while in the midwest and the south we are seeing manpower shortage. If you don't mind the location, you will find very lucrative positions.

 

[Onco]

Overall there is a huge shortage of neurologists in this country; the neuro workforce is just poorly distributed. The coasts are over-saturated, while in the midwest and the south we are seeing manpower shortage. If you don't mind the location, you will find very lucrative positions.

I think you can apply this to any speciality. With Nurology the diseases are quite rare.. thus there is a general oversaturation of nurologists in cities. No big deal.

 

[Wheezy]

I think you can apply this to any speciality. With Nurology the diseases are quite rare.. thus there is a general oversaturation of nurologists in cities. No big deal.

Neurological diseases are not rare. Last time I checked stroke was the 3rd leading cause of death in the USA. It's probably not second because they lump all malignant neoplasms in to one category.

Also stroke is arguably the leading cause of morbidity in the western world. Personaly I'm not convinced, but it does lead to a lot of morbidity.

Don't get me started on how common migraine & tension headache are or even seizures.

 

[humuhumu]

Neurological diseases are not rare. Last time I checked stroke was the 3rd leading cause of death in the USA. It's probably not second because they lump all malignant neoplasms in to one category.

Also stroke is arguably the leading cause of morbidity in the western world. Personaly I'm not convinced, but it does lead to a lot of morbidity.

Don't get me started on how common migraine & tension headache are or even seizures.

Not to mention sleep problems...

 

[tanqueray84]

My clerkship director told me that Neurologist make more than Cardiologist if you look at it per hour. He had a resident who got a job in Branson, MO starting at $450,000, straight out of residency. He said if you're willing to move you can get a job. All the job offers I've seen in the journals start off at $250K

 

[salmonella]

My clerkship director told me that Neurologist make more than Cardiologist if you look at it per hour. He had a resident who got a job in Branson, MO starting at $450,000, straight out of residency. He said if you're willing to move you can get a job. All the job offers I've seen in the journals start off at $250K

1) A cardiology job in Branson, MO, would probably pay $500,000 to $600,000. In not-so-desirable locations, all specialists' salaries are high, not just neurologists
2) The highest paid neurologists are neuro-intensivists, medical directors of stroke programs, headache specialists or neuro-interventionalists; I doubt a general neurologist could make $450,000 a year
3) The neuro job market in big cities is miserable. Anecdotally, $100,000 to $130,000 are the starting salaries for fresh neuro grads.
4) Yes, you can get excellent job offers if you are willing to relocate, especially to the midwest and the south.

 

[ttjan]

Salmonella, wrt 100-130 K starting salary, which city are you talking about? Grads from my program working in LA or San Diego have started at 160-250 K in group practices. I heard on the interview trail 2 years ago that a starting position in Chicago may be 100K, but always wondered whether this was true. Perhaps you are talking about academic jobs, a totally different animal.

 

[soulsearchin]

the salaries that i have heard of are starting typically from 170k to 180k in the northeast..dont know about 250k plus n i dont think theyre as low as 100 to 130 k starting,maybe in the academia they are

 

[soulsearchin]

Compared to all the other specialties, where does neurology rank in terms of lifestyle, pay, and the difficulty of both admissions into the residency program and the residency itself? Thanks a lot in advance.

Lifestyle in neuro is good.Typically one can work M-F 8 hours a day and make in excess of 200k.
The pay varies.Most sites give it as 180 k to 345 k/yr.However the starting positions are offered as 170 k plus with an increase after partnership is offered.Ive heard of partners earning 600 k to 700k/yr.
The average matching score for neuro was 219 last year.Low compared to alot of other specialities and high compared to some.Lets see what this years match brings us.
i cannot say with certainty about the difficulty of the residency itself.however the board pass ratio is 66 percent overall for first time candidates.

 

[Mollaret]

The more lucrative areas are stroke, neuro-critical care and interventional neurology.

Despite the extra special heaping dose of stress and added inpatient work hours in these areas, stroke and neuro-critical care are not especially lucrative. Although, interventional neurology may pay better because of the procedural reimbursement. Stroke and neuro-critical care are in high demand, but the compensation is less than some procedural-oriented subspecialties such as EMG, EEG, Sleep, and Pain.

 

[BuddhaCanooda]

Lifestyle in neuro is good.Typically one can work M-F 8 hours a day and make in excess of 200k.
The pay varies.Most sites give it as 180 k to 345 k/yr.However the starting positions are offered as 170 k plus with an increase after partnership is offered.Ive heard of partners earning 600 k to 700k/yr.
The average matching score for neuro was 219 last year.Low compared to alot of other specialities and high compared to some.Lets see what this years match brings us.
i cannot say with certainty about the difficulty of the residency itself.however the board pass ratio is 66 percent overall for first time candidates.

What location are you referring to? Do you have stats on those doing EMG? It sounds rather high to go 180k to 345k as a general neurologist. How do you see the future being with regard to an aging population and growing demand for neuromusc. dz?

BC

 

[soulsearchin]

What location are you referring to? Do you have stats on those doing EMG? It sounds rather high to go 180k to 345k as a general neurologist. How do you see the future being with regard to an aging population and growing demand for neuromusc. dz?

BC

the average quotes here is from the salary sites that have been listed elsewhere in this forum.the 600 to 700 k neurologists are a couple ofreally successful practitioners in the south,but i think thats a rare one.
as for the RMGS i dont have stats on that.

my question to anyone here is that the starting salaries mentioned above by you people as 130 k,do they apply to the tristate NY/NJ/PA area...im asking specifically in the NJ area...is the neuro market saturated over there too?and what are the prospects of practicing neuro there?

 

[salmonella]

It's also important to consider competitions from other specialists, for example:

1) PM and R doing EMG/NCS
2) Pulmonologists doing sleep medicine
3) Psychiatrists seeing dementia patients
4) Neuro-radiologists and neurosurgeons doing interventional neuro procedures