Why Neurology considered as "Non-preferred" among medical students ?

[one11]

Hello ,

Why Neurology considered as "Non-preferred" among medical students ?

since it is easy to get into neurology residency positions, and most of the medical student like to get into surgery, cardiology, GI, Derma ... etc, and even if you look around in any hospital, you will not find much neurologist compared to other specialties .

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[HarveyCushing]

Hello ,

Why Neurology considered as "Non-preferred" among medical students ?

since it is easy to get into neurology residency positions, and most of the medical student like to get into surgery, cardiology, GI, Derma ... etc, and even if you look around in any hospital, you will not find much neurologist compared to other specialties .

Not sure what you mean by "non-preferred" but I assume you are asking why is it not more popular? Here is a thread on that exact topic that will probably answering all your questions. Read until your hearts content: http://forums.studentdoctor.net/showthread.php?t=350164

 

[Amos]

Hello ,

Why Neurology considered as "Non-preferred" among medical students ?

since it is easy to get into neurology residency positions, and most of the medical student like to get into surgery, cardiology, GI, Derma ... etc, and even if you look around in any hospital, you will not find much neurologist compared to other specialties .

I don't think it has to do with a lack of interest in the field. Students love the neuro rotation at my school.

However the vast, vast number of "preferred" or "competitive" specialties are those that either make a lot of money or have an easy lifestyle, or both (derm, rad onc, etc). That is also why everyone wants to do cards and GI fellowships after a medicine residency vs. some other underserved branches of IM.

Neuro is neither the highest paying nor the easiest residency (though it is plenty good in both respects in my book). Thus you have to really like the nervous system and prioritize topic interest vs. other factors to seriously pursue it.

It will be very interesting to see what the "hot" fields are in 20 years when government run universal health care is predominant and reimbursement for procedures drops through the floor.

 

[bonran]

The fact is that some things about neuro are not well publicised or known even to residents in the field. Neurology is a mystery even to most physicians. It takes time to understand synthesizing a neuro exam. One needs to make sure that you match in a good neuro program with strong academics & a good faculty (Epilepsy, NM & Stroke should be strong) to get good all round training. There are a lot of mediocre programs out there where this is not the case. Also, when one gets into a neuro residency,one should do so with the mindset that you are going to train to be a well rounded neurologist (not with a specialist mind-I wanna go into stroke/EEG/EMG). One also needs to get a strong IM training in the prelim year, a combined IM/Neuro trained resident is much better than someone who does a 1 year prelim year IMO.
Neuro is relatively hard work for the first 2 years of the residency-prelim & the PGY-2 neuro year. Following this, its usually smooth sailing if the program is relatively large (thus reducing the call & work load on residents).

Neuro has relatively good compensation & great lifestyle (compared to plain IM, Ob-GYN, FP, Gen Surg. & specialties like nephro, endo, ID, pulm & cc). One has to deal very little with social issues a' la IM & FP as most patients have neurological diseases & very few are fakers (except in Headache & Pain medicine). There are some branches of neurology which get amongst the top reimbursements:

Vascular with Interventional NR: One of the highest paid specialties after Ortho & NSx, certainly higher than derm, ophtho & ENT (though it is hard work with long hrs). Reimbursements between 300,000 (academics) to 400,-700,000 (private practice), with a lot of people hitting the big M in a few years.

EEG with intraoperative monitoring & cortical mapping: Again very good reimbursements though available in select centers. Clinic hours 9-5.

Neuro with sleep medicine: Sleep reimbursements & easy lifestyle. Clinic hours 9-5.

Neuro with interventional pain management: Pain management reimbursements & easy lifestyle, horrible PAINFUL patients. One has to have an aptitude for this sort of thing. Clinic hours 9-5.

EMG with intraoperative monitoring: Very good reimbursements. Clinic hours 9-5.

Movement Disorders with DBS training: Great reimbursements. Clinic hours 9-5.

Neuroimaging: Good reimbursements & good lifestyle.

Besides, general neurologist are in high demand & garner a higher pay than gen IM- low end get 160,000-180,000 (in large cities like NY, Chicago, Houston & LA); higher end get 250,000-290,000 (in the south-east & mid-west). One of my seniors who went into private practice a couple of years back with 2 months of EMG (his country did not sponsor him for fellowship training) training had a 2 year guaranteed salary of 290,000 with 90% of profits as production bonus plus all the perks (sign-on, moving bonuses). And yes, he went to a small town in north Arkansas.

Pediatric neurology is another hidden gem that many MS & peds residents dont know about. There is an acute shortage nationally in this specialty with pay scales above 200,000 in the mid-west & SE. With specialization in Epilepsy/Developmental/Neurogenetics, one will get more.

I have been offered pays in the 220-240,000 range with production bonus & added perks in an academic visa-waiver jobs during my interviews. For a citizen it would mean 20-40,000 more. In private practice, it would be 30-50,000 higher in visa-waiver jobs. This is just to give you an idea of what is out there if you have "dollar signs in your eyes" in your PGY-4 year.

 

[medsRus]

Neuroimaging: Good reimbursements & good lifestyle.

What can one do as a "neuroimaging" neurologist? Are there many programs and demand? Thank you.

 

[bonran]

Yes you can. It will give you reading privileges for MRIs, CT scans of the head & neck. There are some programs out there, the most famous being The Dent Institute, Buffalo & the UAB, Alabama program. Please check out the UCNS website at http://www.ucns.org/apps/directory/ or at the AAN fellowships search engine at http://www.aan.com/education/fellowships/.

The problem arises when radiologists try to block recruitment. Their excuse is that you cannot read other body imaging & hence will not be able to fit in the call schedule with radiologists (yes but it is better to have good quality Neuroimaging read than a very poor quality gen. radiology read as seen in peripheral hospitals). There are very few neuroradiologists & not enough to service the peripheries. The quality of radiology read is so poor that most neurologists read their own films anyway.

The other excuse that is used to keep neurologists out is that they are not taught to read extracranial stuff- ENT, neck & spine. Again not true. These programs & the neuroimaging fellowship guidelines state that an approved program (by UCNS, not ACGME) has to train you to read these films.

 

[medsRus]

Yes you can. It will give you reading privileges for MRIs, CT scans of the head & neck. There are some programs out there, the most famous being The Dent Institute, Buffalo & the UAB, Alabama program. Please check out the UCNS website at http://www.ucns.org/apps/directory/ or at the AAN fellowships search engine at http://www.aan.com/education/fellowships/.

The problem arises when radiologists try to block recruitment. There excuse is that you cannot read other body imaging & hence will not be able to fit in the call schedule (yes but it is better to have good quality Neuroimaging read than a very poor quality gen. radiology read as seen in peripheral hospitals). There are very few neuroradiologists & not enough to service the peripheries.

The other excuse that is used to keep neurologists out is that they are not taught to read extracranial stuff- ENT, neck & spine. Again not true. These programs & the neuroimaging fellowship guidelinesstate that an approved program (by UCNS, not ACGME) has to train you to read these films.

Thanks for the info. The UCNS program won't let me search for neuroimaging programs and says:

Neuroimaging (Available in the future)

 

[Vader]

a combined IM/Neuro trained resident is much better than someone who does a 1 year prelim year IMO.

What does this mean? How many neurologists actually have trained separately in both internal medicine and neurology?

 

[Amos]

What does this mean? How many neurologists actually have trained separately in both internal medicine and neurology?

A bunch of the old school guys like Marty Samuels are double boarded, but that's because neuro used to be a fellowship off of internal medicine. Very few recent graduates are.

Maybe he meant prelim medicine vs. a transitional year.

 

[bonran]

No, I meant exactly what is in there. A combined IM/Neuro program as in MCW/Stonybrook etc.

 

[BlackFrancis33]

Bonran, I am just finishing a neurology residency and I have to respectfully dissent about some of your opinions on IM training. Yes it is important as a foundation in your intern year, but I don't think that combined training is a requirement to train a well rounded general neurologist particularly if you are seeing mainly neurology clinic and acting as a neurology consultant. If you are going to be primarily a neurohospitalist/intensivist, yes you would likely benefit from and need more IM training. Regardless you need to learn the borderlands of Neuro and IM, and learn it well. But when I hear this argument about combined IM training being a necessity I think it is another factor that discourages prospective applicants, implying that neurology training is not adequate. In my opinion, this sentiment comes from a woebegone era of 2 hour neurologic exams and pneumoencephalograms (and the surrender of modern imaging technology).

 

[medsRus]

Bonran, I am just finishing a neurology residency and I have to respectfully dissent about some of your opinions on IM training. Yes it is important as a foundation in your intern year, but I don't think that combined training is a requirement to train a well rounded general neurologist particularly if you are seeing mainly neurology clinic and acting as a neurology consultant. If you are going to be primarily a neurohospitalist/intensivist, yes you would likely benefit from and need more IM training. Regardless you need to learn the borderlands of Neuro and IM, and learn it well. But when I hear this argument about combined IM training being a necessity I think it is another factor that discourages prospective applicants, implying that neurology training is not adequate. In my opinion, this sentiment comes from a woebegone era of 2 hour neurologic exams and pneumoencephalograms (and the surrender of modern imaging technology).

So, if I do a transitional year, I would not be missing out on anything in the future?

 

[BlackFrancis33]

I feel that a transitional as long as it includes inpatient IM and ICU experiences should be just fine. A transitional can sometimes be an advantage if you can get in on a worthwhile neurosurgery rotation, perhaps even 1 month of inpatient neurology, and some medicine specialities such as Rheum or Cards clinic experiences. If the transitional experience appears questionable in any way, an IM internship is probably a 'can't miss' as far as preparation for the rest of your residency.

 

[Amos]

So, if I do a transitional year, I would not be missing out on anything in the future?

Most neuro programs require medicine prelim, either at the place you are doing neuro or somewhere else decent. I've heard of a few that allow transitional years, but they are few and far between.

Good news is that it isn't too hard to get ICU, cards, rheum etc in most med prelims.

 

[darksideone]

Most neuro programs require medicine prelim, either at the place you are doing neuro or somewhere else decent. I've heard of a few that allow transitional years, but they are few and far between.

Good news is that it isn't too hard to get ICU, cards, rheum etc in most med prelims.

I agree with Amos. From my research of programs, and speaking with residents and PD's, the prelim year seems to be the preferred route to go. As Amos said, most programs require it and the others probably prefer it. If you are debating between prelim and transitional, you might want to contact the PD of the programs you are looking at and ask them?

 

[bondi]

Cal resident did prelim, PGY2 looked for pgy3 spots couldnt find any----now doing PGY2 IM looking for a swap back to neuro if poss...

btw neuro is all about research if you are not into research you wont have the understanding of neuro.

 

[Mattchiavelli]

to clear up some confusion-

the specific guidelines from the ACGME [the regulatory body that says if your residency program is legitimate or not] state the PGY-1 year requires
-8 months of IM with primary patient care responsibility
OR
-6 months of IM PLUS 2 more of peds, IM, EM, or FM
ALSO
you can't do more than 2 months of neurology in your PGY1 year

Most TY programs have 6 months required IM and a lot of time for electives. Most categorical IM programs have 8+ months of inpatient IM, and IM interns get worked like dogs.

If you want to do child neuro you do 2 years of peds and then like 3 years of neurology where when you're doing neurology training you're treated like a fellow at most institutions

Honestly I think the confusion of this whole system scares off some applicants that don't want to deal with 2 sets of interviews, ranking Neuro AND PGY1 years, etc

 

[skatertudoroga]

hello how competitive is neuro for DO people. and what are some of the good programs and which are DO friendly? thanks.

 

[NeuroJ]

How research intensive are neuro residencies?

And to tag along to to skatertudoroga's question, are there any neuro fellowships at any of the DO schools?

 

[thinker]

Canadian national IMG (non-carib, not graduated yet) with an Msc in neuroscience from Canada.. is it possible to land a neurology residency in the US on H1B visa? would I even need the H1B visa? i'm interested in neurology but would like to get a feel of my theoretical chances

and can we expect the future of neurology to improve due to the aging population?

thanks!

 

[danielmd06]

Neurology is exploding right now. The demand for us has really seemd to increase in the past five years, and is predicted to continue increases for at least the next ten years (the aging population does play a role in this). Salaries are on the rise and job opportunities abound.

I believe it is less popular than many other specialties right now for several reasons, but mostly because:

(1) If you google the salaries (as medical students are wont to do), neurology often comes up lower than many other medical and surgical subspecialties. This is fast changing as you can find online. Thank goodness.

(2) Many students never had a good neuroanatomy/neuroscience class in medical school and much of neurology is subsequently difficult to understand. I have the exact same problem with nephrology.

(3) American allopathic grads are like lemmings when it comes to their thinking. So many of them see a larger number of foreign medical grads in neurology and this gets equated with lack of desirability of the job. The whole "if it were so desirable then wouldn't more American medical grads want to do it?" and this mentality contributes to a self-perpetuating cycle. The same thing happens with USMLE scores.

As an aside, I think this is one of the reasons why many residents become disillusioned with their jobs. They mindlessly picked a specialty based on a two weeks' rotation, average USMLE scores for the matched specialty, a googled salary, a cool attending/resident...and little to no thought about what a residency might really be like or what the finished job would be like. It happens. Trust me.

(4) This is going to sound a bit harsh but...I think lots of neuro attendings come off as strange, quirky people at many instiutions. So they don't do as good a job as perhaps they could at recruiting. Cool, charismatic attendings draw more medical students in as applicants any day.

(5) Neuro at a big tertiary care center can be a busy service with proportionately fewer residents manning the trenches. Neurosurgery oft has the same problem (albeit with the promise of more $$$ at the end of the rainbow). This is because many private neuro groups are strictly outpatient and won't take emergency call. So EVERYTHING neuro-esque after hours can feasibly get funnelled into one or two major hospitals in an area...ergo, you have a super busy service that is surprisingly discrepant with many "real world" private practice neurology opportunities. Medical students see this and think "hey this is awful...I don't want to work this hard" without considering the finished product.

 

[bronx43]

Neurology is exploding right now. The demand for us has really seemd to increase in the past five years, and is predicted to continue increases for at least the next ten years (the aging population does play a role in this). Salaries are on the rise and job opportunities abound.

I believe it is less popular than many other specialties right now for several reasons, but mostly because:

(1) If you google the salaries (as medical students are wont to do), neurology often comes up lower than many other medical and surgical subspecialties. This is fast changing as you can find online. Thank goodness.

(2) Many students never had a good neuroanatomy/neuroscience class in medical school and much of neurology is subsequently difficult to understand. I have the exact same problem with nephrology.

(3) American allopathic grads are like lemmings when it comes to their thinking. So many of them see a larger number of foreign medical grads in neurology and this gets equated with lack of desirability of the job. The whole "if it were so desirable then wouldn't more American medical grads want to do it?" and this mentality contributes to a self-perpetuating cycle. The same thing happens with USMLE scores.

As an aside, I think this is one of the reasons why many residents become disillusioned with their jobs. They mindlessly picked a specialty based on a two weeks' rotation, average USMLE scores for the matched specialty, a googled salary, a cool attending/resident...and little to no thought about what a residency might really be like or what the finished job would be like. It happens. Trust me.

(4) This is going to sound a bit harsh but...I think lots of neuro attendings come off as strange, quirky people at many instiutions. So they don't do as good a job as perhaps they could at recruiting. Cool, charismatic attendings draw more medical students in as applicants any day.

(5) Neuro at a big tertiary care center can be a busy service with proportionately fewer residents manning the trenches. Neurosurgery oft has the same problem (albeit with the promise of more $$$ at the end of the rainbow). This is because many private neuro groups are strictly outpatient and won't take emergency call. So EVERYTHING neuro-esque after hours can feasibly get funnelled into one or two major hospitals in an area...ergo, you have a super busy service that is surprisingly discrepant with many "real world" private practice neurology opportunities. Medical students see this and think "hey this is awful...I don't want to work this hard" without considering the finished product.

Thanks Danielmd. So, the increases in neurology salaries are mostly due to a shortage of supply? Wouldn't that mean these salary increases are mostly hospital jobs, since actual reimbursement hasn't gone up?
With that said, do you know how the private practices are doing? I've heard that cardiology is getting hit left and right in reimbursement and many private practices have dried up or gotten bought out by institutions. Is the same thing happening in neuro?

 

[neurolddoc]

?
With that said, do you know how the private practices are doing? I've heard that cardiology is getting hit left and right in reimbursement and many private practices have dried up or gotten bought out by institutions. Is the same thing happening in neuro?

How private practices are doing depends on the private practice. Reimbursements are flat. To some extent, that can offset with increased volume, or particularly, increased testing volume. The testing volume is under pressure, as an increasing number of primary care physicians are pulling Doppler, NCT/EMG and other studies into their practice.

It is all about adapting to changing circumstances.

 

[deleted102545]

Neurology is exploding right now. The demand for us has really seemd to increase in the past five years, and is predicted to continue increases for at least the next ten years (the aging population does play a role in this). Salaries are on the rise and job opportunities abound.

I believe it is less popular than many other specialties right now for several reasons, but mostly because:

(1) If you google the salaries (as medical students are wont to do), neurology often comes up lower than many other medical and surgical subspecialties. This is fast changing as you can find online. Thank goodness.

(2) Many students never had a good neuroanatomy/neuroscience class in medical school and much of neurology is subsequently difficult to understand. I have the exact same problem with nephrology.

(3) American allopathic grads are like lemmings when it comes to their thinking. So many of them see a larger number of foreign medical grads in neurology and this gets equated with lack of desirability of the job. The whole "if it were so desirable then wouldn't more American medical grads want to do it?" and this mentality contributes to a self-perpetuating cycle. The same thing happens with USMLE scores.

As an aside, I think this is one of the reasons why many residents become disillusioned with their jobs. They mindlessly picked a specialty based on a two weeks' rotation, average USMLE scores for the matched specialty, a googled salary, a cool attending/resident...and little to no thought about what a residency might really be like or what the finished job would be like. It happens. Trust me.

(4) This is going to sound a bit harsh but...I think lots of neuro attendings come off as strange, quirky people at many instiutions. So they don't do as good a job as perhaps they could at recruiting. Cool, charismatic attendings draw more medical students in as applicants any day.

Man, all that rings so true, especially the 3rd bullet point. I've had to "defend" myself against my classmates and other residents when they inquire why I'm going into neurology.

Great post! I think it encompasses pretty well why neuro is a "non-preferred" field.

 

[Mattchiavelli]

(2) Many students never had a good neuroanatomy/neuroscience class in medical school and much of neurology is subsequently difficult to understand. I have the exact same problem with nephrology.
...
(4) This is going to sound a bit harsh but...I think lots of neuro attendings come off as strange, quirky people at many instiutions. So they don't do as good a job as perhaps they could at recruiting. Cool, charismatic attendings draw more medical students in as applicants any day.

Very good post! I had a few things to add to it-

Regarding 2 and 4, our department chair of neurology teaches basic science neuroscience, and I know it's a major reason our school has a large number of applicants to neurology residencies each year. He's very knowledgeable, engaging, and affable and it really goes a long way.

also I agreed with 3 and with ReDox- I've been surprised at how many attendings/residents have a little derogatory comment about neurology/neurologists when I tell them what I'm doing for residency. From older folks I chalk it up to the fact that they didn't have a great grasp of the field in med school and having not dealt with it for some 30 odd years, they really have no clue what they are talking about at this point [a lot of these comments deal with lack of treatment options and radiology making the field irrelevant].

Younger folks that say these things tend to have a black and white view of patient care, as in patient is either broken or fixed. A lot of these people I've noticed are going into procedural oriented fields or diagnostic rads. They see our patient care as "well the patient still has MS/Parkinson's/neuropathy/ALS/epilepsy etc" wheras neurologists can appreciate the role proper diagnosis and management has in improving quality of life and independent living.

Something that hasn't been brought up is having a disproportionate number of patients with comorbid psych d/o's or behavioral issues secondary to their neurological disease. It's not everyone's cup of tea and a lot of people that are really into that go into psychiatry. Child neurology also gets involved with children that can have severe behavioral issues which can be extremely intimidating to med students uncomfortable with that type of patient.

One last thing- US medical education is weighted very heavily to in-house hospital care vs outpatient setting, and I think outpatient neurology is worlds more interesting than inpatient. If my 3rd year clerkship in neurology had been 4 weeks inpatient instead of 2 in and 2 out I'd probably be doing gyn or anesthesia.

sorry it was so long, I've been ruminating on this during interviews

 

[95439]

Very good post! I had a few things to add to it-

Regarding 2 and 4, our department chair of neurology teaches basic science neuroscience, and I know it's a major reason our school has a large number of applicants to neurology residencies each year. He's very knowledgeable, engaging, and affable and it really goes a long way.

also I agreed with 3 and with ReDox- I've been surprised at how many attendings/residents have a little derogatory comment about neurology/neurologists when I tell them what I'm doing for residency. From older folks I chalk it up to the fact that they didn't have a great grasp of the field in med school and having not dealt with it for some 30 odd years, they really have no clue what they are talking about at this point [a lot of these comments deal with lack of treatment options and radiology making the field irrelevant].

Younger folks that say these things tend to have a black and white view of patient care, as in patient is either broken or fixed. A lot of these people I've noticed are going into procedural oriented fields or diagnostic rads. They see our patient care as "well the patient still has MS/Parkinson's/neuropathy/ALS/epilepsy etc" wheras neurologists can appreciate the role proper diagnosis and management has in improving quality of life and independent living.

Something that hasn't been brought up is having a disproportionate number of patients with comorbid psych d/o's or behavioral issues secondary to their neurological disease. It's not everyone's cup of tea and a lot of people that are really into that go into psychiatry. Child neurology also gets involved with children that can have severe behavioral issues which can be extremely intimidating to med students uncomfortable with that type of patient.

One last thing- US medical education is weighted very heavily to in-house hospital care vs outpatient setting, and I think outpatient neurology is worlds more interesting than inpatient. If my 3rd year clerkship in neurology had been 4 weeks inpatient instead of 2 in and 2 out I'd probably be doing gyn or anesthesia.

sorry it was so long, I've been ruminating on this during interviews

Quick heads up - MAKE SURE if you go to a prelim program they don't look down on the specialty you're going into. I've heard nothing but nasty comments about neurology where I'm at. The residents are embarrasingly poor in the field, and the neurology attendings are almost as bad (except for 1). It's really frustrating and I wouldn't recommend it to anyone..unless you like fighting for Head CT's on patients with obvious stroke symptoms...

 

[GoodmanBrown]

One last thing- US medical education is weighted very heavily to in-house hospital care vs outpatient setting, and I think outpatient neurology is worlds more interesting than inpatient. If my 3rd year clerkship in neurology had been 4 weeks inpatient instead of 2 in and 2 out I'd probably be doing gyn or anesthesia.

How is the split of inpatient vs. outpatient for a general, private practice neurologist? I'm only an MS1, but I'm finding outpatient stuff more enjoyable than inpatient. Not sure how a general neurologist splits his/her time. This is assuming I'm not making any extra effort to swing my practice one way or the other.

 

[danielmd06]

How is the split of inpatient vs. outpatient for a general, private practice neurologist? I'm only an MS1, but I'm finding outpatient stuff more enjoyable than inpatient. Not sure how a general neurologist splits his/her time. This is assuming I'm not making any extra effort to swing my practice one way or the other.

Basically, you can find whatever you want. I've run across many jobs that are strictly outpatient general neurology. Call includes coverage of the group's outpatient practice only. No emergency call, no inpatient admissions, and no inpatient consults. These are the ones I prefer.

Others have involved outpatient general neurology with inpatient consults. Others offer the whole enchilada.

 

[lewis2011]

Hey,
I am a FM intern. I was wondering if I could do neurology residency after finishing FM?

 

[Terpskins99]

Hey,
I am a FM intern. I was wondering if I could do neurology residency after finishing FM?

It depends if your hospital has an internal medicine residency program and if your floor months were run by the IM department.

http://www.abpn.com/downloads/ifas/IFA_Cert_N-ChiN AFTER_2011_MR_1-20.pdf
You can contact an accreditation officer at 847.229.6500 and/or email at [email protected] to discuss your specific case.

"A full year of ACGME-accredited training in internal medicine or, as an acceptable alternative, a full year in an ACGME-accredited program in which a minimum of six months of training must be in internal medicine, the details of which must be documented by the training director. The composition of these six months may NOT include rotations in neurology, family medicine, or emergency medicine. To ensure that these six months constitute a high-quality experience, they should emphasize progressive responsibility for the resident. At least two of the additional six months must be spent in internal medicine, pediatrics, and/or emergency medicine. For candidates entering neurology residency training on or after July 1, 2001, at least two of the additional six months must be spent in internal medicine, pediatrics, family medicine, and/or emergency medicine. No more than two of the remaining four months may be spent in neurology." Page 9.

 

[FictionalGirl]

A note on the poster who said that many attendings have some subtly unkind things to say about the neuro folks...... I feel like that happens in a lot of fields. My roommate is going into EM next year and when she told attendings that's what she was going to do they told her "oh, why are you doing that? it's a waste of a brain. you won't have to think. you should do something else, you're a smart girl......" Which, as far as I'm concerned, is ridiculous. If i'm going to the ER with weird symptoms at 4a.m. I want my doc to be as smart as possible. I would be happy to see OmgWtfBbq? coming at me with a stethoscope.

I think the problem is people espouse the same prejudices they heard when THEY were medical students without ever exploring the field enough to understand what it is they're knocking. So whenever I hear people in neuro badmouthing the EM folks it makes me sad --- mostly because I know that a) they're not stupid b) they can't be expected to know everything about every specialty thats why they call consults and c) it's their job to call and ours to respond.

What I'm trying to say is.... everybody makes snarky comments about everybody else because there is always something about your field that you're unhappy about that you perceive someone else as not having to deal with so they seem like an easy target. Don't like managing blood pressure/diabetes/social issues all at the same time? Cut on neurologists for not being able to cure anything. Don't want to be called for a consult at 3am? Bag on the ER. Unhappy that the antibiotic gave your post-op patient c.diff? Rag on the I.D. consult.

Can't we all just get along?

......of course, there's no question that neuro is the field that attracts all the cool kids....