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e_is_hv

Neurology!?

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Hi All,

 

I'm looking for info on the boards about Neuro, and the latest thread I could find was from 2005, if you could believe it! I'm interested in this field, but info is hard to come by. Can anyone, perhaps a resident, do an overview of the speciality? I'm particularly intrested on the lifestyle as both an attending and a resident, and things like call etc (a friend of mine told me that neuro resident call is 1:4, but home call, throughout the residency. I find the home call hard to believe).

 

Thanks so much!

e_is_hv

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A word about home call: all it means is that you are not "confined" in-house for the entire duration of your call (because hey, you could be driving between hospital sites - as an example). It has no bearing on how busy you may or may not be. In practice, home call just means that you can do call more often than in-house call, and that you may not get a call room. Yes, if you are taking rad onc or pathology home call, you may actually spend an evening at home waiting to be paged. But at our hospital, radiology, general surgery seniors, and neurosurgery are all technically home call. Again, this does not tell you how much time they actually spend outside the hospital while on call (if any).

 

I did one month of neurology CTU (team) as an off-service resident in PGY-1. I'm sure the call schedule depends on what rotation you are on, as well as how many residents there are to take call. I think I was on once or twice a week. On call, we covered wards, ER consults, and stroke protocol patients (if anyone was brought in by EMS as a possible stroke patient, we would drive in immediately to see them). Since there was no good place to sleep except the hideaway futon in the residents' room (which would have necessitated rearranging furniture), I usually went home by around 3 am.

 

As for info on the specialty, I'm not sure if any neurology residents frequent this board, but there should be more information on the web. Here are a couple of links to get you started:

http://www.med.ualberta.ca/Library/Documents/Education/StudentAffairs/neurology.pdf

http://www.aan.com/go/education/students/medical

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Hi All,

 

I'm looking for info on the boards about Neuro, and the latest thread I could find was from 2005, if you could believe it! I'm interested in this field, but info is hard to come by. Can anyone, perhaps a resident, do an overview of the speciality? I'm particularly intrested on the lifestyle as both an attending and a resident, and things like call etc (a friend of mine told me that neuro resident call is 1:4, but home call, throughout the residency. I find the home call hard to believe).

 

Thanks so much!

e_is_hv

 

Neuro call generally gets very busy and even though it is home call, don't expect to stay home. There are always lots of strokes to attend to and like Lactic Folly said, in practice, home call just means that you can do call more often than in-house call. A lot of other specialties like Nephro, GI do home call as well but residents/fellows still have to come in to the hospitals and most end up spending a large portion of their call in the hospital just as though they were doing in house call.

 

If you're looking for a "lifestyle" specialty ... Neurology sure isn't one of them.

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That being said, lifestyle as an attending likely varies a lot depending on subspecialty and practice setup. I worked with a neurologist who had an outpatient practice only - 8-6, M-F, no call. There are also those who are hospital-affiliated who deal primarily with outpatients in their area of specialization (e.g. dementia), perhaps spending a component of time in research, and are on call only for the few weeks of the year that they are on-service (covering CTU and call).

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That being said, lifestyle as an attending likely varies a lot depending on subspecialty and practice setup. I worked with a neurologist who had an outpatient practice only - 8-6, M-F, no call. There are also those who are hospital-affiliated who deal primarily with outpatients in their area of specialization (e.g. dementia), perhaps spending a component of time in research, and are on call only for the few weeks of the year that they are on-service (covering CTU and call).

 

Attending lifestyle is going to vary regardless of specialty but for the most part, neuro is not one of those fields where you can plan parties when you're on call, and it generally is not a field that affords you the luxury from a lifestyle perspective of dealing selectively with only outpatients.

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I'm a Neurology Resident (PGY-2). I love this specialty but, as said above, it's not always easy!

 

I agree with what other people said above regarding house calls. I was on call yesterday and it was a typical saturday house call: I was at the hospital from 8:00 am until 11:00 pm (ER consults, seeing neurology ward patients who are not going well). I was home by 11:30 pm. Then I received 4 calls throughout the night but didn't have to go back to the hospital.

 

I had maybe 2 house calls with no calls at all, but it doesn't happen often. I also had horrible house calls where I had finished doing the ER consults at 2:00am and ended up coming back to the hospital at 4:30am. Then you have to start your regular day at 7:45 am.

 

We have few emergencies in neurology but they happen often. So while on call, you will have to go back to hospital for acute strokes (and there are a LOT! but I guess it depends on your hospital), status epilepticus, meningitis and some other rare cases (cerebral veins thrombosis for example).

 

The number of house calls per month will depend on the number of residents in your program.

 

The day-to-day life depends on the rotation you are in. We have lighter schedules in EMG/EEG but I regularly end my day at 8:00 pm while on rotation on the neurology ward.

 

I hope this helps! You can ask more specific questions if you want, I'll do my best to answer them! :)

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Hi, Thanks so much for the responses, especially Annemd, just because it's great to hear from someone actually in the program!

 

I'm just wondering about neurology in general (so forgive me, I have lots of questions!). It seems like a fascinating field, but do you find it depressing? What's the best and worse thing about it?

 

Is neurology a field where you can open your own private practice in the community? If so, what do you are the main cases you can expect to see?

 

What's the job market like? Is neuro a saturated field? Are the residents having a hard time finding work?

 

And lastly, what do you find the lifestyle of the attendings like? Is it comparable to IM (better or worse)?

 

Sorry about so many questions, but info is so hard to come by.

 

Thanks,

e_is_hv

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Hi, Thanks so much for the responses, especially Annemd, just because it's great to hear from someone actually in the program!

 

I'm just wondering about neurology in general (so forgive me, I have lots of questions!). It seems like a fascinating field, but do you find it depressing? What's the best and worse thing about it?

 

Is neurology a field where you can open your own private practice in the community? If so, what do you are the main cases you can expect to see?

 

What's the job market like? Is neuro a saturated field? Are the residents having a hard time finding work?

 

And lastly, what do you find the lifestyle of the attendings like? Is it comparable to IM (better or worse)?

 

Sorry about so many questions, but info is so hard to come by.

 

Thanks,

e_is_hv

 

Thread is a couple of weeks old, but I can try to help.

 

1. Depressing? At times. Depends on how thick a skin you have. You have to be compassionate, of course, because 80% of inpatient practice will be stroke, most of who are debilitated. You don't do anything for these patients, except try to prevent the next stroke. The main recovery is going to be with rehab (ie, after they have left your care). a lot of brain tumors too. you really do have to learn how to detach yourself from the patient, otherwise it can hit you hard.

 

2. Best thing? for me, the diagnostic aspect. the whole "where is the lesion, what is the lesion" is like a puzzle that can be really fun to solve.

Worst thing? see point 1 above. most of your residency will be inpatient practice and you deal with geriatric patients with multiple comorbidities, most of who will never live independently again. This is why outpatient clinics can be a refreshing change of pace.

 

3. private practice? for sure. you don't have to be affiliated with the hospital in any way. I know plenty of neurologists who are primarily in their community clinics, and only show up for a 2-week stint on the wards 2-3 times per year, otherwise have no research or nothing else to do with the University.

main cases? 50% migraine (ok I exaggerate, but not by much. you'd be surprised)

 

4. job market? pretty good. depends on where/what you want to do, like anything. but i know several neurologists who set up shop, and in 3 months, their waiting list is already more than 3 months long. With the increasing proportion of the population who is geriatric and increasing incidence of diabetes, there is definitely no shortage of work. If you want to be a community neurologist, with your own clinic, no problems on the job front. If you want to do a fellowship and be associated with an academic centre, you are left to the whim of yuor health board and institution. They can be really short-sighted with regards to hiring people, so this can be trickier.

 

I have recently heard one attending talking about a clinic just outside of Vancouver that really wants a neurologist and is willing to pay all overhead. That is HUGE, and may indicate the demand.

 

5. lifestyle is highly variable and what you make of it. it also depends on how shady your billing practices are. if you are a mother and value your family time, your family time goes way up, and income way down. If you are a workaholic, vice versa. if you are a shady biller, you get free time, and a decent chunk of change.

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hi guys!

 

do you guys know what the call schedule for neuro is like at major centres? (toronto, vancouver etc...)

 

it'd seem that with the high number of residents (esp in toronto), call wouldn't be as bad as smaller centres with less # of residents. but i was wondering if that assumption is true??

 

is neuro call really that bad with lots of strokes etC?

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I'm also interested in doing my residency in neurology and I'm wondering how competitive it it. What are some of the things you would recommend? is being involved with research considered a necessity?

 

Ruthlessly bumping because I also want to know this

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Ruthlessly bumping because I also want to know this

 

you can go through the CaRMS stats on their website for each year to see how many pick Neuro as their first choice, how many (if any) unfilled spots there are after each round etc. This would give you an idea of how competitive it is. My understanding is that it's generally moderately competitive (more than FM, psych and IM but less than others).

 

To make yourself a more attractive applicant, you could do research in neuro-related topics during your pre-clerkship, do neuro electives in 4th yea etc.

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I am about to start my neurology residency in the US. I'm from Canada and was wondering about how the field is doing north of the border.

 

1) Is it financially possible to sustain a private practice?

2) Is there demand for neuro-hospitalists?

3) Is there good renumeration for procedures like NCS, EMG's, EEG's, sleep studies, etc.?

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I'm interested in neurology as well. How's the lifestyle for neuro as a resident and as an attending and is it relatively well remunerated?

 

i'm no neurology anything,

 

but i was under the impression that they're not so well remunerated compared to other specialties, i'm thinking prob on par with family med

 

i'll try asking when i shadow someone in neurology sometime later

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I think the financial renumeration depends....

 

If you are in the hospital primarily and taking stroke call, doing EMG's on the side or other procedural stuff like sleep labs, then I think you should make much more than the average GP.

 

On the other hand, if you do exclusively private practice with no EMG or procedure, then your salary will obviously take a hit. Maybe even less than family docs cause neurologists usually just don't have the volume of patients.

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That's interesting to know. Does anyone know of particular neuro programs in Canada that seem to stand out and also how competitive matching to neuro is?

 

i know western and toronto are large neuro centres. western is big on epilepsy in particular. not sure about elsewhere.

 

i don't think neuro is particularly competitive. i think the most recent year had 40 spots and 40 people who selected it as their first choice. all of them got it.

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i know western and toronto are large neuro centres. western is big on epilepsy in particular. not sure about elsewhere.

 

i don't think neuro is particularly competitive. i think the most recent year had 40 spots and 40 people who selected it as their first choice. all of them got it.

 

Western has made on of it major focuses neurology. They have top research going on in a number of areas (ha - even the Dean is a neurologist).

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Shameless bum-- first year med student who may be interested in neurology, and want to get a bit more up to date input/advice for neurology. How's the job market/competitiveness of neurology these days? 

From what I understand, the job market is good, and will probably get even better as our society ages.

 

In terms of competitiveness - the previous round of the match saw 37 applicants who selected it as their first choice, with a quota of 42 seats. It does not look to be competitive. 

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hi, this thread seemed to have been inactive for 2 years.

 

Just wondering how competitive neurology is as a specialty and if things have changed. In terms of resident's life, remuneration as a neurologist.

 

Which programmes across continue to have the best neurology program?

 

Thanks,

 

AN

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