Neurology

What are some important statistics around the specialty?

One out of three people are affected by a neurological disorder (WHO)

What general advice do you have for someone choosing this specialty?

Neurology is one of the few fields that still rely on physical exam, the science is also changing quickly with new treatments and diagnostic methods

What are the top three areas that students can focus on to help prepare themselves for a successful residency application and a successful transition to residency? 

USMLE grades, letter of recommendations that states they are good team worker and professional, research in Neurology

What resources would you share with a student who is just starting to research their interest in this specialty and/or wants to learn more specifics of this specialty?

AAMC offers a lot of information in (prepare for residency) section and (choose your specialty) section

American Academy of Neurology (AAN) American Board of Psychiatry and Neurology

American Neurological Association (ANA) National Institute of Neurological Disorders and Stroke Society for Neuroscience World Federation of Neurology

The best way to know what you like is to do rotations in that specialty. Neurology is very large and there are a lot of differences between inpatient and outpatient work. Make sure you rotate in both settings to get a feeling for the workday

Ask the residents how their workday feel like

What subspecialties exist with this specialty?

Vascular neurology, interventional neurology, epilepsy, headache, neuromuscular, neuro-ophthalmology, neuro-otology, neuroimmunology, neurology in women, movement disorder, neuro-oncology, neuro-intensive care, pain management...etc

What does a typical workday or work week look like (hours/schedule/shifts, work setting, team-based environment, acuity, etc.)?

Neurology can be subcategorized into two domains; inpatient and outpatient. In most academic centers neurologist do a combination of both inpatient and outpatient work, you can choose to do both or either or

Most outpatient neurologists have a 9-5 workday where they see stable patients either for the first time or follow up visits. Many people practice general neurology which means they see all kinds of neurological complaints, others see patients only in their subspecialties, most common subspecialties are

1. Epilepsy: mainly outpatient; neurologists see patients in clinic for first time or follow up, manage their medications and devices, read EEGs. Can also have a

comprehensive clinic with neurosurgery and neuropsychology for surgical candidates to prepare for epilepsy surgery

2. Neuromuscular: mainly outpatient; neurologists see patients with peripheral neurological systems; the most common complaint is polyneuropathy. Most have ALS clinic where they see patients with therapists. Most do EMG/NCS

3. Movement disorder: mainly outpatient. Most common disorder is Parkinson's disease. Neurologists see patients and adjust their devices like DBS (deep brain stimulator), also refer to neurosurgery for deep brain stimulator placement when patient is a good candidate

4. Headache: mainly outpatient. Most common is migraine. Neurologists do medication management and procedures like Botox injection and occipital nerve block

5. Sleep: mainly outpatient where neurologist see patients sleep disorder and read sleep studies

6. Pain: a lot of procedures and medication management

7. Neuro-ophthalmology; for disorders in vision that are related to the brain

8. Neuro-otology: mainly see vertigo patients

9. Neuroimmunology: they mainly see multiple sclerosis patients and manage their medications, most work in an infusion center

10. Neuro-oncology: for tumors in the brain, either primary or metastatic

Inpatient neurologists see patients who are admitted to the hospital; most work in a shift basis schedule. Inpatient neurolgoist work weekends and holidays. Most common subspecialties are

1. Neuro-intensivist works in ICU, takes care of neurological patients who need ICU care, mainly brain bleeds, subarachnoid hemorrhages, strokes post TNK or thrombectomy, status epilepticus, myasthenia gravis crisis, post-surgical patients

2. Stroke neurologists: work mainly in patients but can also have clinics for follow ups. See all stroke and brain bleed patients in the hospital, makes decisions for thrombolysis and thrombectomy, close relation with neuro ICU, neurosurgery and neuro intervention

3. Neuro-interventionist mainly does procedure for neurology patients like thrombectomy, aneurysm coiling, angiogram...etc

4. Neuro-hospitalist works only in the hospital, shift base, sees all neurology patients who are admitted to the hospital

What are the important traits, qualities, and/or considerations recommended for physicians in this specialty?

patience, good exam skills, empathy, understanding how the brain works

How does the specialty work differ in various settings (e.g. a private vs community vs an academic environment)?

community jobs usually do general neurology. it is hard to find a community job that offers subspecialty opportunities while most academic places offer at least part subspecialty opportunities

What does training for this specialty look like? 

neurology is a four-year residency, one prelim and three neurology

Most neurology programs are categorical, some of them are still advanced

Most neurology residency programs are academic with few that are community based.

What types of experiences might strengthen my future residency application, especially in areas of service, leadership, and research?

Community outreach program and volunteer work is a great place to start, research in neurology, being a part of a neuro- interested group in medschool

Is there a specialty interest group? If not, what other networking options would you recommend? Are there any specific national organizations or committees I should join? 

Yes, also research opportunities for medschool through the waterfall program

Please reach out to James Bates - jamesbates@arizona.edu or Annalise Bracher - arb116@arizona.eduif you are interested in joining Waterfall

What advice would you offer MS1s and MS2s who are interested in this specialty? 

start a project in an area you are interested in trying to answer a question you have. I am happy to guide you what attending to reach out to for the project depending on the subspecialty

How and where can I find other mentors for this specialty?

waterfall program and CSA Is there anything else in addition to the suggestions above that could aid my future application, now that Step 1 is P/F?

good grades in step 2 average is 247

Which group and association memberships might strengthen my future residency application (e.g., AOA, GHHS, MSG, Specialty specific groups, etc.)?

all of those

How important are Step 2 scores to this specialty?

Vital

Are publications important to this specialty? Is there a general number of publications or presentations I should be aiming for? How important is it for these to be within the specialty I am pursuing?

all publications are great especially if they are neuro-specific. they are not essential but definitely strengthen the application

Are there any special considerations when applying for residency?

My advice is to stay close to family or a support group as residency is hard. Make sure you get along with the current residents and share the same philosophy in life. make sure the program offers mentorship

What is a general recommendation for how many programs to apply to (recognizing that this may vary based on student situation)?

This depends on the number of applicants and the number of spots in any given year. This also changed recently with virtual interviews in the last couple of years.

On average US MD students interview in 10 programs and apply to 43 programs on average from (NRMP data)

What letters of recommendation are recommended for this specialty?

Students are allowed to send up to 4 LORS to the programs. We need at least three, (you can submit up to 6) they don't all have to be from neurologists but at least one has to and the more neurology letters the student has the better it is. It would be great if all of them were from neurologists. We do read all LOR you submit, they can be from any other specialty

If other disciplines are appropriate for letter of recommendation writers, are there specific specialties you would strongly recommend? 

not applicable

How competitive are the residency programs in this specialty?

Neurology is not a very competitive specialty, but we are very selective in choosing residents. We aim to find people who have passion for neurology, who have good abilities to explain disease and spend time doing a detailed neuro-exam

Median Step 2 score is 247

When do programs typically offer interviews?

October-December

What is UA COM-P's history with matching in this specialty?

All our students who applied for neurology last year did match

Are away-rotations required for this specialty and if so, when should I plan to do them?

they are not required