Careers in Neurology Why consider Neurology? What are the career options? How do I get there?   --------------------------...
What is neurology?
Neurology? <ul><li>Study of disorders of the brain, spinal cord, peripheral nerves, neuromuscular junction, and muscles. <...
What is a neurologist?
A neurologist? <ul><li>Thoughtful  and  logical .  True enough. </li></ul><ul><li>Favor eponymous,  obscure diagnoses , pr...
Neurology then and now <ul><li>1974 : a 38 y.o. woman came into the ER with global aphasia and right hemiplegia. </li></ul...
What do neurologists do? <ul><li>Evaluate patients with possible neurological disorders. </li></ul><ul><li>Perform studies...
 
Training in Neurology <ul><li>One year of internal medicine. </li></ul><ul><li>Three years of neurology. </li></ul><ul><li...
Medical Schools, MUSC Neurology Residents and Fellows, 2003-2004 . . . . . International : Colombia Germany Hungary Turkey...
Director, Postgraduate Education <ul><li>“ We are pleased to learn of your interest in the  MUSC Neurology residency .  Ou...
Board Certification <ul><li>Successful completion of 4 years of residency (IM + neurology).  Take RITE years 2, 3, and 4. ...
Subspecialty certificates for adult neurology offered by the ABPN: residency + fellowship <ul><li>Clinical neurophysiology...
Other fellowship options <ul><li>Epilepsy. </li></ul><ul><li>Critical care. </li></ul><ul><li>Sleep medicine. </li></ul><u...
How many neurologists do we have?  How many do we need? <ul><li>1950:  1500. </li></ul><ul><li>1970:  2400. </li></ul><ul>...
Why is the need for neurologists increasing at this rate? <ul><li>The general population is aging. </li></ul><ul><li>Aging...
Career prospects <ul><li>Private practice: </li></ul><ul><ul><li>Outpatient only. </li></ul></ul><ul><ul><li>Combined outp...
What’s the attraction? <ul><li>Interesting diagnostic exercise. </li></ul><ul><li>Rapid advances in diagnosis and treatmen...
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  1. 1. Careers in Neurology Why consider Neurology? What are the career options? How do I get there? ---------------------------------------------------------------------------------------------- Paul B. Pritchard, III, M.D. Professor of Neurology January 26, 2006
  2. 2. What is neurology?
  3. 3. Neurology? <ul><li>Study of disorders of the brain, spinal cord, peripheral nerves, neuromuscular junction, and muscles. </li></ul><ul><li>Includes care of pediatric and/or adult age groups. </li></ul><ul><li>Diagnoses are as benign as tension headache and as lethal as amyotrophic lateral sclerosis (ALS). </li></ul>
  4. 4. What is a neurologist?
  5. 5. A neurologist? <ul><li>Thoughtful and logical . True enough. </li></ul><ul><li>Favor eponymous, obscure diagnoses , preferably named in memory of some French physician, eg., Guillain-Barre syndrome. </li></ul><ul><li>Diagnose and adios : can one really do anything about neurological disease? </li></ul><ul><li>The latter two characterizations are not really the case. </li></ul>
  6. 6. Neurology then and now <ul><li>1974 : a 38 y.o. woman came into the ER with global aphasia and right hemiplegia. </li></ul><ul><li>Dx/Tx plan : </li></ul><ul><ul><li>make bedside diagnosis </li></ul></ul><ul><ul><li>start an IV </li></ul></ul><ul><ul><li>hope and pray for improvement </li></ul></ul><ul><li>2004 : a 38 y.o. woman, same story. </li></ul><ul><li>Dx/Tx plan : </li></ul><ul><ul><li>obtain history/exam </li></ul></ul><ul><ul><li>stat CT scan, labs </li></ul></ul><ul><ul><li>arteriogram, intra-arterial tPA </li></ul></ul><ul><ul><li>2 days later patient has only mild facial weakness, occasional paraphasic error. </li></ul></ul><ul><ul><li>Exam now normal. </li></ul></ul>
  7. 7. What do neurologists do? <ul><li>Evaluate patients with possible neurological disorders. </li></ul><ul><li>Perform studies which assist in diagnosis/treatment: </li></ul><ul><ul><li>Lumbar punctures </li></ul></ul><ul><ul><li>EMG, nerve conduction studies. </li></ul></ul><ul><ul><li>Evoked potentials. </li></ul></ul><ul><ul><li>Sleep studies (polysomnography). </li></ul></ul><ul><ul><li>And in some cases: CT/MRI scans, epidural blocks, video-EEG, Botox injections. </li></ul></ul>
  8. 9. Training in Neurology <ul><li>One year of internal medicine. </li></ul><ul><li>Three years of neurology. </li></ul><ul><li>Two options: </li></ul><ul><ul><li>combined program, eg., MUSC: 4 year residency, with 10 months of internal medicine during the first year. Advantage: go through one match (NEMP). </li></ul></ul><ul><ul><li>Separate internal medicine year, then 3 years of neurology. Disadvantage: 2 matches. </li></ul></ul>
  9. 10. Medical Schools, MUSC Neurology Residents and Fellows, 2003-2004 . . . . . International : Colombia Germany Hungary Turkey China (2) India . . . . . .
  10. 11. Director, Postgraduate Education <ul><li>“ We are pleased to learn of your interest in the MUSC Neurology residency . Our residents are a diverse and highly capable group in whom we take considerable pride. If we may assist you, please contact us by telephone (843-792-3222), mail (Suite 307, 96 Jonathan Lucas Street, Charleston, SC 29425), or via email: pritchap@musc.edu. We look forward to seeing you at MUSC.” </li></ul>Paul B. Pritchard, III, M.D. Professor of Neurology Director, Postgraduate Education
  11. 12. Board Certification <ul><li>Successful completion of 4 years of residency (IM + neurology). Take RITE years 2, 3, and 4. </li></ul><ul><li>Pass written board exam given by the American Board of Psychiatry and Neurology (ABPN). </li></ul><ul><li>Pass oral board exam given by the ABPN. </li></ul>
  12. 13. Subspecialty certificates for adult neurology offered by the ABPN: residency + fellowship <ul><li>Clinical neurophysiology (EEG, EMG, evoked potentials, other monitoring techniques). </li></ul><ul><li>Vascular neurology (vascular imaging and evaluation). </li></ul><ul><li>Pain medicine (diagnostic and treatment procedures). </li></ul>
  13. 14. Other fellowship options <ul><li>Epilepsy. </li></ul><ul><li>Critical care. </li></ul><ul><li>Sleep medicine. </li></ul><ul><li>Multiple sclerosis. </li></ul><ul><li>Geriatric neurology. </li></ul><ul><li>Movement disorders. </li></ul><ul><li>Neuro-ophthalmology. </li></ul><ul><li>Neuromuscular disease. </li></ul>
  14. 15. How many neurologists do we have? How many do we need? <ul><li>1950: 1500. </li></ul><ul><li>1970: 2400. </li></ul><ul><li>1980: 4600. </li></ul><ul><li>1990: 8100. </li></ul><ul><li>2000: 11,000. </li></ul><ul><li>2010: expect plateau @ ~12,200. </li></ul><ul><li>Kurtzke et al., ( Neurology 36:1576-1582, 1986). estimate national need of 19,100 by 2010, i.e., availability = 6900 short of the need . </li></ul>
  15. 16. Why is the need for neurologists increasing at this rate? <ul><li>The general population is aging. </li></ul><ul><li>Aging brings increased incidence of common neurological disorders, eg., stroke, epilepsy, and dementia. </li></ul><ul><li>Availability of effective treatments for neurological disorders is growing rapidly. </li></ul>
  16. 17. Career prospects <ul><li>Private practice: </li></ul><ul><ul><li>Outpatient only. </li></ul></ul><ul><ul><li>Combined outpatient/inpatient. </li></ul></ul><ul><ul><li>Critical care neurology: ICU, stroke unit. </li></ul></ul><ul><li>Academic practice: </li></ul><ul><ul><li>Clinician/teacher. </li></ul></ul><ul><ul><li>Investigator/teacher. </li></ul></ul><ul><li>Industry careers, eg., pharmaceutical. </li></ul><ul><li>Mean income ( Business 2.0 , March 2003): $185,000. </li></ul>
  17. 18. What’s the attraction? <ul><li>Interesting diagnostic exercise. </li></ul><ul><li>Rapid advances in diagnosis and treatment over past 25 years, with better things yet to come. </li></ul><ul><li>Opportunity to help patients with problems as mundane as migraine and as obscure as Osler-Weber-Rendu. </li></ul>

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