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Careers in Neurology

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Vascular neurology (vascular imaging and evaluation). Pain medicine (diagnostic and treatment procedures). Other fellowship options. Epilepsy. ... – PowerPoint PPT presentation

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Title: Careers in Neurology


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
What is neurology?
3
Neurology?
  • Study of disorders of the brain, spinal cord,
    peripheral nerves, neuromuscular junction, and
    muscles.
  • Includes care of pediatric and/or adult age
    groups.
  • Diagnoses are as benign as tension headache and
    as lethal as amyotrophic lateral sclerosis (ALS).

4
What is a neurologist?
5
A neurologist?
  • Thoughtful and logical. True enough.
  • Favor eponymous, obscure diagnoses, preferably
    named in memory of some French physician, eg.,
    Guillain-Barre syndrome.
  • Diagnose and adios can one really do anything
    about neurological disease?
  • The latter two characterizations are not really
    the case.

6
Neurology then and now
  • 1974 a 38 y.o. woman came into the ER with
    global aphasia and right hemiplegia.
  • Dx/Tx plan
  • make bedside diagnosis
  • start an IV
  • hope and pray for improvement
  • 2004 a 38 y.o. woman, same story.
  • Dx/Tx plan
  • obtain history/exam
  • stat CT scan, labs
  • arteriogram, intra-arterial tPA
  • 2 days later patient has only mild facial
    weakness, occasional paraphasic error.
  • Exam now normal.

7
What do neurologists do?
  • Evaluate patients with possible neurological
    disorders.
  • Perform studies which assist in
    diagnosis/treatment
  • Lumbar punctures
  • EMG, nerve conduction studies.
  • Evoked potentials.
  • Sleep studies (polysomnography).
  • And in some cases CT/MRI scans, epidural blocks,
    video-EEG, Botox injections.

8
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9
Training in Neurology
  • One year of internal medicine.
  • Three years of neurology.
  • Two options
  • combined program, eg., MUSC 4 year residency,
    with 10 months of internal medicine during the
    first year. Advantage go through one match
    (NEMP).
  • Separate internal medicine year, then 3 years of
    neurology. Disadvantage 2 matches.

10
Medical Schools, MUSC Neurology Residents and
Fellows, 2003-2004
.
.
.
International Colombia Germany Hungary Turkey Chi
na (2) India

.
.
.
..
.
.
.
11
Director, Postgraduate Education
  • 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_at_musc.edu. We
    look forward to seeing you at MUSC.

Paul B. Pritchard, III, M.D. Professor of
Neurology Director, Postgraduate Education
12
Board Certification
  • Successful completion of 4 years of residency (IM
    neurology). Take RITE years 2, 3, and 4.
  • Pass written board exam given by the American
    Board of Psychiatry and Neurology (ABPN).
  • Pass oral board exam given by the ABPN.

13
Subspecialty certificates for adult neurology
offered by the ABPN residency fellowship
  • Clinical neurophysiology (EEG, EMG,
    evoked potentials, other monitoring
    techniques).
  • Vascular neurology (vascular imaging and
    evaluation).
  • Pain medicine (diagnostic and treatment
    procedures).

14
Other fellowship options
  • Epilepsy.
  • Critical care.
  • Sleep medicine.
  • Multiple sclerosis.
  • Geriatric neurology.
  • Movement disorders.
  • Neuro-ophthalmology.
  • Neuromuscular disease.

15
How many neurologists do we have? How many do we
need?
  • 1950 1500.
  • 1970 2400.
  • 1980 4600.
  • 1990 8100.
  • 2000 11,000.
  • 2010 expect plateau _at_ 12,200.
  • Kurtzke et al., (Neurology 361576-1582, 1986).
    estimate national need of 19,100 by 2010, i.e.,
    availability 6900 short of the need.

16
Why is the need for neurologists increasing at
this rate?
  • The general population is aging.
  • Aging brings increased incidence of common
    neurological disorders, eg., stroke, epilepsy,
    and dementia.
  • Availability of effective treatments for
    neurological disorders is growing rapidly.

17
Career prospects
  • Private practice
  • Outpatient only.
  • Combined outpatient/inpatient.
  • Critical care neurology ICU, stroke unit.
  • Academic practice
  • Clinician/teacher.
  • Investigator/teacher.
  • Industry careers, eg., pharmaceutical.
  • Mean income (Business 2.0, March
    2003) 185,000.

18
Whats the attraction?
  • Interesting diagnostic exercise.
  • Rapid advances in diagnosis and treatment over
    past 25 years, with better things yet to
    come.
  • Opportunity to help patients with problems as
    mundane as migraine and as obscure as
    Osler-Weber-Rendu.
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