Neurologists are physician specialists who diagnose and treat patients with diseases and disorders affecting such areas as the brain, spinal cord, peripheral nerves, muscles, and autonomic nervous system.
Neurologist Career History
The development of modern neurology began in the 18th and 19th centuries. Studies were performed on animals in order to understand how the human brain functioned. Although these early studies produced some useful information, major research in the field of neurology did not begin until the end of the 19th century. Aphasia, epilepsy, and motor problems were targeted and researched. Techniques for brain mapping were also introduced in an effort to determine the locations of functional areas.
In the early 1920s, Hans Berger invented the electroencephalograph, which records the electrical activity in the brain. This achievement led to greater capabilities in diagnosis, treatment, and rehabilitation. During the late 20th century, neurology was further advanced by computerized axial tomography (CAT scans), nuclear magnetic resonance, and neurosurgery.
By the 21st century, continued research led to better drug therapies and a clearer understanding of brain function. Results of this research have given neurologists such resources as new surgical techniques and treatments, including implanted “pacemakers” for certain types of epilepsy; they have also increased their understanding of the causes of neuropathic pain, provided new drug treatments for migraines, and resulted in the discovery of genetic links for certain conditions. As the field of neurology continues to grow, treatments and—in some cases—cures are being found for diseases that previously had not even been identified with a name.
Neurologist Career Description
A neurologist evaluates, diagnoses, and treats patients with diseases and disorders impairing the function of the brain, spinal cord, peripheral nerves, muscles, and autonomic nervous system, as well as the supporting structures and vascular supply to these areas. A neurologist conducts and evaluates specific tests relating to the analysis of the central or peripheral nervous system.
In addition to treating such neurological disorders as epilepsy, neuritis, brain and spinal cord tumors, multiple sclerosis, Parkinson’s disease, and stroke, neurologists treat muscle disorders and pain, especially headache. Illnesses, injuries, or diseases that can adversely affect the nervous system, such as diabetes, hypertension, and cancers, are also treated by neurologists.
Neurologists see patients in two capacities—as a consulting physician or as the patient’s principal physician. A neurologist works as a consulting physician when asked by a patient’s primary care physician to consult on a case. For example, when a patient has a stroke or shows signs of mental confusion, that patient’s primary care doctor may ask a neurologist to consult on the case so that they can determine exactly what is wrong with the patient. In this circumstance, as a consulting physician, the neurologist conducts a neurological examination and evaluates the patient’s mental, emotional, and behavioral problems to assess whether these conditions are treatable. To do the exam, the neurologist may interview the patient, give vision, balance, and strength tests, and order a magnetic resonance imaging scan (MRI) of the person’s brain. After the neurologist has gathered information from such a variety of sources, he or she will discuss the findings with the primary care doctor and make a diagnosis. Treatment plans are then made.
A neurologist is often the principal physician for people with such illnesses as Parkinson’s disease, epilepsy, or multiple sclerosis. Because these are chronic and sometimes progressive conditions, the neurologist monitors the development of the illness and works to treat the patient’s symptoms, which may include muscle spasms, seizures, or loss of coordination. The neurologist may prescribe medications (such as an anticonvulsant), physical therapy (to maintain strength or coordination), or new tests (such as a CAT scan). Depending on the patient’s condition, the neurologist may see the patient anywhere from every few months to once a year.
The neurologist also works with psychiatrists, psychologists, and other mental health professionals as necessary, because a patient’s social condition and emotional issues are closely tied to neurological health. Patients with dementia, for example, often also suffer from depression. When a neurologist notices that a patient being treated seems withdrawn and unusually down, the neurologist may call in a psychiatrist to determine if anything can be done to help with the patient’s emotional needs.
Neurologist Career Requirements
Neurologists first earn an M.D. degree and become licensed to practice medicine. If you are interested in pursuing a medical degree, a high school education emphasizing college preparatory classes is a must. Science courses, such as biology, chemistry, and physics, are necessary, as are math courses. These classes will not only provide you with an introduction to basic science and math concepts but also allow you to determine your own aptitude in these areas. Since college will be your next educational step, it is also important to take English courses to develop your research and writing skills. Foreign language and social science classes will also help make you an appealing candidate for college admission as well as prepare you for your future undergraduate and graduate education. Courses in computer science are a must, as well, since the computer is changing the way medicine is communicated and shared by busy medical professionals.
Those physicians who choose to specialize in adult neurology must first complete an internship (with a minimum of eight months spent in internal medicine) and a three-year residency in neurology. Both the internship and residency must be accredited by the Accreditation Council for Graduate Medical Education (ACGME). Those wanting to work in child neurology have several training pathways to choose from, including completing two years of a pediatrics residency or one-year residencies in internal medicine and pediatrics. Again, these must be ACGME accredited. In addition, the ACGME notes there are a growing number of programs that combine fields and prepare graduates to be eligible for certification in two areas, such as neurology/internal medicine or neurology/psychiatry. The residency programs provide supervised neurology experience in both hospital and ambulatory (outpatient) settings. Educational conferences and research training are also part of a neurology residency.
Certification or Licensing
Upon completion of residency training, neurologists may seek certification in neurology or child neurology from the American Board of Psychiatry and Neurology (ABPN). To be eligible for certification, qualified applicants must have an unrestricted state license to practice medicine; have the required years of residency training; and must pass both a written and oral examination as administered by the ABPN.
All physicians must be licensed to practice in the United States. To become licensed, physicians must pass a state exam, which is administered by their state’s board of medical examiners.
Because they treat patients who may have suffered injuries to the head, neurologists need to have a calm and soothing presence with patients who may be experiencing alternating emotions, including confusion and anger. In addition to compassion, neurologists need to be capable of sifting through a lot of data for specific details.
Exploring Neurologist Career
One of the best introductions to a career in health care is to volunteer at a local hospital, clinic, or nursing home. In this way it is possible to get a feel for what it’s like to work around other health care professionals and patients and possibly determine exactly where your interests lie. As in any career, reading as much as possible about the profession, talking with a high school counselor, and interviewing those working in the field are other important ways to explore your interest.
Neurologists are employed by hospitals, research institutes, managed-care offices, trauma centers, and colleges and universities. Some are self-employed in their own or group practices.
Neurologists interested in teaching may find employment at medical schools or university hospitals. There are also positions available in government agencies such as the Centers for Disease Control, the National Institutes of Health, and the Food and Drug Administration.
Pharmaceutical companies and chemical companies hire physicians to research and develop new drugs, instruments, and procedures.
There are no shortcuts to entering the medical profession. Requirements are an M.D. degree, a licensing examination, a one- or two-year internship, and a three-year residency. Upon completing this program, neurologists are then ready to enter practice. They may choose to open a solo private practice, enter a partnership practice, enter a group practice, or take a salaried job with a managed-care facility or hospital. Salaried positions are also available with federal and state agencies, the military, including the Department of Veterans Affairs, and private companies. Teaching and research jobs are usually obtained after other experience is acquired.
Neurologists who work in a managed-care setting or for a large group or corporation can advance by opening a private practice. Some physicians may become directors of a laboratory, managed-care facility, hospital department, or medical school program. Some may move into hospital administration positions. A neurologist can also achieve recognition by conducting research in new medicines, treatments, and cures, and publishing their findings in medical journals. Participation in professional organizations can also bring prestige.
With further training, a neurologist may become a neurological surgeon. Neurological surgeons, also known as neurosurgeons, diagnose, evaluate, and treat patients with disorders or injuries affecting the central, peripheral, and autonomic nervous systems. This specialist provides both nonsurgical and surgical care, depending on the nature of the injury or illness.
Individual salaries for neurologists vary depending on such factors as type and size of practice, geographic area, and professional reputation. According to Physicians Search.com, neurologists receive starting salaries that range from $100,000 to $190,000. Those with three years of experience had an average salary of $196,563. Salaries ranged from $130,872 to $252,765.Because of the variety of factors influencing earnings, these figures should only be thought of as a guide.
Neurologists working for hospitals, research institutes, and universities receive typical benefits such as paid vacation time, health insurance, and retirement plans. Those who run their own practices must pay for such extras themselves.
Neurologists, like many physicians, must divide their time between patient consultations, study and publishing, and office or departmental administration. Most neurologists work far more than 40 hours a week. A neurologist may see anywhere between 10 and 30 patients each day. They perform medical histories, diagnose problems, and explain treatment and rehabilitation options.
Neurologist Career Outlook
While the U.S. Department of Labor projects occupations in the health care field to grow faster than the average through 2014.The USDL reports that patient demand should create a substantial number of jobs for specialists. The future for neurologists, therefore, should be bright as the need for their expertise increases. One reason for this increased need is the country’s growing senior population. Older people are often affected by neurological problems, including a wide variety of dementias. As research continues and treatments become available there should be more resources neurologists can drawn on to help patients manage such diseases as Alzheimer’s. Additionally, research should provide answers to questions about what causes certain diseases and why and how these diseases progress. When doctors know these answers, they will be able to provide increasingly accurate treatments for such illnesses as amyotrophic lateral sclerosis (Lou Gehrig’s disease), multiple sclerosis, and Parkinson’s disease. For these reasons, neurologists should experience strong job growth.
For More Information:
- Accreditation Council for Graduate Medical Education (ACGME)
- American Academy of Neurology (AAN)
- American Neurological Association (ANA)