Monthly Archive: March 2012

Spotlight Interview: Why Did You Choose Neurology?


 

A Neurology Attending's Perspective: From an interview with a neurology attending at the University of Michigan, in Ann Arbor

Part of an interview series entitled, "Specialty Spotlights", which asks medical students' most burning questions to physicians of every specialty.  See what doctors from every specialty had to say about why they chose their specialty and how to match in their residency.

 

  • What attracted you to neurology?

The subject matter was, and still remains, the most interesting part of medicine to me.  I love figuring out where the problem is—the “localize the lesion” question that is the heart of neurology.  But perhaps the most important is that I enjoy the day-to-day interactions with patients:  the types of questions they have, the exams I have to do, the problems we have to deal with…  I saw what it was like in med school, and realized this was my favorite by far.

 

  • Describe a neurologist's typical work day?

A clinic day is 8-5, with fairly long visits for each patient.  I get 30 minutes for a follow up and 60 for a new.  Most of the visit is getting the history.  In the hospital (teaching hospital with residents), rounds are usually mid-morning, consults in the afternoon.

 

  • What type of lifestyle can a neurologist expect?  

There are a few neurological emergencies, which are uncommon but usually end up going to an ICU right away.  You can pick a subspecialty that has minimal emergencies.  Most private jobs I see have call q 4-6.  However, call is usually from home, answering questions.  The biggest determinant of lifestyle is reimbursement.  If you have a billable procedure like EMG, botox, EEG, sleep studies, you can pay your salary quite easily and have a very relaxed schedule—probably 50 hours a week at most.  Without a procedure, much more time is necessary, as the visits can last a long time so you may have long clinic hours.  60 hours or so.  Call may be q4-6 but I rarely see attending neurologists in the hospital after 9 PM or before 7 AM.  Usually call is handled from home.

 

  • What is the potential salary of a neurologist?

A private neurologist will start at about $200-250K.  They will need some procedure (EEG, EMG, sleep studies, botox, etc) to be able to maintain that without a terrible clinic schedule.

 

  • What is the job market like for neurology?

I get advertisements for neurology positions all over the country, all the time.

 

  • What are the potential downsides of neurology that students should be aware of?

Seeing patients in clinic takes longer than most specialties but bills the same, which can hurt the reimbursement a lot. Most neurologists need some sub-specialty training to get a procedure like EMG or EEG.  In a private hospital, you stand the risk of being consulted on every mental status change, which is rarely neurologic.  They are easy consults, but could make call very annoying.  Most neurologists just tell the consulting team to get a bunch of tests that night and then see the patient in the AM.

 

  • Every specialty has a reputation, how do you respond to the reputation of neurologists?

There are two.  The first reputation is that neuro cannot fix anything, only diagnose it.  This is now an archaic idea, since we now can treat almost every disease to some degree: we have acute stroke treatments (tPA), many MS treatments, and neurological diseases are one of the top areas of drug research in all companies.  The second is a reverse reputation (one that we notice ourselves about other physicians):  most physicians are terrified of Neurology, and would often much rather consult us than do a neuro exam.  This is a shame, and leads to some disappointing situations.  But it also generates a bit of an “outsider” image between us and all other specialties, somewhat similar to the disconnection between medicine and surgery.

 

  • What else would you tell medical students who are considering neurology?

If you like figuring out problems like a medical detective, and if you are a very observant person who likes little details,neurology should be at the top of your list.

 

Editor's Note: For more help choosing a specialty in medicine, I highly recommend one or both of these two great books. I found both very useful.

 

Spotlight Interview: Matching in Dermatology

 
 
A Dermatology Resident’s Perspective:

From an interview with a dermatology resident at Wayne State University in Detroit, Michigan

Part of an interview series entitled, “Specialty Spotlights“, which asks medical students’ most burning questions to physicians of every specialty.  See what doctors from every specialty had to say about why they chose their specialty and how to match in their residency.

 

 

  • How competitive is the dermatology match?

Very. There are not a lot of training programs as compared to otherspecialties. On top of that, each program may only have 2-3 spots yearly. As you can imagine, this creates a competitive atmosphere in the Dermatology match.

 

  • What are residencies looking for in a dermatology applicant?
There are rumors about Dermatology i.e. You must do research, you must have 250+ on Step 1, etc. Although these will help in the match, each applicant has their own characteristics that may impress a program (i.e leadership,Clinical experiences). In general, a well-rounded student will be very competitive. Honors in third year clerkships will be very helpful. Dermatology programs particularly look at the Internal Medicine clerkship as a strong indicator. 

 

  • What do you wish you knew before application/interview season?  

Since Dermatology is competitive, it is important to apply broadly across the country. The application and travel expenses can be costly so prepare wisely.

 

  • What should students look for in a dermatology residency?

Important aspects of Dermatology training include a diverse patient population, wide variety of training in all Dermatology subspecialties (Pathology, Pediatrics, Procedural, Mohs and Cosmetics) and learning environment (clinic vs. inpatient; large program vs small program)

 

  • What other advice do you have for students applying to dermatology residency?

It is important to immerse yourself in the field of Dermatology. Performing well in a Dermatology clerkship will be very helpful. Away rotations are helpful to show a program how well you can fit in at that program AND will give you the opportunity to get a strong letter of recommendation from  Program director at your away rotation.

 

Editor's Note: Applying for residency or preparing for your interviews? I highly recommend First Aid for the Match, The Successful Match: 200 Rules to Succeed in the Residency Match, and The Residency Interview: How To Make the Best Possible Impression .


 

Spotlight Interview: Why Did You Choose Dermatology?

 

A Dermatology Resident’s Perspective: From an interview with a dermatology resident at Wayne State University in Detroit, Michigan

Part of an interview series entitled, “Specialty Spotlights“, which asks medical students’ most burning questions to physicians of every specialty.  See what doctors from every specialty had to say about why they chose their specialty and how to match in their residency.

 

 

  • What attracted you to Dermatology?

The variety of pathology seen in the field of Dermatology initially attracted me. The field allows your to be a clinician, a surgeon and a pathologist all in one day. This kind of variety seems to allow me to be entertained for the next 20+ years.

 

  • Describe a Dermatologist’s typical work day?

The majority of Dermatologist spend there days seeing patients in clinic. Common things are common so most days consist of diagnosis and treatment of skin cancer, acne, benign skin conditions, warts, etc. Some Dermatologists mix their day up with procedures such as benign or cancer excisions, aesthetic procedures, laser surgeries, etc. dermatopathologist spend their days viewing pathology slides to lead to the diagnosis of various skin conditions. Mohs micrographic surgeons use a special surgical technique to treat skin cancer at the microscopic level. Procedural and Cosmetic Dermatologists uses injections, chemicals, lasers and surgical techniques to improve the aesthetic appearance of their patients.

 

  • What type of lifestyle can a Dermatologist expect?  

Most Dermatologist work 5-6 days weekly. The majority of patients are seen between 8am and 5 pm. Dermatologist who are affiliated with hospitals may seen Dermatology consults throughout the day and occasionally on weekends. There are only a few Dermatological emergencies. Therefore, your evening and weekends are used to enjoy family or personal interest. Although the hours of a Dermatologist may be limited to 40-50 hours per week, most Dermatologist will tell you they spend a large amount of time reading new literature and review old text as the field is very vast. A good trained Dermatologist must stay up with current recommendations.

 

  • What is the earning potential of a Dermatologist?

Typically, a Dermatologist may earn roughly between $200,000 and $400,000. This depends on the setting of your practice (Academic vs. Private), location of your practice (Urban vs. Rural) and Volume of patients. With any specialty, there are always outliers. Dermatologist who see large volumes of patients, perform cosmetic or surgical procedures, may earn more income.

 

  • What is the job market like for Dermatology?

There is currently a shortage of trained Dermatologist across the United States. Therefore, the job market is pretty good.

 

  • What are the potential downsides of Dermatology that students should be aware of?

Many people (especially other physicians) comment about the awesome lifestyle of Dermatologist. Although generally dermatologist have great lifestyles, they work very hard for this lifestyle. If you are looking for a field that is “easy,” Dermatology is not for you. The training is an intense 3 years filled with countless hours of clinic and reading…Lots of reading. Life as an attending may be seen as glamorous but your earning potential is based on how hard you work. Due to the shortage of Dermatologist, many physicians have to “stretch themselves thin” in order to accommodate their patient population. Many Dermatologist work beyond normal business hours and even weekends to accommodate the patients they serve.

 

  • What else would you tell medical students who are considering Dermatology?

It will be very helpful to get a full Dermatology experience during your medical school training. The more you see, the better you will understand the field and if it is a good choice for you.

 

Editor's Note: For more help choosing a specialty in medicine, I highly recommend one or both of these two great books. I found both very useful.