The average human brain weighs three pounds and transmits an estimated 70,000 thoughts per day. When something is going wrong in the brain because of injury, disease, or malfunction, it can affect the whole body. Clinical neurologists are dedicated to understanding brain function, helping patients with neurological and nervous system disorders and working to improve the quality of life for people with diseases like Parkinson’s and Lou Gehrig’s disease.
What is a Clinical Neurologist?
Clinical neurology specialists offer medical and diagnostic care for many neurological conditions. These conditions may include: blackouts and seizures, dizziness, headaches including migraines, memory or concentration loss, muscle weakness and pain, numbness or tingling, sleep disorders, slurred speech, spinal cord injury, tremors and twitches, unsteadiness, vision changes and more.
In addition to studying and treating conditions related to the brain, clinical neurologists are trained to treat and manage patient disorders of the nervous system including the central, autonomous and peripheral nervous systems and the tissues, muscles and blood vessels that are included.
A neurologist may come into contact with patients that have diseases like Parkinson’s disease, epilepsy, Lou Gehrig’s disease, encephalitis as well as injuries to the skull, brain hemorrhage, diseases of the spinal cord, carpal tunnel, cerebrovascular accidents and more.
In order to understand how the brain functions and how it affects the rest of the body, neurologists may also be involved in research programs that attempt to understand some of the major questions we still have about the brain.
Educational Requirements for Becoming a Clinical Neurologist
The minimum educational requirement of a neurologist is a doctorate degree. Subspecialties in neurology may benefit from a post-graduate fellowship lasting between one and eight years.
Step-by-Step Educational Path to Becoming a Clinical Neurologist
Bachelor’s Degree
All aspiring doctors must first attend to their undergraduate education. While this step is the first of many years of study and practical learning, it is an important one. Successful undergraduate study will set the student up to understand a variety of subjects that will be studied more in depth throughout the rest of their education.
During undergraduate training, students will take courses in physics, biology, inorganic and organic chemistry, psychology and English, among classes required for their chosen major. These are pre-requisites for being accepted into medical school and should be given special attention. A student desiring to attend medical school should plan their undergraduate education to include every course that is required by medical school without lengthening their time as an undergraduate.
There is no specific undergraduate degree that is required for students who are working towards medical school. Many students choose a major in the sciences that will automatically include most of the courses that are prerequisites, but it is not necessary. With proper planning the student can major in nearly any field of study while also obtaining the necessary foundation of scientific knowledge and critical thinking skills to move forward successfully.
Medical College Admissions Test
The Medical College Admissions Test (MCAT) is the required test for entry into medical school. It is generally taken the junior year of undergraduate study so that scores can be provided with applications into medical school. The test covers various areas of foundational scientific knowledge, critical thinking and problem solving and is a measure of how prepared a student is for their medical school studies. Students will be tested in the following four categories:
Since this is such an important test, it is recommended that students take full advantage of all the available testing resources including study groups, online pre-tests, tutoring, and expert advice in order to be fully prepared for the MCAT. Resources and information about the MCAT can be found at the Association of American Medical Colleges website.
Medical School
Medical school is a four-year focus on developing students for their careers as physicians and deepening their understanding of important scientific knowledge, practical skills, medical ethics and the art of the profession.
In order to gain acceptance into medical school, which is highly competitive, students will be required to submit their application, proof of a cumulative undergraduate GPA of 3.0 or higher, proof of successful completion of required science courses with a GPA of 3.0 or higher, letters of recommendation from professors and other professionals that highlight the student’s personality, work ethic and intelligence as it sets them up for success as a medical school student and doctor, any extra-curricular activities that show a dedication to the field, leadership abilities or sense of compassion and volunteerism, and any other information that sets them apart from other students.
Since medical schools are so competitive it is wise for undergraduate students to develop a plan for obtaining the required experience that will help them gain admission. By setting aside time to volunteer at a hospital, gain patient experience in other capacities, or obtain medical training such as Certified Nursing Assistant or Emergency Medical Technician, the student can show they are capable and willing to dive into the hard work and discipline or medical school and a career as a successful doctor.
Medical school is set up in two two-year stages.
United States Medical Licensing Examination Parts I and II
The United States Medical Licensing Examination is a three-part test required for all physicians in the United States. During medical school, students will complete the United States Medical Licensing Examinations, Parts I and II. Part I is taken post-coursework and pre-practical rotations and shows that the student has acquired the necessary primary knowledge of the practice of medicine to be able to work with patients in a supervised setting. Part II is taken after rotations and shows that the student has acquired the practical skills and knowledge in the clinical setting to begin to practice medicine unsupervised.
Internship
Immediately following medical school, aspiring neurologists enter into their internship phase of education. This internship can be focused on internal medicine or surgery, depending on the career goals of the physician. This period of education usually lasts one year, though some internship programs are up to three years long. Internships can be focused on either patient care or research, or potentially split between the both areas with a focus on understanding the many sides of the subspecialty. The internship phase will give the student experience prior to entering their neurology residency program where they will work independently with neurology patients in a care setting.
Residency
Residency is the first chance students have to begin practicing medicine on their own. In this stage of education the aspiring doctor is called a “Resident” and will work with patients at a training hospital where continued education and mentoring can take place. Neurology residents will spend time making rounds, monitoring and examining patients, attending lectures and researching and analyzing case studies. All of this work is designed to give the resident the knowledge they need to understand how the patients they interact with may present, what to look for, and what can be done to help. The Accreditation Council for Graduate Medical Education (ACGME) should accredit residencies so they can properly apply to the doctor’s education and further study.
Fellowship
While physicians can begin practice directly after residency, there are a lot of good reasons to continue education through a fellowship program. A fellowship program will allow the doctor to seek out education in a sub-specialty. Some of the sub-specialties available are listed on the American Academy of Neurology website and include:
Depending on the type of fellowship and focus, lengths very from one to eight years. To be accepted into a fellowship, the doctor must submit their current Curriculum Vitae, a personal statement, medical school diploma, current letters of recommendation, USMLE 1, 2 and 3 scores and any other qualifying information.
Certification
Certification is voluntary, though a beneficial additional study and testing method for neurologists to maintain relevant knowledge about their field of practice. The American Board of Psychology and Neurology provides certifications based on experience and test scores. Certification is maintained through continuing education and self-assessments which are required periodically throughout the physicians career.
Understanding the Career Path
Work Environment
Neurologists can have their own practice, work in clinical laboratories or in a medical research setting, be involved in academia, or apply for positions with the government. There are also positions available in federal agencies where there is a psychological evaluation component like one would find in researching a crime.
The largest percentage of Neurologists (26%) spend 30-40 hours per week seeing patients with another 21% spending fewer than 30 hours a week with patients and another 25% spending between 41 and 50 hours a week on patient care. Within these hours, 28% of neurologists see between 25 and 49 patients per week while an additional 25% see between 50 and 75 patients each week.
Neurologists spend more time with patients than many other specialties with 42% reporting that they spend over 25 minutes with each patient that they see. These patient visits usually occur in a clinic based setting. Unless the neurologist works in the hospital or has a patient in the hospital, it is much more likely that they will see their patients in their clinic.
In addition to patient care, neurologists must take care of paperwork as part of their administrative duties. 30% report that they spend between 10 and 14 hours a week on paperwork.
Salary
The mean income for neurologists, according to the most recent Medscape report, is $217,000 per year. Over 20% of neurologists earn over $300,000 a year while about 15% earn less than $100,000.
Neurology is one of the medical specialties where this is a sharp difference in income based on gender. Male neurologists have a mean income of $227,000 while female neurologists earn about $189,000. This is a 20% income gap, which is less than many other specialties, but still significant.
There is a significant variation in salary based on geographic location for neurologists. Neurologists who practice in the South Central region of the United States, which includes Texas, Oklahoma and Arkansas, earn a mean of $250,000. This is 29% higher than the lowest compensation are of the Mid-Atlantic region with a mean of $194,000.
Work setting and situation play a role in compensation as well. The breakdown of mean earnings by setting and situation are as follows, organized from highest to lowest:
Setting
Situation
Research
Some clinical neurologists choose to be involved in research which attempts to further understand and develop treatments for neurological diseases and disorders. For example, the Neurological Clinical Research Institute at Massachusetts General Hospital (NCRI), “develops, designs, supports and manages innovative observational and interventional trials for neurological disorders.”
As with other research facilities, the mission of NCRI is to accelerate research in neurological disorders and supporting the entire therapeutic development process. This includes developing therapies, designing research and studies including clinical trials, providing resources, education and mentoring, and developing collaborations that can bring about needed studies and information within the field.
The Mayo Clinic Department of Neurology is one of the largest in the world. It includes more than 100 subspecialized experts that work together to evaluate, and treat people with developing techniques and technologies. Mayo clinic researchers can be part of several laboratories and programs include everything from Alzheimer’s disease to neuro-regeneration. They diagnose and treat more than 500 neurological conditions – including rare and complex cases.
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