By Frank Xing, MD
Medical students have long had a love/hate relationship with the nervous system. As a second year medical student, I still remember sitting in my small group trying (and failing) to understand the intricacies of the cranial nerves. Though the material may be intimidating, the rewards are just as great. In this day and age of advanced imaging and fancy diagnostics, neurologists still practice medicine as it was intended. A thorough history and physical exam remain the bedrock of my specialty. The neurological exam is so powerful, we are literally able to distinguish the boundaries between life and death (brain death by neurological criteria). But in this age of TikTok videos and viral Instagram hits, I’m going to go old school and give you the Dave Letterman treatment with the top 5 reasons why you should choose neurology as your future career.
Reason 5: The brain is just that cool.
This is the part of humans that makes us us. The fact that you’re able to read and understand this blog post stems from the millions upon billions of neurons firing at this very moment. I just want you to chew on that while you continue reading.
Reason 4: The brain is truly the last frontier of medicine.
I will be completely honest with you: Our understanding of brain function remains rudimentary at best. Sure, we can discern the mundane sensory and motor pathways with relative ease. But the thought-provoking questions of my specialty remain to be answered. How can we stop Alzheimer’s disease which devastates our ever-aging population? How can we restore function after a spinal cord injury? These are just some of the truly life changing advances in my specialty that have yet to be answered. We need your help to find these discoveries.
Reason 3: The practice of neurology is at an inflection point.
If I were to draw a historic parallel, neurology today feels a lot like cardiology in the 1950s. Back then, the treatment options for a myocardial infarction or congestive heart failure consisted of giving patients aspirin and bedrest. Yet as the field progressed, new treatment options like beta blockers and ACE inhibitors became available, which dramatically changed the disease trajectory of these cardiac patients. In neurology today, we are experiencing a similar transformation. Just within the last several years, multiple new therapies for migraine have come online, shifting the way we manage these patients. The window for stroke intervention has been expanded to allow more patients to receive disability-sparing therapy. You may call me an optimist, but I fully expect that, within my career as a neurologist, we will see dramatic treatment advances in ALS, in neurodegenerative conditions like Parkinson’s, and many more.
Reason 2: The plethora of job opportunities in neurology gives you the ability to shape your future practice.
Are you someone who enjoys acute inpatient medicine and who loves running down to the CT scanner to give TPA? If yes, then being a vascular neurologist may be just the career for you. Or do you enjoy seeing patients in clinic, and would like to follow them over time to build that patient-physician relationship? If yes, then consider a career as a neurophysiologist or headache specialist. From the ICU to the EMU to the multidisciplinary ALS clinic, the possibilities are endless in how you would like to shape your specialty niche.
Reason 1: We need you.
The demand for good neurological care will only continue to grow with an aging population. And this shortage of supply will be compounded by the looming retirement of older neurologists, which has been particularly exacerbated in the setting of COVID-19. The addition of telemedicine may help extend the reach of the existing workforce, but these are only half hearted measures at best. Telemedicine will never be able to fully replace the diagnostic accuracy of a neurological exam performed at the bedside. Good neurological care still requires the accumulated wisdom gained through a rigorous medical school curriculum coupled with residency training.
I whole-heartedly invite all of you to join us on this journey. Together, we will build a better future for our patients.