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How to Become a Neurologist

February 28, 2022
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IntroductionAbout NeurologyHow Hard is it to Become a Neurologist?Becoming a Neurologist: Step by StepCost to Become a NeurologistIs Neurology Right for You? How to DecideOther ConsiderationsFAQs: Becoming a Neurologist


The road to becoming a neurologist is often a lengthy, difficult journey. This post will explore how to become a neurologist, outlining the major steps between first entering a pre-med program and the ultimate goal of establishing a neurology practice.

Introduction

If you’re wondering how to become a neurologist, you might consider the fact that neurology is a difficult brand of medicine unwelcome news. It requires a considerable educational expense and at least 12 years of progressive learning prior to practice. However, all that time and effort eventually pays off.

Becoming a neurologist gives you access to a diverse array of subspecialties, research opportunities, and the ability to make a healthy living while helping patients who suffer from neurological diseases or disorders. For many, being a neurologist is worth all the hardship of becoming a neurologist.

Our step-by-step guide to becoming a neurologist will help you realize the dream of aiding others while working in a fascinating branch of medicine. From pre-med to board certification, tuition to average annual salaries, this post will reveal everything you need to know on your journey to becoming a neurologist.

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About Neurology

Neurology is a branch of medicine focused on the workings and failings of the nervous system. This includes the central nervous system (consisting of the brain and spinal cord) and the peripheral nervous system (consisting of the organs, limbs, and skin). The peripheral nervous system also branches out into the autonomic and somatic nervous systems. 

As the name suggests, the autonomic nervous system performs automatic bodily responses, such as heart rate and digestion, while the somatic nervous system performs more deliberate functions such as the movement of muscles.

You may have noticed that the complete nervous system is related to just about every major and minor function of the human body. This should give you some idea as to the complexity of the nervous wiring that keeps us running.

A neurologist’s duties consist of diagnosing, treating, and managing brain and nervous system disorders like ALS, dementia, epilepsy, stroke, Parkinson’s disease, MS, and concussions. Note that neurology is a non-surgical practice, unlike its related practice of neurosurgery.

Since neurology is a largely diagnostic branch of medicine, neurologists use detailed patient history in tandem with physical examinations to pinpoint disorders affecting their patients. The neurologist's role is considered more cerebral than other medical specializations since it relies on the neurologist’s diagnostic skills to uncover often rare nervous system disorders and diseases.

Becoming a neurologist also offers the opportunity of many subspecializations. From child neurology to clinical research to neuropharmacology, a neurologist can choose from a wide array of fellowships that best fit their professional goals and lifestyle.

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How Hard is it to Become a Neurologist?

Becoming a neurologist is almost as hard as actually practicing as a neurologist. This is especially true during the medical school phase of becoming a neurologist.

An examination of US medical students and residents found that they considered neurology to be one of the most difficult medical specializations. These students and residents also felt they had the “least confidence in dealing with patients with neurological complaints.”

This same examination of medical trainees concluded that this unease toward neurology stemmed from the “complexity of neurological diagnosis and basic neuroscience.” However, first-year residents who felt less difficulty in their neurological practices suggests that more patient exposure helps aspiring neurologists break through the initial complexity of their chosen medical specialization.

So, in summary, it is hard to become a neurologist. Yet, with more practical experience, the path to becoming a neurologist gets easier. Moreover, a lack of prospective neurologists combined with an ever-increasing demand for neurologists means there is very little competition for positions in the specialized field.

Becoming a neurologist takes a diligent and passionate resolve to overcome the complexity of neuroanatomy. Once you conquer the initial difficulty hump of med school neuroscience, the road to helping patients with their neurological conditions becomes much easier to reach.

Becoming a Neurologist: Step-by-Step

It’s helpful to think of your path to neurology as a series of stepping stones. The first stone is completing a pre-med program, and the last is receiving a medical license and board certification. Here’s a step-by-step outline of your journey to a career in neurology, just to make sure you don’t trip up.

Pre-med Program Prerequisites 

To become a neurologist, you will have to complete a college or university pre-med program with a sufficient GPA, take the MCAT exam, and complete medical school. After graduating, you will have to get through a year-long internship, then a three-year-long residency, and complete the licensing and relevant board certification exams. All together, becoming a neurologist is at least a 12-year endeavor. 

This 12-year timeframe does not include any fellowships you may want to pursue after practicing as a neurologist.

If you find you are strangely unperturbed by a 12-year learning process, it’s probably because you possess the diligence and passionate persistence necessary to become and function as a neurologist.

Undergraduate Pre-med Program

An undergraduate pre-med program serves as the foundational element to your career as a neurologist. However, simply coasting through a four-year program is not enough for any prospective neurologist.

To prepare for medical school and your eventual specialization into neurology, you should focus on relevant subjects during your undergraduate education. Early courses relating to neurology include biological sciences, microbiology, biochemistry, and human anatomy.

Moreover, you should maintain a healthy GPA, optimally never dipping below a 3.6. This will better your chances of eventually attending your first-choice medical school. Don’t make the mistake of assuming your undergrad years should be dedicated to academics alone. Even at such an early stage, you can still gain relevant experience through shadowing an experienced physician, volunteering in the healthcare field, or even working administrative jobs in healthcare.

This preemptive initiative will better your chances of acceptance to a medical school and will provide you with early knowledge that will make becoming a neurologist that much easier.

Medical College Admissions Test (MCAT)

Sometime during your last two years as an undergrad, you must take the MCAT exam as a prerequisite to studying medicine. The MCAT is a rigorous, multiple-choice test of your problem-solving skills, critical thinking skills, and knowledge of the scientific concepts and principles you’ve studied during your pre-med education.

Considering the importance of your MCAT results and the expansiveness of its content, you should prepare for the exam through independent study, working one-on-one with a tutor, or even a prep course dedicated to the MCAT. Practice exams are another great resource you should utilize. Providing assistance with past exams is just one aspect included with Inspira Advantage’s private MCAT tutoring service.

Medical School

After sending your MCAT results and applications to your prospective medical schools and later completing the interview process, acceptance letters will hopefully start showing up in your mailbox.

Just as with your undergraduate program, your medical school career will run four years long. However, unlike your pre-med experience, the content of your medical school curriculum will provide an overview of the study of medicine.

Your medical school experience will likely be divided into two distinct parts: two years of pre-clinical followed by two years of clinical training. Your pre-clinical years will be geared toward teaching you basic and more general medical concepts. However, the clinical training you will eventually receive is where you may gain hands-on experience interacting with patients in more specialized contexts. This clinical stage of your education will serve as your first substantial taste of neurological practice.

As previously stated in this post, many med students feel intimidated by neurological concepts and practice because of the complexity of human neuroanatomy. However, with persistence, more experiential learning will help you grow accustomed to diagnostic procedures and hone your diagnostic judgment.

Internship

Now that you’ve gone through a collective eight years of academia, your path to becoming a neurologist will only progress further by accumulating relevant work experience. Your first step outside the halls of an academic institution should be toward an internship under the supervision of an experienced medical doctor.

This internship should extend to about one year, and during that time, you will get more hands-on experience as a physician in a real-world setting, complete with the benefit of a dedicated mentor. You will also begin to develop the interpersonal skills necessary to perform well as a physician, especially as a neurologist. Since a neurologist’s main duties are diagnostics and non-surgical treatment, effectively and sympathetically communicating with patients is an integral skill.

Before your internship runs its course, you should already pursue residency opportunities related to your desired specialization: neurology.

Residency

Your residency is where you are, for the first time, able to perform as a specialized physician in a real-world setting. Since you’ve chosen neurology as your desired specialization, your residency is three years in length.

As the years in your residency pass by, you will become more familiar and experienced with neurological practice because of inpatient and outpatient rotations. Each year you will also be given more independence and responsibility to work with patients and perform other duties related to neurological practice.

Another notable difference between your residency and your previous internship experience is that you will actually be paid as a medical resident. The average annual compensation for a medical resident is $64,000. However, after being whittled down by the cost of living, this annual sum may only do so much in compensating for any accumulated student debt.

State Medical Licensure Examinations

Even after completing years of medical education and experience as a physician, a state medical license is required to practice as a medical doctor. To become state-licensed, you will have to pass a series of three exams administered by the United States Medical Licensing Examination organization.

These state licensing exams are designed to test your ability to effectively marry the medical concepts you’ve learned through school with the practical knowledge gained in your time as an intern and resident. Needless to say, the three licensure exams are quite comprehensive.

This three-step exam will contain both oral and written components. Much like the MCATs, the USMLE exams take tremendous time and effort to tackle. Resources such as diligent independent study, private tutoring, and prep courses are invaluable to your success.

It will cost close to $1000 for each step of the USMLE exam, so paying for a private tutor and passing the first time is a financially wise move. Most medical licensing authorities require completion of all USMLE steps within a seven-year period, beginning as soon as you pass the step 1 exam.

American Board of Psychiatry and Neurology Certification

Board certification is the final step before you can practice as a neurologist. Like the MCATs and USMLE steps, board certification requires an exam consisting of both oral and written components.

The board certification exam is distinguished from the many other tests you must take by its specialized focus. This exam will test your knowledge of neurological concepts and practices, especially the diagnosis of impaired nervous system function.

Note that there is a separate board certification exam for neurology with special qualification in child neurology. This special qualification exam will also test your neurological knowledge as it pertains to patients in the neonatal period, infancy, early childhood, and adolescence.

After passing your USMLE exams and receiving either a neurology board certification with or without a special qualification in child neurology, you can officially call yourself a neurologist. However, the journey does not have to end. You can also pursue board certification in a neurological subspecialty. This step is only necessary if you wish to pursue an intensely specialized practice such as neuromuscular medicine, vascular neurology, neurodevelopmental disabilities, etc.

Maintenance of Board Certification

If you successfully completed all of the previous steps outlined in this post, you are now a neurologist. However, there is a caveat. Advances in neuroscience and neurological practice never cease to progress, so you shouldn’t either. To maintain your board certification and continue practicing as a neurologist, you will have to participate in a C-MOC program.

There is no end date for a C-MOC program as it is a continuous maintenance of your certification. Meeting all the program requirements will enable you to keep practicing as a neurologist. These requirements include completing:

Cost to Become a Neurologist

Though the annual salary for a neurologist is considerable — averaging at $290,000 with about $39,000 in incentive bonus pay — the time and cost associated with becoming a neurologist is equally notable. There’s pre-med fees, med school fees, and the cost of living during your internship and residency period, too.

Let’s consider pre-med expenses first. The National Center for Education Statistics recently concluded that the “annual current dollar prices for undergraduate tuition, fees, room, and board” came to around $18,383 for public institutions, $47,419 for private nonprofit institutions, and $27,040 at private for-profit institutions. Multiply whichever annual cost applies to you by four, and you have your full pre-med expenses.

Then comes the medical school expenses. The recent debt of graduating medical students averaged $207,000 for the extent of their entire four years. This dollar figure includes medical school tuition, books, necessary technology costs, living expenses, and additional fees.

Once your residency comes along, the average $64,000 compensation may ease the financial scorch that pre-med and med school have left you. However, the money you will actually retain is subject to your particular living expenses and lifestyle. Either way, the money earned from your residency will only do so much to alleviate your student debt.

Even after years of neurological practice and the approximate $290,000 per annum that comes with it, you will still be dealing with student debt in addition to the cost of living. Yet once it is all paid off, your hefty annual salary will almost definitely give you freedom from all financial woes.

Is Neurology Right for You? How to Decide

Since neurology is a non-surgical practice, a neurologist will spend most of their time communicating and diagnosing patients, sans anesthetization. This is why comfortability and a certain degree of skill in interpersonal communication are key for an aspiring neurologist.

Dr. Govindarajan, a neurologist with a specialization in neuromuscular disease, gives four adjectives to describe a typical physician in neurology: “Thoughtful. Empathetic. Sincere and responsive.” Since neurology is a complex branch of medicine that relies on careful communication for diagnosis, a sincere emotional investment in the well-being of all patients is a fundamental necessity.

A neurologist needs to possess a natural inclination towards sympathy and a strong emotional resolve. Often, neurologists must work with patients suffering from progressive, untreatable neurological diseases and disorders. The ideal neurologist can brave the most hopeless cases while still doing everything in their power to alleviate the patient’s suffering.

As for the general lifestyle afforded by a career in neurology, the wide array of available fellowships makes it possible to find the particular position that is right for you. Neurology’s many subspecializations come with their own particular work schedules and conceptual focuses. There are even research opportunities and non-medical positions related to neurology that might be a better fit for your particular lifestyle.

Other Considerations

One important thing to consider is that a neurologist is not a neurosurgeon. While a neurologist’s role is non-surgical, a neurosurgeon’s role obviously is surgical. Both medical practitioners tend to work closely together, yet they are distinct from each other.

The path to becoming a neurosurgeon is much different from the neurologist's path. For one thing, a neurosurgeon must spend upward of six years in residency compared to a neurologist’s three years. The pay is also different. A recent MGMA Provider Compensation and Production Report held the 20th percentile of annual neurosurgeon’s compensation at $677,216.

It’s also worthy to note that though neurology is somewhat competitive in top residency programs, it remains an overall relatively non-competitive residency. The discrepancy between the increasing demand for neurologists and the dearth of neurologists in supply means there’s little competition in establishing a practice, too. 

FAQs: Becoming a Neurologist

1. What factors might influence a neurologist’s annual salary?

There are many factors to consider when trying to pinpoint how much you might be able to make as a neurologist. Some of the most notable factors are as follows:

2. What is the highest paying neurological subspecialty?

Interventional neurology and neurocritical care are among the highest paying neurology subspecialties, often bringing in $350,000 or more. This dollar range is also applicable to leadership roles in typical neurological practice.

The annual salary for interventional neurology particularly stands out at an approximate figure of $600,000 or more. However, the demand for particular subspecialties is known to fluctuate on an annual basis.

3. How does neurology differ from other branches of medicine?

Medical students, residents, and professionals often note that neurology is full of ‘zebra’ cases. ‘Zebra’ is a term used to describe rare diseases and conditions. This means that the typical diagnostic maxim for most other branches of medicine, insisting that the simplest conclusion is often the right conclusion, does not apply to neurological practice.

Neurology is also described as being a more cerebral branch of medicine. This, again, relates to the rarity of the diseases and disorders at play. A neurologist must possess an incredibly honed diagnostic sense, since the answers they are searching for are very rarely the simple answers.

4. Are there any downsides to neurological practice?

A neurologist often sees long-term patients afflicted with progressive, yet untreatable neurological diseases. To say the least, it can be stressful to establish relationships with patients while knowing there’s no possible way to solve their problems, once and for all. In such cases, neurologists must show emotional resolve and satisfy themselves and their patients by simply doing all they can to ease the suffering a neurological disorder brings.

Final Thoughts 

In summary, the path to becoming a neurologist is a long, expensive, and often arduous one. It takes a great deal of emotional investment to get through the 12-year learning process that precedes practice. It also takes a clear and thorough understanding of each step along your path to neurological practice, which you now possess.

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