Specialties

In the past, I had never put much thought into neurology and its related specialties. This rotation was good for me to think about whether I want to be a neurologist. I really like the brain; it's a fascinating organ, we're breaching the frontier of neuroscience, new therapies are being developed, the impact of brain-related diseases is tremendous, and the symmetry (mostly) of the brain satisfies my OCD tendencies. There's an overlap with psychiatry as well as medicine; some drugs work for both neuro and psych conditions (yet I don't think we can explain on a molecular level how epilepsy is similar to bipolar disorder) and there's a tight relationship between cardiovascular parameters and neurologic function. As a specialty, I don't think I'm heavily considering neurology at this point; I don't see myself in the resident's shoes, and I don't get as excited about managing common neurologic problems as the rare ones. While outpatient complaints interest me now, I think they will eventually become routine. And even though inpatient neurology has great pathophysiology, I simply don't like comatose patients. None of the crazy sub-sub specialties interest me (epilepsy, neurovascular, oncology, neuromuscular) except maybe neuro infectious disease. Outcomes for many neurologic diseases are devastating and rehab is the only treatment we have at this time. I think I might be interested in doing another rotation in neurology (consult at Moffitt), but to learn rather than for a future career.

I also got exposure to neurosurgery and neuroradiology, neither of which makes my list of future fields. Neurosurgery is impressive; of all the organs to do surgery on, nothing beats the brain. But I don't think I am built for the stress and pressure of it. Being a neurosurgeon is equivalent to being a movie star. Also, the pathology, while interesting, is limited mostly to mass lesions such as tumor and bleeds, craniotomies for increased pressure, and insertion of devices such as ventricular drains and brain monitors. Neuroradiology, too, is simply not for me. I'm just not into brain anatomy and MRI. Interventional would be very cool but I'd probably go the route of neurology to interventional neurology if I chose to do that.