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Sunday, April 15, 2012

Final Thoughts: Neurology

My sixth clerkship of third year (Neurology) has come to an end...
  • 5 weeks, 27 days, 170 hours of work in areas ranging from Outpatient Neurology (Specialties including Headaches, Seizures, Neuro-muscular Disorders, Movement Disorders, and Vestibular Disorders) to Inpatient Primary and Consult Services.
  • Working on Outpatient, I worked 11 days for 71.5hours (average of 6.5hours/day; about 28.6 hours/week)
  • Working on Inpatient, I worked 16 days for 98.5 hours (average of 6.2hours/day; about 39.4 hours/week).
  • I enjoyed 5 days off in the last 33 (that's ~1 day/week).
  • I completed 0 nights on call.
  • I studied neurology outside of work a total of 70 hours.
  • My total work in Neurology over the past 5 weeks is: 240 hours in 5weeks (48 hrs/week...about 7 hrs/day).


What I LOVED about Neurology:
  • The neurologists seem to love their lifestyle.
  • There is adequate time to teach (or study).
  • The diseases are interesting; Diagnosing neurologic problems is kind of like solving a good mystery...you find the clues, trace it back to the places in the body where the lesion(s) is/are located, and placing a name to the process. 
  • You get to read a lot of CT and MRI images, which is something I'm finding that I quite enjoy doing.
  • I love Parkinson's patients. I just do.
  • I'm fascinated by seizures. They are interesting, and (for the most part) treatable.


What I DIDN'T love about Neurology:
  • While the daily hours worked weren't too bad, you still need to be in the hospital every day. In the perfect world, I'd rather work a few long shifts and have proper days off.
  • There are a lot of diseases which aren't very treatable. Especially ALS, strokes, MS, and all of those neurodegenerative diseases. They make me incredibly sad, and its frustrating not to be able to offer much help to the patient (aside from your kindness, care, and commitment).
  • You see a fair amount of psychiatric patients, which can lead to multi-million dollar workups that don't yield any significant neurologic diagnosis.
  • The tests can be so expensive! With the cost of healthcare continually rising, I fear that some of these expensive tests might not be as easily ordered after the healthcare reform takes place.
  • I've seen more pain med seekers on this service than I have on any other service.
  • There are a lot of frequent readmissions, especially for migraineurs. I wish we had more to offer them to help relieve their pain without expensive hospitalizations.
  • There aren't many patients that you can "cure", but there are many patients whose diseases are manageable.


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