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Neurology is the medical specialty related to the human nervous system. The nervous system encompasses the brain, spinal cord, and peripheral nerves. A specialist physician who treats patients suffering from neurological disease is called a neurologist. Related yet distinct fields of medicine include: psychiatry, neurosurgery and their subspecialties.
Neurologists examine patients who have been referred to them by other physicians in both the inpatient and outpatient settings. A neurologist will begin their interaction with a patient by taking a comprehensive medical history, and then perform a physical examination focusing on evaluating the nervous system. Components of the neurological examination include assessment of the patient's cognitive function, cranial nerves, motor strength, sensation, reflexes, coordination, and gait.
In some instances, neurologists may order additional diagnostic tests as part of the evaluation. Commonly employed tests in neurology include imaging studies such as computed axial tomography (CAT) scans, magnetic resonance imaging (MRI), and ultrasound of major blood vessels of the head and neck. Neurophysiologic studies, including electroencephalography (EEG), electromyography (EMG), and evoked potentials are also commonly ordered. Neurologists frequently perform lumbar punctures in order to assess characteristics of a patient's cerebrospinal fluid.
Some of the commonly encountered conditions treated by neurologists include headaches, radiculopathy, neuropathy, stroke, dementia, seizures and epilepsy, Parkinson's Disease, multiple sclerosis, head trauma, sleep disorders, neuromuscular diseases, and various infections and tumors of the nervous system.
Treatment options vary depending on the neurological problem. They can include everything from referring the patient to a physiotherapist, to prescribing medications, to recommending a surgical procedure.
Some neurologists specialize in certain parts of the nervous system or in specific procedures. For example, clinical neurophysiologists specialize in the use of electrodiagnostic techniques (EEG and EMG) in order to diagnose certain neurological disorders. Neurosurgery is a distinct specialty which involves a different training path, and emphasizes the surgical treatment of neurological disorders.
There are also many non-medical doctors, those with PhDs in subjects such as biology and chemistry, who study and research the nervous system. Working in labs in universities, hospitals, and private companies, these neuroscientists perform clinical and laboratory experiments and tests in order to learn more about the nervous system and find cures or new treatments for diseases and disorders.
There is a great deal of overlap between neuroscience and neurology. A large number of neurologists work in academic training hospitals, where they conduct research as neuroscientists in addition to treating patients and teaching neurology to medical students.
Neurologists often spend part of their day in their office, interviewing and examining patients, and then spend another part of the day visiting other patients in the hospital and reviewing their progress. They also spend time meeting with doctors who have referred patients to them, discussing the patients' progress.
Most neurologists and neuroscientists are employed full-time, working a 5-day, 40 to 50-hour week. However, this number can vary considerably, depending on experience and the type of position held. Many doctors may be expected to work more hours each week, especially at the beginning of their careers. It is not uncommon for a doctor to put in more than 60 hours a week.
Neurologists who work in hospitals usually have to work evening and weekend shifts to meet the needs of their patients. Doctors are also often "on-call" at times when they are not at work. This means that they can be called in at any time, day or night, to attend to emergencies. On-call activities can add several hours to a neurologist's workweek.
While neurology is not physically demanding work, there can be a great deal of stress involved. This is especially true if neurologists are working with patients who are extremely sick, or even terminally ill.
Education and Training
Persons who are interested in becoming a neurologist must first attend medical school. Good grades in high school and university are generally required, as well as taking the Medical College Admission Test (MCAT) if one is to pursue a Doctor of Medicine degree. Medical school matriculants generally hold at minimum a bachelor's degree. Medical school provides a general medical education and grants students a Doctor of Medicine (MD), Doctor of Osteopathic Medicine (DO), or Bachelor of Medicine/Bachelor of Surgery (MBBS, MBChB) upon successful completion. Graduating medical students then elect a post-graduate or residency program in neurology or pediatrics or one year of internal medicine. Residents in either pediatrics or internal medicine must then enroll into neurology fellowships such as pediatric neurology, or general neurology. Neurologists may chose from a variety of subspecialties.
Neurology residency consists of practical, on-the-job training, in hospitals or other medical settings. The training program provides residents with specific training as a neurologist, and usually takes about four years to complete. In the United States, the first of these four years consists of either a transitional or internal medicine internship, which includes broad exposure to general adult medicine. The second through fourth postgraduate years are spent in a devoted neurology residency, after which time the successful graduate can apply for licensure. After residency, graduates may choose to pursue board certification through the American Board of Psychiatry and Neurology. Some neurologists will complete voluntary, additional training in a fellowship program in order to gain experience in a subspecialty area.
Persons wishing to become a non-medical neuroscientist must first complete a bachelor's degree in neuroscience or a related discipline. The next step is to obtain a master's degree in neuroscience (2 years to complete) and then a PhD (at least 4 years). While there may be research positions available to those with a master's degree, a PhD is generally required to become a university professor or a senior research scientist.
- Accredited Program Search. Accreditation Council for Graduate Medical Education. URL accessed on 26 November 2011.
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