Another month has flown by and I’m all finished with my neurology rotation. So far, it has been my favorite rotation (against family med and peds) and for the most part it was an enjoyable month. Neuro was one of my favorite classes of MS1/2 and so I was really excited to complete this month. Neuro isn’t my first choice of specialty at the moment (teaser for a future post, its PM&R!), but it’s pretty close to the top. I think it plays to my engineering background more than other specialties. The similarities with electrical engineering are pretty obvious, but in general, its filled with problem solving. Something is wrong with your patient and you have this intricate system of “wires” that could possibly be broken somewhere along the way…find the problem and then try to find a solution to fix it. Sounds a lot like engineering if you ask me! Even aside from this correlation, how can the human brain not just blow your mind to think about. Even if you don’t want to be a neurologist, I don’t think you can be a doctor and not be fascinated with how our brains work.
The logistics of IUSM’s Neurology rotation: IU is at a huge advantage having all of the major hospitals in Indianapolis when it comes to rotation sites. For neurology, the month is divided into two, 2 week periods. The clerkship directors ask for our preferences in the weeks before. We get to choose from in/outpatient adult neurology, pediatric neurology, or even neurosurgery. They can’t guarantee you get what you want, but they work really hard to fit your preferences. I chose to spend 2 weeks with the Riley Children’s hospital consult team and 2 weeks at Eskenazi’s outpatient neuro clinic.
There are some other requirements on this rotation that were pretty manageable. Like most rotations, you have to do 2 nights of “call” from 5-10pm (it’s usually much shorter), and there are patient evaluations to fill out, lectures to attend a few times a week..the typical stuff.
Thankfully the exam was pretty straightforward, as well. A lot of the NBME shelf exams leave you feeling like you were hit by a bus, but the consensus with neuro is that its typically not too bad.
My personal experiences at each site: Riley. I actually enjoy being around kids. Not so much to want to be a pediatrician, but I really liked the environment at Riley when I was there for pediatrics, so I was happy to go back for two weeks. My time at riley can be summed up in 1 word: SEIZURES. Seriously, that felt like all we ever did. Sure there were occasionally more “exciting” things, but I definitely learned my fill of managing and treating seizures in kids. The Riley service is consult only. So that means we don’t have our own floor or unit of the hospital. Rather, we just take consults on other patients and then follow/manage them as long as necessary. It was a really busy service, but probably not typical of what to expect if you want to be a general neurologist. SO if you enjoy being around kids and have any interest in pediatrics, this is probably the best place to spend part of your neuro rotation time. If you just want to get as much experience with typical neurology as possible, its probably not the best service, compared to an inpatient unit at an adult hospital.
Eskenazi: I had never been to Eskenazi before this block. For those that don’t know, Eskenazi is the new hospital that replaced Wishard. Its the county hospital, so it has a very diverse patient population. Also, it’s an amazingly beautiful building and actually looks a lot more like a hotel. I really enjoyed my block here. They put you with a different staff doctor each day, so you get to see a lot of patient variety. I spent time in epilepsy and MS clinics, did general new patient neurology clinics, some movement disorder days, and a variety of other things. In general it was a very thorough experience with the different types of conditions you can encounter as a neurologist. I’d say if you think you want to do neurology or you would like a more general neurology experience, Eskenazi outpatient was a great block.
Overall, this month didn’t really change my mind much on specialty choices, and thats OK. I honestly don’t really expect any month to just knock my socks off. I’d like to think I’m the person at the store just browsing for the moment. I think I know what I want, but I’m just keeping an open eye out for something else that might surprise me. To me, neuro will probably always be the most interesting field ON PAPER, or in the classroom. I could read about the brain function all day. However, the patient population and actually working with these diseases in clinic didn’t seem as interesting to me as I thought it would from reading a book.
So, in the words of Jay-Z, on to the next one. Psychiatry! I’m really not sure at all what to expect next month, but if the past few are any indication, it will definitely be eventful