Dr Emma Tallantyre, post-CCT research fellow, University Hospital of Wales, and Dr Stuart Vernon, foundation doctor at Bristol Royal Infirmary, discuss the specialty of neurology. They explain what drew them to neurology, how varied the specialty is, and also stress the importance of finding senior mentors for advice and support.
Introduction to neurology
Neurologists manage diseases affecting the brain, spinal cord, nerves and muscles. Neurology is a hugely rewarding specialty that has been transformed in the last 20 years by new technology and interventions.
Neurology is a broad and varied specialty that holds great appeal, but misconceptions about it abound. Here is a guide to neurology's best kept secrets:
Secret 1: Neurology is more straightforward than you think
Lectures on the nervous system at medical school can be some of the most interesting but might seem quite daunting. However, in time, with good supervision, it will become much easier to understand. None of the components of making a fancy diagnosis are difficult – a good history, a targeted examination, an informed search of the literature – yet the process is made all the more satisfying by others being mystified.
Secret 2: Neurologists have effective treatments
There is good reason for neurology to hold particular appeal for individuals who enjoy uncovering diagnostic conundrums. Neurology is fascinating, but this has led to a misconception that neurology is all about diagnostics with little in the way of therapeutic intervention. The last decade has seen an explosion in the treatment options for many neurological conditions leading to a considerable shift in the workload.
Secret 3: Most neurologists are purely clinicians – research is not essential
Research is strongly encouraged in some areas of neurology but is not essential. Many trainees are opting to go out-of-programme for opportunities such as teaching qualifications or clinical fellowships in place of research.
Secret 4: Neurologists do a lot of acute medicine
All of the evidence points towards the future of neurology being at the front door to the hospital. There will always be a need for good outpatient services for chronic conditions but for those seeking opportunities in acute medicine there will be a vital role for acute neurologists in the 21st century.
Training and working in neurology
- For information on the training pathway, see the Joint Royal Colleges of Physicians Training Board (JRCPTB)
- Visit the neurology ST3 recruitment page for more information on the recruitment and interview process
- Visit the Association of British Neurologists website
- Medical Care: Neurology
- Clinical Medicine articles:
- Cooney M, Carroll A. Cost effectiveness of inpatient rehabilitation in patients with brain injury. Clin Med 2016;15:109–13.
- Axinte L, Fiddes B, Donaghy A et al. Experience from two decades of the Cambridge Rapid Access Neurology Clinic. Clin Med 2015;15:437–41.
- Diener H, Solbach K, Holle D, Gaul C. Integrated care for chronic migraine patients: epidemiology, burden, diagnosis and treatment options. Clin Med 2015;15:344–50.
- Weatherall M. Drug therapy in headache. Clin Med 2015;15:273–9.
- Ahearn D, Umapathy D. Vestibular impairment in older people frequently contributes to dizziness as part of a geriatric syndrome. Clin Med 2015;15:25–30.
- Jackson M. Concise guidance: diagnosis and management of the epilepsies in adults. Clin Med 2014;14:422–7.
- Thaller M, Hughes T. Inter-rater agreement of observable and elicitable neurological signs. Clin Med 2014;14:264–7.
- Morrish P. Neurology: still in first gear (letter to the editor). Clin Med 2014;14:94–6.
- Pickrell W, Smith P. Treatment of resistant epilepsy. Clin Med 2014;14:s1–s6.
- Varatharaj A, Gordon F, Williams P. A case of collapse. Clin Med 2013;13:592–3.
- Hewer RL. Neurology on the move? Clin Med 2013;13:440–2.
- Fuller G, Smith P, Rossor M. Neurology in motion. Clin Med 2013;13:443.
- Luintel A, Young T. Headache caused by straining. Clin Med 2013;13:414.
- Haddow L, Cartledge J, Manji H. HIV and the brain: from AIDS to old age. Clin Med 2013;13:s24–s28.
- Hurford R, Tyrrell P. Stroke thrombolysis: where are we and where are we going? Clin Med 2013;13:s20–s23.
- Compston A. Neurology: quo vadis? Clin Med 2011;11:589–90.
- Douglas MR, Peake D, Sturman SG et al. The inpatient neurology consultation service: value and cost. Clin Med 2011;11:215–17.
- Stanton BR. The neurology of old age. Clin Med 2011;11:54–6.
- Petheram KRC. Neurology on the acute take. Clin Med 2010;10:148–50.
- Smith PEM, Mucklow J. The Specialty Certificate Examination in neurology. Clin Med 2010;10:533–4.
- Winer J. CME Neurology: Neurology of endocrine disease. Clin Med 2010;10:387–90.
- Jung A, Raman A, Mallewa M, Solomon T. Neurology research and teaching in Malawi. Clin Med 2009;9:570–1.
- Morrish P. What is happening to English neurology? Clin Med 2008;8:576–8.
- Turner-Stokes L, Sykes N, Silber E, on behalf of the Guideline Development Group. Long-term neurological conditions: management at the interface between neurology, rehabilitation and palliative care (Concise Guidelines). Clin Med 2008;8:186–91.
- Clinical Medicine CME neurology section (2013):
- Worth P. How to treat Parkinson’s disease in 2013. Clin Med 2013;13:93–6.
- Leach J, Abassi H. Modern management of epilepsy. Clin Med 2013;13:84–6.
- Keogh M, Chinnery P. How to spot mitochondrial disease in adults. Clin Med 2013;13:87–92.
- Stone J. Functional neurological symptoms. Clin Med 2013;13:80–3.
- Williams T. Motor neurone disease: diagnostic pitfalls. Clin Med 2013;13:97–100.
- Future Hospital Journal article:
- Appleton J, Nicholl D. The TOS 2 study: an international multi-centre study assessing the quality of neurological examination. Future Hospital Journal 2015;2:s16.
Historical highlights from the library, archive and museum collections
Thomas Willis (1625–1675) can claim to be the father of the specialty of neurology. Read more about his life and work in Thomas Willis: the father of neurology on the RCP library, archive and museum blog.