Overall, I had a good time on neurology clerkship. I think the content is reasonable to be learned within 5 weeks. Neurosurgery and stroke were my favorite. I enjoyed the intensity of acute neurologic conditions. Although I did not really care for the chronic neurologic conditions, I was fascinated by pathology and presentation of multiple sclerosis. It was frustrating that there were so many patients who we did not know how to treat, because we tried everything in the books.
One thing I had love hate relationship was neurologic exam. It is one of the hardest physical exam in my opinion. If you know pathology behind each exam and understand what you are looking for, it makes a huge difference. Also getting a descent reflex hammer is going to make you a reflex expert. It is not even that expensive. Also I don't think I am going to be a neurologist, but I can definitely see myself loving neurosurgery.
Neurosurgery: It was my first surgery experience and I absolutely loved it. I really appreciated the variety and intensity of the field. Neurosurgery runs the neurology ICU, so we were able to see many non-surgical patients as well. The day started at 5:30 and ended around 5-6PM. I had one call. If there was no emergency surgery, we were let go early. I wish I got to know the patients more though. I would suggest you read up on the patients if you want to have some idea on what is going on on rounds.
Neurology inpatient consult: This was my least favorite service, because it was not really busy and there was not much to do. The team rounded in the morning with the general inpatient neurology team, so the consult students were just doing nothing in the morning. I wish they just told us to come at 1PM instead of in the morning.
Neurology inpatient: This is where you would see the bread and butter of neurology. Patients were generally very sick, suffering from chronic debilitating neurologic conditions like Multiple sclerosis, Myasthenia gravis and chronic headache.
Stroke inpatient: This was my favorite. Because my attending rounded early, the days started at 6:30AM, but we finished early in the morning. The rest of the day, we were mostly free if there was nothing going on with our patients. We saw patients with acute stroke and TIA. You will be an expert in management of acute stroke and secondary prevention of stroke after a week. This is a great place to learn brain vasculature and nervous system structure. If you make an effort, you can learn to read CT scans and MRI of the brain.
Outpatient neurology: This was compilation of random neurologic conditions. The content depended on specialty of the attendings. I was with epilepsy specialist and neuro-ophthalmologist. I wish I was able to see patients on my own. It was always overcrowded, so I honestly did not get much of it this one.
Pretest Neurology: It was highly recommended by everyone. The explanations are not that great, but the questions are really great guide to content and details we have to know for the shelf.
Case Files Neurology: I read this one the last before the shelf after Pretest, It helped me to organize the content I learned from Pretest in my head. There were a few cases that I did not see in pretest. If you don't have time, then I don't think it was a must.
Uworld/Kaplan: They cover slightly different content. I would not say one is better than the other. I remember liking Kaplan a little bit better, because it is more detail orientated, while Uworld is concept orientated. I suggest you do both if it is possible.
Blueprints Neurology: I honestly did not like this one. If you don't remember anything about neurology from your step studying, this is a good introductory book. However, the content is not sufficient to give you knowledge to navigate shelf questions though.
Be Sure to Study
- Neurological side effects of psychiatry drugs like akathisia, seizure and NMS etc
- Psychiatric conditions that has neurologic symptoms like Non-epileptic epilepsy and Conversion disorders etc
- Central nervous system infectious disease
- Neurosurgery and trauma
- Genetic neurologic conditions