Everything You Need to Know About Neurology From a Neurologist

“Neuro’s badass” was a repeated sentiment in our hour-long conversation with neurologist, Dr. Neil Bhathela. Dr. Bhathela is a sports neurologist and TBI fellow at UCLA Health and he also played an integral part in creating our new clinical course, Sketchy Neuro. Keep reading to learn about what exactly neurology is and why it’s the best specialty.

First of all...What exactly is a neurologist and what do they do?

A neurologist is a medical doctor who diagnoses and treats disorders involving the central and peripheral nervous system. This includes the brain, spine, nerves, vasculature, and autonomic system. Dr. Bhathela commonly treats conditions like concussions, brain bleeds, vascular abnormalities, strokes, epilepsy, seizures, as well as inflammatory and autoimmune diseases such as multiple sclerosis.

Dr. Bhathela reiterates that patient partnership and education is a big part of the job. Neurological diseases can be scary, as a learner and as a patient. “Part of neurology is explaining to the patient what exactly their disease process is. Just like hypertension, you can't really see it, and for the most part, you can't really feel it.” He also gives credit to his mentors and that he has great appreciation for all the people he works with, knowing he can’t be successful without them.

Is a neurologist the same thing as a neurosurgeon?

There's a lot of overlap between the neurosurgeon and the neurologist and there is a stronger partnership between the two roles. The neurosurgeon has expertise and extra training in the operating room, providing surgical and neurovascular interventions. While the neurologist still performs procedures, such as nerve blocks and lumbar punctures, it’s the neurologist who typically diagnoses and treats patients clinically.

Dr. Bhathela says, “For example, a surgeon for epilepsy may implant a device or even excise some tissue of the brain for epilepsy, but it's a neurologist who diagnoses them, finds where in the brain there is hyperactive, and how we can treat them medically.”

The residency lengths also vary where neurosurgery can be anywhere from 6-8 years while neurology is typically 4 years.

What to consider before choosing neurology as your specialty

Choosing a specialty is a very personal decision, it is important to seek meaningful rotations and be proactive by gathering as much information about field before committing. We asked Dr. Bhathela what advice and considerations he would give to current med students, and this is a summary of what he said:

• Neurology is fun, you diagnose with your hands.

• There are a wide array of fellowships that are less competitive than other subspecialities, this allows you to pursue what you are interested in and have a lot of flexibility in researching your passions.

• Neurology still has procedures. If you don’t want to enter the OR but are still interested in doing procedures then this field is a great choice. Common procedures to expect are lumbar punctures and electrophysiological procedures.

• You work very closely with multiple specialties, including cardiologists and radiologists. Dr. Bhathela says, “you're prescribing anticoagulants, the first organ that's damaged or the organ that you immediately notice with a cardiac arrhythmia, PFO, or structural cardiac issue is the brain…You will be skilled at rate and rhythm control agents. You get very familiar with the anticoagulation and antiplatelet. You work very closely with the radiologists with the newest technology. We read our own imaging, whether it's the spine or brain.”

• Neurologists are all around us, the need is huge, and the job market is great. You can work in any setting, including inpatient, outpatient, emergent setting or academic/private setting.

• With advanced technology, the Neurology field is rapidly changing and is super exciting.

Dr. Bhathela concludes by saying, “if you're looking for a field that's challenging, rewarding, and has a lot of new therapeutics, interventions, and diagnosing using the top high-end tech, then neurology is it…I definitely recommend each student rotate through neurology and get a feel of it for themselves. Because whether or not you want to do neurology, neurology's going to be part of your practice.”

There you have it–all the reasons neurology might be your calling. Stay tuned for Neil Bhathela’s full Sketchy Spotlight interview to learn how he chose neurology and how Sketchy helped him as a med student. And even if we haven’t convinced you to go into neurology, check out this guide on how to choose a speciality.