Strokes, Alzheimer’s, Parkinson’s, Lou Gehrig’s disease - these are the types of illnesses that you could be trying to cure if you enter a neurology residency. Unlike a neurosurgery residency, which can take up to 8 years, a neurology residency in the US and Canada lasts for only three years, although many programs require you to take a year to train in another specialty, such as an internal medicine residency. You can choose to do a year of an internal medicine residency, or choose to take a transitional year residency, depending on what the program you are applying to requires. Of course, you, like many other future neurologists, might want to take additional year or two in a medical fellowship to increase your knowledge and training. This article will give you all the important details of how to get into a neurology residency, and tips to make sure you thrive.
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The Best Neurology Residency Programs in the US
- University of Connecticut
- University of Alabama School of Medicine
- Mayo Clinic and College of Medicine
- SUNY Downstate Health Sciences University Program
- Ichan School of Medicine at Mount Sinai
Want to know the top 8 books residency applicants need to read? Watch this video:
The Best Neurology Residency Programs in Canada
- Cumming School of Medicine
- Memorial University School of Medicine
- University of Toronto Faculty of Medicine
- Schulich School of Medicine and Dentistry at Western University
- University of Alberta Faculty of Medicine and Dentistry
What is a Neurology Residency?
Neurology is the study of the brain and nervous system and how illnesses that affect them can affect other parts of the body. As such, you have a lot of options and pathways to follow after completing your residency. Remember that most neurology residency programs last for four years, but the variety of complexity of the brain and nervous systems means that you can choose to train or study other neurological, autoimmune, and degenerative diseases, which all fall under the care of neurologists.
Since neurological disorders affect a lot of people at all life stages, from the very young to the elderly, you can choose between 40 different medical fellowships and subspecialities related to neurology that address conditions in all these population groups and more. The subspecialties include things like:
- Autonomic disorders
- Autonomic medicine
- Balance disorders
- Behavioral neurology and neuropsychiatry
- Child neurology
- Clinical research
- Clinical trials methodology and regulatory science
- Cognitive disorders
- Complementary medicine
During a typical neurology residency, you will most likely be part of a larger team that consists of more senior or chief residents, as neurological disorders are multi-faceted and require multidisciplinary care. You will most likely do a year of internal medicine, as many programs, both in the US and Canada, require applicants to have a year under their belt before entering a neurology residency.
Neurology is a required rotation in many medical schools in the US and medical schools in Canada, so, you will not enter unprepared, entirely, but, as with all residencies, you can still prepare beforehand. You can start by either reading up on different neural pathways in the normal and abnormal states, or read first-hand accounts of people suffering from neurological disorders. The latter is crucial, as an essential trait that you will need as a neurologist is a deep sense of compassion and caring, which we’ll expand on later.
What’s Involved in a Neurology Residency (US)
In the US, neurology residencies can last for up to five years. Some programs are preliminary residencies, meaning that you will need to take a year in another specialty before you start your neurology residency, but others are categorical and do not require you to take any additional training before you enter the residency.
If you do enter a neurology residency in the US, you will find that you will see patients in various formats and location. You will not only do your rounds in a hospital, inpatient setting, but you will also rotate through outpatient or community clinics, where you are brought in for neurology consults asked for by an internist or family doctor with a patient experiencing symptoms of a neurological disorder.
The structure and rotation schedule of your neurology residency depends on the program you are attending, but since neurology is very much a patient-facing discipline your first two years are mostly attending to patients and shadowing more senior residents. You may get one or two months of electives where you can explore your area of interest, and, as is typical, in your fourth year, you have more control and autonomy over what you study or research.
What You Need to Get into a Neurology Residency (US)
The academic and professional requirements to get into a neurology residency are not lengthy, and they are similar to other requirements that are not longer than four years. But getting in, if you have a strong application, and ace the residency interviews, is not the hard part about doing a neurology residency, which we’ll talk about more in the following paragraphs. You need the same types of application materials and other documents to apply through the ERAS, which include:
- USMLE Scores (some programs have a cut-off of 220)
- Residency CV
- Neurology residency personal statements
- 3 or 4 letters of recommendation
These are the hard requirements, but what are the key qualities and attributes that you will need to not only excel, but survive, a neurology residency?
You need to be compassionate, caring, and empathetic.
All doctors have to give bad news, but the life-altering nature of neurological disease makes them particularly insidious. You will have to tell someone they have Alzheimer’s, which is as emotionally and mentally draining for you as it is for your patient. You can and should learn all about neuroscience and neuroanatomy in the lead-up to your residency, but reminding yourself of the impact these diseases and disorders have on people is also essential to making you a kind, and compassionate presence at a person’s worst moment in their life.
Of course, your compassion and empathy are not easily measured by your board-exams or any of your other academic qualities. This means that you should try to pursue any extracurriculars or volunteer positions with patients afflicted with these disorders to develop your compassion and sense of duty so you are not at a loss when it comes time to tell someone and their loved ones that they have a neurological disease.
Applying to a Neurology Residency
You have to apply to all residency programs through the ERAS, and neurology is among the most competitive residencies. The match rate for applicants is 99%, but the number of MD applicants (1,550) is more than the number of positions offered (846), so you should know that getting into one of these coveted spots means your application has to be stellar. We’ll give you some tips on the best ways to impress residency directors, and tell you what you need to work on if you want to enter a neurology residency.
How Neurology Residencies are Structured (US)
The curriculum and rotation schedule of each neurology residency program in the US is different. But, typically, over the four years you are mostly tasked with seeing patients in various settings and departments (mostly internal medicine, pediatrics, and emergency medicine) shadowing a senior resident, and doing your electives. You don’t start to get into subspecialties until the second or third year, where you will have more neurology-related rotations, such as movement disorders, child neurology, and neuro-radiology.
Of course, you can always do a dual-residency, which will take longer than the usual four years, but if you are serious about neurology as a discipline, taking a dual-residency in neurology/internal medicine, or neurology/psychiatry will give you more extensive training and knowledge than a typical four-year residency in only neurology. All these disciplines are closely linked and complement each other, which is why some programs offer them, although they are rare and not all schools or hospitals will have them.
By the end of your four years, you will have more freedom to choose what and where you want to study. Near the end of your residency is where you can also start thinking about applying for board-certification from the American Board of Neurology (ABN), which is a required step to becoming a practicing neurologist. You might also decide on where and in what capacity that you want to practice, whether you want to remain in a hospital setting, or go into a community clinic or set up your own practice.
What’s Involved in a Neurology Residency (Canada)
Canadian programs are a bit longer than neurology residencies in the US, and the majority of programs are preliminary, so you have to complete at least a year in internal medicine before entering a four-year neurology residency. Once in your residency, your first year usually consists of learning more about neuroscience and learning clinical skills (kind of like a “boot camp”), such as taking patient histories and physical exams.
Sharpening these skills is important because so much of neurology depends on studying a patient’s history and previous exams to reach a definitive, and correct diagnosis. Neurology programs in Canada are also divided between adult and pediatric neurology. You apply separately to each program (adult or pediatric) through CaRMS, which is similar to the US where you decide before you apply whether you want to pursue adult or pediatric neurology.
But the structure of your entire residency follows the Competence by Design model ushered in by the Royal College of Physicians and Surgeons of Canada (RCPSC), which has introduced this new model as a way to ensure you can be trusted to perform your duties and responsibilities competently, when faced with a real-world scenario or patient. The CBD model has only recently been introduced but many, if not all, of the best residency programs in Canada will soon make the transition to CBD.
What You Need to Get into a Neurology Residency (Canada)
When applying through the CaRMS, most neurology residency programs in Canada ask for the same things. But, to stand out from all the rest, you should try to fill your medical school electives with strictly neurology-related subjects, such as neuroscience, neuroanatomy, and neuroimmunology. All the complexities and pathways of the brain means that you have to digest a lot of vital information that can be challenging. If you have prepared for this by taking electives in neuroscience then you will not only demonstrate your passion for the field, but your first years will go smoother.
The application requirements are not dissimilar from most residency programs in Canada, but that does not mean you should not put any effort into making them exceptional. You should be ready to address important neurology residency interviews questions, such as why this program, why neurology, and what are your plans for the future. Many, but not all, neurology residency programs in Canada also administer the Altus Suite exam for all applicants, so doing CASPer test prep should help you perform well during the test.
Some of the standard application requirements for neurology residents include:
- Letters of recommendation
- CaRMS personal letter
- CASPer or Altus Suite (program-dependent)
- Medical Student Performance Record (or MSPE in the US)
- Official transcripts
But, aside from these official requirements, many neurology residency directors want to see how well you work with patients and other residents, since neurological disorders are distinctly chronic (think of epilepsy or multiple sclerosis) so you will meet and continue to see patients for a long time. The more experience you have in direct patient care, primary care or any activity that puts you in contact with patients every day is a good way to demonstrate you are able to care for patients in the long-term.
And speaking of the long-term, we mentioned above reading non-fiction accounts of people who have experienced severe neurological disorders or spinal injuries that have impaired their mobility. You should read these not only to develop your sense of compassion, but also patience. It’s important to internalize that you will spend years working with patients to either alleviate their symptoms or improve their quality of life.
Even though all medicine requires patience, being a neurologist implies you have on-going relationships with your patients, and you cannot expect them to recover in weeks or months, as with surgery or trauma patients. For example, the French writer Jean-Dominique Bauby suffered from “locked-in syndrome”, where his cognitive function continued, even though his body was fully paralyzed.
Bauby lived for two years in this condition but managed to write a book, “The Diving Bell and Butterfly” through blinking his eyes whenever a letter was recited to him. A more famous example is the story of actor Christopher Reeve who despite being paralyzed persevered for another decade and regained his independence and autonomy. These accounts can give you a sober perspective on the ups-and-downs of being a neurologist and how you have to have as much perseverance as your patients.
Applying to a Neurology Residency (Canada)
Neurology, and pediatric neurology, are not as popular as other specialties, as it was only ranked a 1st choice by 1.3% of all CaRMS applicants in the most recent match. But the 41 applicants who applied were matched in the 48 neurology residency positions available in Canada for an 85% match rate. All residency programs in Canada use the CaRMS and registering with the service is your first step in preparing your applications.
How Neurology Residencies are Structured (Canada)
Even though the CBD model is becoming the norm, many residency programs are still retaining the usual combination of doing rounds in various wards of a teaching hospital, and academic seminars where you learn from experienced faculty and practicing neurologists. The first years are usually more a continuation of your clerkship years from medical school where you go through rotations in fundamental disciplines such as internal or emergency medicine in both inpatient and outpatient settings.
The later years are where you focus more on neurology-based rotations in neurology wards where you see more patients with neurological disorders. You can choose from different subspecialities and focus on a specific area that interests you. Among the electives that you can choose from in a neurology residency in Canada are:
- Sleep neurology
- Neuro-oncology
- Neuromuscular disease
- Cognitive/behavioral neurology
- Headaches/migraines
How to Get into a Neurology Residency
Take Advanced Electives
If you are serious about neurology, think about taking as many advanced neurology electives in your final year of medical school, such as neurosurgery, pediatric neurology, neuroradiology and neuropathy. Any one of these electives will give you a more in-depth focus on various subspecialties and stand out to residency directors for the challenge you’ve given yourself and your dedication to the field.
Read as Much as You Can
We talked about personal accounts of neurology patients, but you should also read as much as you can about neural pathways, the neurological exam to assess a patient’s cognitive function, clinical neurology, and clinical scenarios, to name a few. The more you pour into absorbing this material the more you will be able to speak about what interests you about neurology when you are in your interview(s).
Join a Professional Society
Being a member of a specific professional or honors society is sometimes viewed favorably by residency directors. It is an impressive professional accomplishment, but many you can join on your own, and it is a good idea, as it gives you access to an entire network of neurology experts, researchers, and doctors along with educational and professional resources. In the US, you can join the American Academy of Neurology, but in medical school you can also join the Student Interest Group in Neurology (SIGN), which is a student-run network with various chapters in the US and Canada. In Canada, you can join various societies, including the Canadian Neurological Society, which you can join as a resident and then later as a board-certified neurologist.
Get Help from Neurology Faculty
Having someone to guide you and give you advice on how exactly to prepare for a neurology residency is indispensable. You can ask the neurology directors or faculty from your medical school to ask if they can help you to choose a program, what books you should read, what extracurriculars you should do, and much more. The more senior the better, as those with more experience and knowledge will be able to help you much more.
FAQs
1. How long are neurology residency programs?
In Canada, they last five years, but they are preliminary residencies where you take two years in a separate discipline and then enter a neurology residency for three years. In the US, many programs are categorial and last for only three years, although some programs may require you to do a transitional year residency beforehand.
2. Are neurology residency programs competitive?
They are, more so in the US than Canada. The match rate is 99% in the US and there are often more applicants than positions available. But in Canada, a neurology residency is somewhere in between low-demand specialties such as family medicine and internal medicine and high-demand fields such as ophthalmology or vascular surgery.
3. How much do neurology residencies pay?
There are no set figures since every neurology residency program in the US and Canada dictates its own pay structure. The average salary for a US neurology resident is $64,600, but in Canada it depends on where you are doing your residency. In Canada, you can expect to earn up to $60,397 in one province, or $66,154 in another.
4. How much do neurologists make?
In the US, the median salary for a neurologist is $268,000. In Canada, the median salary is $333,065. These are both entry-level salaries, and your salary may increase further in your career.
5. Do neurology specialists have long hours or poor work-life balance?
In Canada, only 42% of neurologists say they are happy with the work-life balance, even though 75% say they are satisfied in their professional life. In the US, almost 60% of neurologists reported experiencing burnout, even though, similarly, over 75% said they would become neurologists again. In both countries, the meaning found in the work is the number one motivating factor.
6. Do neurology residency programs include research components?
It depends on the program. Research is often an essential part of any residency, but different programs will have different research opportunities. Some may even require the completion of a research project as part of your residency training, while others may not.
7. Do neurology residency programs value certain parts of the application more than others?
There are certain things that may appeal to neurology residency directors, such as your choice of electives, your board scores, any research you’ve done or participated in and whether you have excellent letters of recommendation. They also want to see true dedication to neurology so shadowing a neurologist or doing research is key.
8. Do MDs fare better than DOs in getting into neurology residency residencies?
Allopathic school graduates do typically fare better than osteopathic school graduates when it comes to matching to disciplines like neurology, especially because of the shortage of positions in the field.
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