Case study

Trainee neurologist — Fizzah Ali

Fizzah loves the variety of working in neurology and the fact there's always something new to learn. Find out what she does as a neurology trainee

How did you get into neurology?

I had my first clinical attachment in neurology during the third year of my medical degree. This really piqued my interest and I became fascinated by the specialty. Between my fourth and fifth year of medical school I completed an intercalated BMedSci in psychological medicine (supervised by a behavioural neurologist). This involved taking a year out of my medical degree to do some research.

After medical school, I completed an academic foundation programme, which didn't include a neurology rotation. However, I kept in touch with doctors that I'd met during my undergraduate training and I took some related courses - for example, a headache course. Some of these courses were aimed at more senior grades, but I still learned from them and they kept me interested in neurology.

During the next stage of my training I opted for an Academic Clinical Fellowship route (an alternative to the core medical training programme) into neurology. I had a clinical rotation in neurology and neuro-rehabilitation. I also spent some time doing research.

What is a typical day like in neurology?

At the moment, I spend the mornings supervising treatment administration to patients with multiple sclerosis and other conditions affecting their nervous system. This includes various intravenous treatments and managing patients if they have a reaction or side effects to the treatment. I usually do a weekly ward round with a consultant.

In the afternoon, I have general neurology clinics where I see patients with symptoms such as headache, dizziness or black outs. These are new patients referred from other specialists, including GPs.

In my previous rotation I also saw patients who'd had transient ischaemic attacks (TIAs). These are also known as 'mini-strokes' and occur when there's a brief interruption of the blood supply to the brain, causing symptoms similar to those of a stroke. The symptoms typically last less than an hour and are completely resolved within 24 hours. We carry out investigations and do some preventative work.

Every month I have a few evenings on call (where a member of staff is available to be called for work, usually outside normal working hours). During this time, I support junior staff in the treatment of neurology and stroke ward patients. I also have a bleeper so that I can respond to queries about patients with possible neurological problems in the hospital. At night when I'm on call, I can be at home as the work usually involves responding to phone calls.

What do you most enjoy?

I love the fact that there's something new to learn every day. The role is varied, as there are so many different neurological conditions. I also enjoy the amount of outpatient (clinic) work.

What are the challenges?

There's always a steep learning curve with each stage of training. You need to be dedicated and allow time for studying. I've opted to work less than full time as I've found it gives me a better work-life balance. This means that training will be spread over a longer time period.

How has the role developed?

Although I'm still quite early on in my specialty training, I've noticed that I'm moving into an increasingly specialised area of medicine.

As you move through your training you notice your skills improving, sometimes without even realising it.

What tips would you give to aspiring neurologists?

It's important to keep asking questions and be aware that there are lots of transferable skills that you'll pick up from other specialties.

Try to squeeze as much learning as you can into your day job, and always be on the hunt for learning opportunities.

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