A career in neurology will suit you if you love complex problem-solving, the diagnostic process and the idea of working with a diverse range of patients
A neurologist is a doctor who is involved with the management of conditions affecting the brain and nervous system.
The brain and spinal cord make up the central nervous system, which is connected to the rest of the body by a network of motor, sensory and autonomic nerves.
A wide range of diseases are treated by neurologists, such as:
- multiple sclerosis
- Parkinson's disease
- Alzheimer's disease and other forms of dementia
- motor neuron disease
- spinal cord diseases
- muscle diseases like muscular dystrophy
- infections affecting the nervous system
- brain tumours (where surgery is required, the patient will be referred to a neurosurgeon).
As a neurologist, you'll need to:
- diagnose complex neurological problems by listening to the patient's history, as well as by examining them and using specific neurological tests
- run outpatient clinics, where you’ll mainly see patients with a chronic condition, i.e. a disease that takes a long time to develop such as Parkinson's and multiple sclerosis, or diagnose rare diseases
- complete ward rounds where you'll look after a caseload of inpatients
- treat acute conditions, i.e. those that come on suddenly, such as stroke
- offer specialist expertise and guidance to other doctors and staff from a range of medical specialties
- spend approximately half a day a week in academic meetings with neurosurgeons, neuroradiologists and other neurological colleagues for learning and development and to discuss cases as a team, drawing on the expertise of all these specialists
- liaise with other medical and non-medical staff in hospital settings to ensure all of the patients' needs are met
- keep up your knowledge of the latest treatments for neurological disorders, which have vastly increased over the past decade
- carry out teaching of junior staff, audits of practice and research.
- The basic starting salary for junior hospital doctor trainees working 40 hours per week at foundation level is £26,614 in the first year, rising to £30,805 in the second year.
- As a trainee at specialty level, you can expect a basic salary of between £36,100 and £45,750. Salaries for specialty doctors (staff-grade) range from £37,923 to £70,018.
- Salaries for newly-qualified consultants start at £76,761 and can rise to £103,490, depending on the length of service.
Allowances are paid for working nights, weekends and being on call. You'll automatically be enrolled on the NHS pension scheme.
Consultants may apply for local and national Clinical Excellence Awards and may also be able to supplement their salary by working in private practice.
Figures relate to the pay and conditions of medical doctors within the NHS, which is the largest employer of neurologists in the UK.
Income data from NHS Health Careers. Figures may differ outside of England, and are intended as a guide only.
A working week will typically be 40 hours, with hours generally between 8.30am and 5.30pm, five days a week. However, it's likely you'll have to work some nights, weekends or be on call (where you're available to be called for work, usually outside your normal working hours). Most trainees at foundation, core and higher level will be expected to work periods of being on call.
Part-time work is possible with opportunities for a good work/life balance. As a core and specialty trainee you'll usually be employed on short-term contracts of six to 12 months.
What to expect
- The role is varied and you'll work with inpatients on the ward, as well as running outpatient clinics.
- You'll encounter more chronic disease than you'll find in most specialties in medicine. This allows you to build a long, therapeutic relationship with some patients who you'll see over years.
- As a trainee, you'll spend some shifts in the emergency department treating patients that come in after having a stroke, or suffering with other neurological emergencies, and you may choose to subspecialise in this area.
- You'll be treating illnesses that can affect the young, such as neuromuscular disorders, and those that affect the old, such as dementia.
- You'll encounter some cases where patients have problems that are mainly psychological but still very disabling. These include types of fits, seizures or black outs that aren't epileptic in origin but related to complicated reactions to stress or traumas. These are still relatively poorly understood but treatments are emerging.
The only way to get into neurology is with a degree in medicine recognised by the General Medical Council (GMC). This usually takes a minimum of five years to complete, although if you've already got a degree in a subject other than medicine (usually a 2:1 or above), you can apply for a four-year accelerated medical graduate entry programme (GEP). Some medical schools accept degrees that are not necessarily in a science-related subject. There are also 'foundation' or 'gateway' degrees available that add a preliminary year to your medical degree. These have been brought in to help widen access to medicine. For more information, see Health Careers.
Your medical degree is followed by two years of foundation training, common to all medical graduates, where you'll work in a hospital as a junior doctor on a rotational basis in different departments, which may include neurology. On successful completion, you'll be awarded a Foundation Programme Certificate of Completion (FPCC).
At this stage you must complete general medical training, which consists of either a two-year core medical training (CMT) programme or a three-year acute care common stem (ACCS) programme. Some trainees may choose to go through an academic route instead of CMT by completing a three-year Academic Clinical Fellowship (ACF). As well as general medical rotations, this will include a six-month research project.
See hospital doctor for full details on the qualifications and training required to be a doctor.
You will need to have:
- excellent knowledge of anatomy, physiology, the central nervous system and other body systems
- good diagnostic skills to determine the type of disease, its severity and extent
- excellent problem-solving and clinical decision-making skills
- the ability to work alone and in multidisciplinary teams
- good time management and organisational skills
- the ability to communicate effectively, both verbally and in writing, with patients and staff from a wide range of backgrounds
- excellent practical skills, to be able to complete clinical neurological examinations such as the lumbar puncture
- familiarity with research methods and a willingness to keep up to date with advances in treatments
- leadership ability.
Before applying to do a medical degree, you'll be expected to undertake work experience, either paid or voluntary, in areas relevant to medicine. This could be through work experience at your local hospital, nursing home or through work-shadowing a doctor. This experience shows your commitment to becoming a doctor and provides insight into the physical and emotional demands of working in medicine.
Once you're a medical student you could consider becoming an undergraduate member of the:
ABN has social media threads which advertise training, opportunities, news or events.
You could also join a university neurology student society to keep informed about developments.
During your two-year foundation training as a junior doctor, try to get onto a neurology rotation. If that's not possible, you can talk to neurologists to arrange a neurology 'taster' session. This will give you a good insight into the work.
The NHS is the largest employer of neurologists. There are also opportunities to work in the private sector. There are currently plenty of opportunities available for neurologists.
Look for job vacancies at:
- BMJ Careers
- NHS Jobs - England and Wales
- NHS Scotland Recruitment
- Northern Ireland Health and Social Care jobs
Look for training posts at:
- NHS specialty training - medical and dental recruitment and selection
- Oriel - the portal to make applications to medical, dental, public health and healthcare science training programmes.
For more information on jobs and training posts, see the Joint Royal Colleges of Physicians Training Board: Neurology.
Whilst you undergo your training in neurology, you'll need to study for exams so that you can hold membership of the Royal College of Physicians (MRCP). The Association of British Neurologists has information about the MRCP Specialty Certificate Examination, which is taken towards the end of neurology training.
As a neurologist, you'll be expected to continue learning throughout your career. Continuing professional development (CPD) is essential if you want to remain on the GMC register. CPD activities can include attending courses, conferences, meetings and workshops, as well as undertaking research and peer-reviewing journal papers.
Although not essential, additional postgraduate qualifications can be useful and many neurologists choose to study for a PhD. If you decide to follow an academic research career, however, you must study for a PhD in an area of original research.
If you wish to integrate more formal teaching into your work, you could study for a qualification in Medical Education.
As a consultant you will gradually gain more experience in your clinical duties and take on more responsibilities. You'll have the opportunity to move into managerial roles, initially as a medical lead (a lead consultant for a team), then as a clinical director (a lead consultant for a department) and later on as a medical director (a lead consultant for a hospital trust).
If you wish to take up scientific research and an academic career, you'll need to start early during your foundation training as this field is highly competitive.
Neurologists interested in teaching future doctors may become a director of medical education, training programme director or associate dean in charge of the entire training programme.
There are also opportunities to work in the private sector or to set up your own practice.
Depending on your specialty, you may have to be geographically mobile in order to move up to the next level.