Neurologist

As a neurologist, you'll use advanced diagnostic tools to investigate conditions that affect neurological function, including movement, sensation, memory and behaviour. You'll care for patients with a range of diseases and disorders involving the brain and spinal cord (central nervous system) and the network of nerves throughout the body (peripheral nervous system). These include:

• strokes
• multiple sclerosis (MS)
• cerebral palsy
• headaches and migraines
• blackouts and seizures
• Parkinson's disease
• Alzheimer's disease and other forms of dementia
• motor neurone disease (MND)
• epilepsy
• spinal cord diseases and injuries
• sleep disorders
• muscle diseases such as muscular dystrophy
• infections affecting the nervous system, such as meningitis and encephalitis
• brain tumours - where surgery is required, patients are referred to a neurosurgeon.

You'll work as part of a multidisciplinary team, which may include other neurology specialists, such as neurosurgeons, and members of the wider healthcare team, including speech and language therapists, occupational therapists and doctors in rehabilitation medicine.

Responsibilities

As a neurologist, you'll need to:

• take detailed medical histories and perform neurological examinations to assess brain, spinal cord and nerve function
• order, interpret and explain diagnostic tests such as MRI and CT scans, electroencephalograms (EEGs) and lumbar punctures
• diagnose and manage acute neurological emergencies, such as strokes, seizures and meningitis
• run outpatient clinics to review and monitor patients with chronic or progressive conditions, including Parkinson's disease, MS and epilepsy
• complete ward rounds and coordinate the care of inpatients with neurological disorders
• provide specialist advice and guidance to other doctors, nurses and allied health professionals across different specialties
• update patients and their families on diagnoses, treatment options and ongoing care plans
• supervise and teach medical students and junior doctors, and contribute to clinical governance activities such as audits
• participate in multidisciplinary meetings with colleagues in neurosurgery, neuroradiology, neurophysiology and rehabilitation medicine to discuss complex cases and new developments
• engage in research and continuing professional development to stay up to date with advances in neuroscience and neurological treatments.

Salary

• The basic salary during foundation training in England is £38,831 to £44,439. Salaries for doctors starting their specialist training range from £52,656 to £73,992.
• As a speciality doctor, you'll earn between £61,542 and £99,216. Salaries for specialist grade doctors range from £100,870 to £111,441.
• Salaries for newly qualified consultants start at £109,725, rising to £145,478, depending on the length of your service.

Resident doctors (formerly known as junior doctors) will earn a basic salary, plus pay for any hours over 40 per week, a pay enhancement for working nights, a weekend allowance and an availability allowance if you're on call.

High-cost supplements are available to doctors working in London. You'll automatically be enrolled in the NHS pension scheme, but you can opt out.

Consultants in England and Wales may apply for local Clinical Excellence Awards and national Clinical Impact Awards. You should also be paid more if you take on extra responsibilities in, for example, management or education. In Scotland, you can apply for discretionary points. Consultants are also 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.

Salary bands differ across the four countries of the UK. Pay negotiation happens annually at different times, so salaries will change when each country agrees their new pay award. Check your country's pay scales for doctors for the most up-to-date NHS salary information on the BMA website.

Income data from NHS Health Careers - Pay for doctors. Figures are intended as a guide only.

Working hours

Neurologists typically work around 40 hours a week, usually between 8.30am and 5.30pm, though you may need to cover evenings, weekends and on-call shifts, especially during training.

Part-time work is possible with opportunities for a good work/life balance.

What to expect

• You'll work with both inpatients and outpatients, managing acute neurological emergencies and running clinics for patients with long-term conditions.
• Most roles are based in NHS hospitals, regional neuroscience centres and teaching hospitals, with some opportunities in private hospitals, academic research units and specialist clinics.
• There is a lot of patient contact, and you'll treat people of all ages, from those with childhood-onset neuromuscular conditions to older adults with conditions such as Parkinson's or dementia.
• The work can be emotionally demanding, requiring resilience, empathy and the ability to stay calm under pressure.
• Travel between hospital sites may be required, particularly for consultants running outreach or regional clinics, but most of your work will take place in clinical and ward-based settings.

Qualifications

To become a neurologist, you must first complete a medical degree recognised by the General Medical Council (GMC). This usually takes five to six years, or four years on an accelerated graduate-entry programme if you already hold a relevant degree (normally a 2:1 or above in a science-related subject). The British Medical Association (BMA) provides guidance on applying to medical school as a graduate.

Some universities offer foundation or gateway courses with an additional year to help widen access to medicine - see the Medical Schools Council (MSC) for more information.

After graduating, you'll complete the two-year paid UK Foundation Programme, rotating through different hospital departments, including neurology. On completion, you'll gain the Foundation Programme Certificate of Completion (FPCC).

Next, you must apply in open competition for the three-year Internal Medicine Training (IMT) programme via Oriel. This is the first stage of specialty training and will provide you with the skills you need to lead on the care of patients in both acute care and general ward settings. During IMT, you must pass the Membership of the Royal College of Physicians (UK) Diploma (MRCP(UK) Diploma).

In your third year of IMT, you must apply for specialty training, again in open competition via Oriel. Specialty training in neurology consists of five years of dual training in neurology and internal medicine, plus stroke medicine as a sub-specialty. During this stage you must also complete the MRCP(UK) Specialty Certificate Examination (SCE) in Neurology.

After successfully completing specialty training, you'll gain a Certificate of Completion of Training (CCT) in neurology and internal medicine with sub-specialty accreditation in stroke, which enables you to register on the GMC specialist register and apply for substantive consultant-level posts in neurology, internal medicine or stroke.

Many neurologists undertake a postgraduate research degree (either a Doctor of Medicine (MD) or PhD) before or during their specialty training.

Not all doctors become consultants - some work as specialty doctors or associate specialists (SAS). To do this, you'll need to register with the GMC and have at least four years of postgraduate training, including two years of specialty training.

Skills

You'll need to have:

• a thorough understanding of how the brain, spinal cord and nervous system work
• excellent diagnostic and analytical skills to identify and assess complex neurological conditions
• confidence in carrying out neurological examinations and interpreting test results
• excellent communication skills to explain diagnoses and treatment plans to patients and their families and to manage relationships with colleagues
• problem-solving and decision-making skills, especially in fast-paced or high-pressure situations
• teamwork and the ability to lead and motivate a multidisciplinary team of healthcare professionals
• resilience and emotional awareness to manage the demands of working with patients who may have life-changing conditions
• organisational and time management skills to balance clinics, ward rounds and administrative duties
• a commitment to keeping up to date with new treatments and technologies through continuing professional development (CPD).

Work experience

When applying to do a medical degree, you'll be expected to demonstrate that you understand what a career in medicine involves. This could be through paid or voluntary work experience at your local hospital, hospice, 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.

Virtual work experience accepted by medical schools is available through Medic Mentor, which also offers free mentoring. You can also learn more about the profession by watching documentaries, listening to podcasts or reading articles about healthcare. What matters most is reflecting on what you've learned about patient care and the realities of medical work.

Once you're a medical student you could consider becoming a student member of the:

• Association of British Neurologists (ABN)
• Royal College of Physicians

Membership provides access to a range of news, information and events, as well as networking opportunities.

You could also join a university neurology student society to keep informed about developments.

During your two-year foundation training as a resident 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.

Find out more about the different kinds of work experience and internships available.

Employers

The NHS is the largest employer of neurologists. There are also opportunities to work in the private sector.

Look for job vacancies at:

• ABN Jobs Board
• BMJ Careers
• Health Jobs UK
• NHS Jobs - England and Wales
• NHSScotland Jobs
• Northern Ireland Health and Social Care Jobs
• websites of private healthcare companies.

Individual trusts and hospitals may also advertise vacancies on their websites.

Professional development

Once qualified, 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 participating in audits, contributing to teaching or engaging in research and quality improvement projects.

Membership of the Association of British Neurologists (ABN) and Royal College of Physicians is useful and offers access to CPD resources, events, online learning and professional networks.

Additional postgraduate qualifications are valued, particularly if you wish to integrate teaching, management or research into your career. Search postgraduate courses in medical education.

For an academic research career, you'll need to study for a PhD in an area of original research.

Career prospects

As a consultant, you'll gain further clinical experience and take on more responsibility, with the chance to progress into leadership roles such as lead consultant, clinical director or medical director. Many consultants also contribute to national organisations, professional bodies and guideline committees.

There are opportunities for neurologists to specialise in areas such as epilepsy, peripheral neuropathy, MS, neuroinflammatory diseases or stroke medicine.

If you'd like to pursue research or an academic career, it's important to start early, often during Foundation Training, by applying for an academic clinical fellowship or completing a higher degree such as a PhD.

There are opportunities to get involved in teaching and training medical students, resident doctors and other healthcare professionals. If you're interested in education, you could become an educational supervisor and potentially progress into roles such as training programme director or director of medical education.

There are also opportunities to work in the private sector or to set up your own practice once you've built up experience and a solid reputation.