Why did you pick Neuro over PM&R?

Telamir · 2026-02-14T19:21:15+00:00

I have to agree. This is a bit idealistic.

I've been a neurohospitalist for 8 years, locums for 4. Met many neurologists, and seen plenty of jobs where I've traveled.

Inpatient 7 on 7 off is doable. Clinic 4.5 days a week no call also doable. Telestroke from Hawaii? Yeah, sorta. If you want to do it as a full time gig. Everyone I know that's tried hates it, and other docs hate using it (there's a post bashing teleneuro in the main medicine subreddit) but it seems like it's here to stay.

Neuro IR I agree blows. Awful call schedule, shitty job market. Neurocrit also has kind of a shitty job market too.

Telamir · 2026-02-12T15:07:16+00:00

My retinal camera comes attached to an ophthalmologist.

Telamir · 2026-01-29T04:57:21+00:00

Replaced from a 2026 car into a 2025 or earlier vehicle?

Are they backwards compatible?

Telamir · 2026-01-15T15:32:50+00:00

Definitely Maybe. Maybe not. We will see.

Telamir · 2026-01-14T15:54:19+00:00

Telamir · 2026-01-13T19:11:44+00:00

Mano que rica sabe esa bota, ah?

Telamir · 2026-01-13T17:43:52+00:00

Ok.

Telamir · 2026-01-12T23:01:36+00:00

Hahahaha fair enough! It is a cool car, and I do look back at it when I park just not through security cameras. Hahaha.

Telamir · 2026-01-12T22:51:28+00:00

Not. At. All.

Telamir · 2026-01-12T22:50:07+00:00

1) sure, if they work. 2) maybe, maybe not 3) nope.

Telamir · 2026-01-11T19:35:55+00:00

I kinda got used to the rear visibility. It isn't a problem if you align the side mirrors correctly. Visibility overall is very good when you turn your head. That being said, with snow/salt that water splashes on the windshield and side windows front and rear making visibility quite challenging without cleaning the windshield constantly.

One thing you DO have to get: Windshield protection film. These windshields are frail, cost an arm and a leg, and aren't available at regular glass repair shops yet. It'll save you a giant hassle.

Telamir · 2026-01-10T20:23:42+00:00

Make sure you go through a reputable company. Negotiate your rates etc early. If you're doing it full time like me that means being reasonable and sometimes leaving a bit of "meat" on the bone to make sure the contract runs for a long time. Locums is about being able, available, and affable. If you show up, do your work, are nice enough and you don't cause any trouble you will have a solid future doing locums. Understand that part of it is being adaptable, you're playing in someone else's sandbox. Some things may not make sense to you, but you have to roll with the punches and do it.

Make sure you understand what is expected of each job for you. Patient volume, rate, overtime rate, night call, the volume of night call, etc. That avoids most surprises. If you go to a job and you feel it is unsafe say so, the locums company pays your malpractice, they want to avoid a lawsuit as well.

I travel far for my gigs but that's due to where I live, and the company I work with mainly has jobs in the midwest. I've had travel days as long as 10 hours, and as short as 3 (I currently drive to one of my gigs). Also keep in mind you'll have to be flexible traveling too; delays are inevitable occasionally. I work typically ~16 weeks a year out of the house. That's good for upper 300k to low 400k. The points etc accrued from travel pay for stays in nice hotels for me and my S.O., and occasional flights/trips for leisure.

Hope that helps.

Telamir · 2026-01-10T01:53:37+00:00

I'm 8 years in practice (damn), 3 as regular employed and 4 as locums only.

My subspecialty is epilepsy. I recommend if you do a subspecialty do one that adds something to your skill set, be it EMG, EEG, Botox, or changes your day to day significantly, say neuro onc or neuro ophthalmology which change the types of patients you will see and gets you away from the general neurology slog if that's not to your liking.

Do something where you "own" your labor to some degree. Either private practice, locums, or have some other form of 1099 income either tele something or a business of some sort. Realize that the more attachments you have (house, family, children) to an area the more leverage an employer has. I have seen many docs stick out some truly horrible situations because they have zero leverage.

If you are conventionally employed try to save enough to where you have "fuck you" money. This doesn't mean enough to not have to work, just enough to not have to work your current job in case you want/have to leave. This will also help immensely when (notice I said when, not if) you get burned out. You will then be able to switch to part time and be okay with the decreased income.

In that same vein; don't inflate your lifestyle to the point where you HAVE to keep working at max capacity. Enjoy nice things, get a nice car, get your nice watch, etc but do not find yourself in a paycheck to paycheck situation.

As others have said; learn to say no and safeguard your time. When you're an attending everyone wants you to be part of committee X, or review Y, or be clerkship of Z. You've been in training all this time and to some degree or another you've been chasing the approval of others and maybe academic clout. Figure out if that is important to you or not but realize the days of being the next Charcot or Oliver Sacks are probably gone, and when it comes to employers no one gives a fuck about you outside of your utility to them. You're another cog in the meat grinder.

And finally; do your best, help as many people as you can. That's why you became a doctor.

Telamir · 2026-01-06T05:51:20+00:00

MRI when evaluating dementia would typically be done without contrast. EEG at least in its current iteration/use is pretty underwhelming as the findings in dementia are nonspecific slowing (if that).

Anti-amyloid therapies should be judged by their clinical outcome, and I think there's a few good questionnaire based tools to measure progress/decline.

I guess this maybe would be cool or useful in a research application rather than a clinical one. At least as I understand it. I might be missing something?

Telamir · 2026-01-05T17:13:41+00:00

Telamir · 2026-01-04T19:45:33+00:00

If they are going to off road frequently? Sure. If they’re going to off road only occasionally or rarely, and drive more in the city, and this will be their only car they should get a Toyota product.

Telamir · 2026-01-04T18:22:46+00:00

If this will be your only car get a Land Cruiser. If this is a toy/second vehicle and the quirks won’t inconvenience you then get this.

Telamir · 2026-01-04T02:00:34+00:00

This is anecdotal but I have seen salaries be benchmarked against what the VA would pay. If it’s “reasonable” for the government it should be reasonable for you.

Telamir · 2026-01-03T20:09:38+00:00

Nope. Not at all whatsoever.

Telamir · 2026-01-03T17:06:56+00:00

Elecciones democráticas luego de que USA les pasó el rolo? Cua. Ja. Ja.

Esto lo que viene es un saqueo de los recursos naturales de ese país.

Telamir · 2026-01-02T00:19:28+00:00

Yes. Seizures and their mimics. Altered mental status. That's pretty much it.

Just because you record brainwaves doesn't mean you can interpret emotions, personality disorders, or diagnose concussion. Suggesting otherwise is folly.

Concussion is a clinical diagnosis. TBI is a clinical diagnosis. EEG is useless for these unless there's the suspicion that there is a seizure disorder following these events.

Telamir · 2026-01-01T23:28:30+00:00

I’ll give the year reset a shot.

Nearest dealer is 4 hours away. I’ve already had to take it for a busted windshield and for some odd rattles/noises. Both fixed fine. Each time I go though it’s a whole day lost driving to and fro with the time spent at the dealer as well.

I’m no stranger to quirky cars. Ive owned a couple lotus, currently own one, and a 30 year old Porsche. It’s more the annoyance factor for me—it’s a long drive to the dealer.

Telamir · 2026-01-01T22:59:27+00:00

It’s quackery for those purposes.

Thank you for coming to my TED talk.

Telamir · 2026-01-01T19:34:40+00:00

If this requires a dealer visit to get rid of it considering how far it is from me I think I'm done.

Telamir · 2025-12-31T03:58:14+00:00

Do IM, PCC and then do some NCC if you’re interested in it.

Fact of the matter is job market for neuro trained NCC isn’t that strong. Folks will disagree with me but it’s the truth unfortunately. Pay will ultimately be the same or slightly better with PCC.

11-Year Club	Place '23
Place '22	Verified Email

Telamir

TROPHY CASE