What it's like to be in neurology: Shadowing Dr. Govindarajan

AMA Wire
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As a medical student, do you ever wonder what it’s like to be a neurologist? Here’s your chance to find out.

Meet Raghav Govindarajan, MD, a neurologist and featured physician in AMA Wire’s® “Shadow Me” Specialty Series", which offers advice directly from physicians about life in their specialties.

Read his insights to help determine whether a career in neurology might be a good fit for you.

"Shadowing" Dr. Govindarajan

Specialty: Neurology

Practice setting: University hospital

Years in practice: 2

A typical week in my practice:

I am a neurologist with specialization in neuromuscular disease. I take care of patients with muscular dystrophies, myasthenia gravis, amyotrophic lateral sclerosis and neuropathies. I also take care of patients with headaches, multiple sclerosis, Parkinson’s disease and many more medical issues. In addition, I do procedures, including BOTOX® for a variety of conditions, electromyography, skin and muscle biopsies. A typical day is spent in the clinic and is a mix between taking care of patients and doing procedures. I also teach medical students and residents in the clinic as well give didactic lectures and spend half a day doing research on amyotrophic lateral sclerosis.

The most challenging and rewarding aspects of caring for patients in neurology:

Neurological care requires time and patience. The challenging part is to find the balance between providing care and keeping up with the expectations of the management in maintaining productivity. The most rewarding part is to see the smiles on the faces of the patients and families when they come to see me.

Three adjectives that describe the typical physician in neurology:

Thoughtful. Empathetic. Sincere and responsive.

How my lifestyle matches or differs from what I envisioned in med school:

Neurology offers more than 11 different fellowships, and the lifestyle depends upon the fellowship and kind of practice one chooses. I was always interested in an outpatient academic career, and my current practice closely reflects that. The only thing I wish is that I had more time to teach. Private practice offers greater flexibility of work hours than being employed by a hospital or hospital system, but each has its advantages and disadvantages. There are some careers in neurology, such as neurocritical care and vascular neurology, which are predominantly hospital- and inpatient-based. Further, the neurohospitalist subspecialty is an up-and-coming career choice for many neurologists and provides the option of one week on and one week off, ideal for raising a family. Finally, many neurologists are choosing administrative careers and other non-medical careers.

The American Academy of Neurology also offers more details on many of these career options.

One skill every physician in training should have for neurology but won’t be tested for on the board exam:

Many neurological conditions are chronic and can affect patients of all ages. One quality we are looking for is the ability to provide sincere, empathetic, compassionate care to patients and their families. This is easier said than done. I shudder at the thought of giving a diagnosis of amyotrophic lateral sclerosis (Lou Gehrig’s disease), and these conversations take a lot out of you as a physician. This is not tested in board exams but is a very important quality for a neurologist.

One question physicians in training should ask before pursuing neurology:

Neurology is all about history and exam. We have a lot of fancy investigations, but history and exam still forms the core of neurological care. So the question is, are you willing to get your hands dirty and spend the time needed in doing a careful, methodical history and exam?

Three books every medical student interested in neurology should read:

  • The Man Who Mistook His Wife for a Hat by Oliver Sacks, MD
  • Reaching Down the Rabbit Hole: A Renowned Neurologist Explains the Mystery and Drama of Brain Disease by Allan Ropper, MD, and Brian Burrell
  • Phantoms in the Brain: Probing the Mysteries of the Human Mind by V.S. Ramachandran, MD, PhD, and Sandra Blakeslee

Online resources students interested in neurology should follow:

The American Academy of Neurology has some great resources about neurology residency, neurology as a career option, awards and scholarships for students, and much more.

Additional advice for students who are considering neurology:

Neurology is a rapidly growing field with lots of new treatment options (did you know that we have more than 10 different treatment options for multiple sclerosis?) and research opportunities. In addition, it offers both cognitive as well as procedural options with a great lifestyle. Check it out!

If you had a mantra or song to describe your life in this specialty, it’d be:

I live my life and career based on 4Ps: Passionate, pragmatic, persistence, partnering with colleagues and patients.

Want to learn more about your specialty options

  • Read more profiles in AMA Wire’s "Shadow Me" Specialty Series to learn additional insights from physicians in such specialties as otolaryngology, vascular surgery, infectious disease, adolescent medicine and physical medicine and rehabilitation, among others.
  • Check out the AMA’s Choosing a Medical Specialty resource guide (member log in required).
  • Be sure to avoid these 5 common mistakes students make when choosing a specialty.
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Sep 21, 2017
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