Neurologist

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A neurologist is a physician who specialises in the diagnosis, treatment and management of disorders of the nervous system, including diseases of the brain, spinal cord, nerves and muscles. Future Growth Strong

The scope of a neurologist is wide and can include involvement in the treatment of epilepsy, stroke, cerebral palsy, neural tube defects, muscular dystrophy, autism spectrum disorder, movement disorders, acquired brain injury, and speech, language and memory problems.


ANZSCO ID & description: 2533: Investigates, diagnoses and treats diseases and injuries of the human brain, spinal cord, nervous system and muscle tissue. Registration or licensing is required.

Alternative names:  Internal Medical Specialist, Medical Practitioner, Physician, Specialist

Specialisations: Neurogeneticist, Neurophysiologist, Neuroradiologist, Neurosurgeon, Paediatric Neurologist

Knowledge, skills and attributes

A neurologist needs:

  • the intellectual ability to apply the concepts of neurological medicine

  • to enjoy finding solutions to problems, dealing with people and directing the work of others

  • to be confident and a strong decision maker

  • excellent communication and interpersonal skills

  • to empathise and be compassionate towards others

  • emotional strength and maturity

  • to be able to work under pressure and have the stamina to work long hours

  • strong ethics

Looking a brain scan
(Source: Medical News Today)

Duties and Tasks

  • examining patients to determine the nature and extent of problems after referral from General Medical Practitioners and other medical specialists, and undertaking laboratory tests and diagnostic procedures

  • analysing test results and other medical information to make diagnoses

  • prescribing and administering drugs, and remedial and therapeutic treatment and procedures

  • recording medical information and data

  • may admit or refer patients to hospitals

  • may consult other medical specialists

Working conditions

Neurologists work in hospitals, private practice or a combination of both. Some neurologists work 60+ hours a week which can include shift, weekend and on-call responsibilities.

A typical day involves seeing patients and time spent doing paperwork. Although the job can be emotionally demanding it can also be emotionally rewarding.

Did You Know?

The Conversation 27 July 2015

The Conversation


We all get headaches from time to time. In fact, nearly every second person in the world had a headache at least once in the past year. But these can feel very different, depending on which of the nearly 200 types of headache you have.

More than half (52%) of people will have a tension-type headache at some point in their life, around 18% will get a migraine and 4% will suffer from chronic daily headaches. These are the most common headache-related diagnoses. Although there are some variations globally, the figures seem remarkably consistent across populations.

Secondary headaches can be initiated by triggering factors such as medication overuse, medication side effects, neck pain, sinus disease or dental problems. These account for small percentages individually compared to the primary headaches, but may be more treatable if the predisposing problem can be sorted out.


Migraine alone is the sixth-most-disabling condition globally.

Migraines are usually one-sided, associated with nausea and light sensitivity (photophobia) and may be preceded by idiosyncratic sensory experiences called an “aura”. Aura phenomena can include moods or emotions, such as deja vu, visual symptoms (flashing lights or jagged lines are common) or problems with speech.

Migraine is a clinical diagnosis; there is no objective test that can verify it with our current technology. But compared to the frustration of researching and treating tension-type headaches, migraine has been steadily giving up its secrets over the past decade.

Migraine physiology is extremely complex. The headaches seem to arise because of dysfunctional regulation of the tone of some of the blood vessels inside the skull.

Migraine sufferers – migraineurs – may have genetic vulnerability to migraines because of overly responsive calcium channels in their nerve membranes or other mutations which result in them having overactive signalling pathways in the brain.

Environmental or internal triggers can provoke these nerves to over-react, resulting in the activation of a reflex pathway. This dysregulation of normal structures causes the headache, nausea, photophobia and phonophobia (sound sensitivity) typical of an attack.

The period of headache in a migraine attack corresponds with a rise in the blood levels in the head of a peptide called calcitonin gene-related peptide (CGRP). CGRP is one of the most common pain-inducing signal molecules in the body. When the CGRP falls, the headache goes away. Where the extra CGRP comes from is not clear but it probably is released from the overactive networks of cells in the brainstem.

Triptans work by activating certain subtypes of serotonin receptors in the brain. Taking a triptan early in a migraine attack seems to directly lower the CGRP release and oppose its effects on blood vessels, thereby stopping the attack. Triptans are not useful, however, to prevent frequent attacks of migraine.



Tools and technologies

Neurologists use specialised equipment including computerised axial tomography (CAT), magnetic resonance imaging (MRI) and electronencephalography (EEG). Others tools include molecular biology, electrophysiology and neuroimaging.


Education and training/entrance requirements

To become a neurologist, you must first become a qualified medical practitioner and then specialise in neurology.

These post-graduate degrees usually take four years to complete. Entry requirements include completion of a bachelor degree in any discipline, although studies in neuroscience are recommended. You must also sit the Graduate Australian Medical Schools Admissions Test and attend an interview at your chosen institution.

On completion of the postgraduate medical degree, you must work in the public hospital system for two years (internship and residency). To specialise in neurology, doctors can apply to the Royal Australasian College of Physicians to undertake further training and ultimately receive fellowship.

Did You Know?

A recent study in Australia revealed there are 5 concussions every 1,000 player hours.

Currently, however, there is no single gold standard measure of brain disturbance and recovery following concussion in sport.

(Source: Brain Foundation)

 

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