You like the idea of the brain, knowing all of its intricacies, and the idea of being

你喜歡大腦的想法，知道它所有複雜的東西，以及被的想法

a brainiac yourself.

一個聰明的自己。

Let's debunk the public perception myths, and give it to you straight.

讓我們來揭穿公眾的認知誤區，直接給你說說。

This is the reality of neurology.

這就是神經病學的現實。

Dr. Jubbal, MedSchoolInsiders.com.

朱波醫生，醫派內參網。

Welcome to our next installment in So You Want to Be.

歡迎來到我們下一期的《所以你想成為》。

In this series, we highlight a specific specialty within medicine, such as neurology, and help

在這個系列中，我們強調了醫學中的一個特定的專業，如神經病學，並有助於

you decide if it's a good fit for you.

你決定它是否適合你。

You can find the other specialties on our So You Want to Be playlist.

你可以在我們的 "所以你想成為的人 "播放列表中找到其他特產。

If you want to vote in upcoming polls to decide what future specialties we cover, make sure

如果您想在即將到來的民意調查中投票決定我們未來的專業內容，請確保

you are subscribed.

你已經訂閱了。

If you'd like to see what being a neurologist looks like, check out my second channel, Kevin

如果你想知道作為一個神經科醫生是什麼樣的，請看我的第二個頻道，凱文。

Jubbal, M.D., where we'll be covering a day in the life of a neurologist soon.

Jubbal，醫學博士，我們很快就會報道神經科醫生的一天生活。

Neurologists are the physicians that specialize in the non-surgical management of the variety

神經內科醫生是專門從事非手術治療各種疾病的醫生。

of central and peripheral nervous system disorders.

中樞和外周神經系統疾病；

For surgical management, neurosurgery is the specialty you're looking for.

對於手術治療，神經外科是你要找的專業。

Neurologists manage everything from headaches and migraines to the most devastating and

神經內科醫生可以處理從頭痛和偏頭痛到最具破壞性和最嚴重的疾病。

incurable diseases like amyotrophic lateral sclerosis, or ALS, and Huntington's disease.

不治之症，如肌萎縮側索硬化症，或ALS和亨廷頓氏病。

Strokes, which are the fifth leading cause of death and first leading cause of disability

中風，是第五大死亡原因和第一大殘疾原因；

in the United States, are diagnosed and treated by neurologists.

在美國，由神經科醫生診斷和治療。

Many believe that neurologists primarily diagnose conditions, but cannot do much to treat any

很多人認為，神經科醫生主要是診斷病情，但對任何治療都無能為力。

of them.

其中。

While there are several conditions for which modern medicine has limited management options,

雖然現代醫學對幾種病症的處理方案有限。

research in neurology is rapid and our therapies are improving.

神經病學的研究進展迅速，我們的治療方法也在不斷改進。

For example, strokes used to be untreatable, leaving patients with lifelong disability.

比如，中風過去是無法治療的，讓患者終身殘疾。

However, in the past few decades, our understanding of strokes has improved drastically.

然而，在過去的幾十年裡，我們對筆畫的認識有了很大的提高。

As they say, "time is brain", and rapid interventions such as tPA and endovascular thrombectomy

俗話說 "時間就是大腦"，tPA、血管內血栓切除術等快速介入治療。

are now understood as critical in favorable outcomes.

現在，人們認識到這對有利的結果至關重要。

Parkinson's disease care has been revolutionized with deep brain stimulation.

帕金森病的護理已經通過腦深部刺激進行了革新。

Epilepsy care has improved through new anti-seizure medications, vagus nerve stimulation, and

通過新的抗癲癇藥物、迷走神經刺激術，癲癇護理得到了改善。

epilepsy surgery.

癲癇手術。

Brain tumors of all types now have a multitude of treatment options.

現在各種類型的腦腫瘤都有多種治療方法。

ALS is still a devastating illness, but clinical trials for novel therapies are showing tremendous

ALS仍然是一種毀滅性的疾病，但新型療法的臨床試驗正在顯示出巨大的。

promise.

承諾。

When you think about the patients requiring neurological care, it makes sense that it's

當你想到需要神經系統護理的病人，這是有道理的。

a specialty with less rosy outcomes.

一個結果不太樂觀的專業。

A substantial portion of diseases in neurology are chronic and progressive, but neurologists

神經內科的疾病有相當一部分是慢性的、進展性的，但神經內科醫生的

help their patients live a life of dignity and enjoy the time they have left in a meaningful

幫助他們的病人過上有尊嚴的生活，並在有意義的情況下享受他們剩下的時間。

way.

辦法。

The bread and butter of neurology consists of stroke, seizures, headaches, and dementia,

神經科的麵包和黃油包括中風、癲癇、頭痛和痴呆。

but there's a great deal more to it, as we'll explore shortly with the wide variety of fellowship

但還有更多的內容，我們稍後將與各種團契一起探討。

opportunities.

機會。

There are a few ways to categorize neurology:

神經內科的分類有幾種方法。

Inpatient neurologists work in the hospital setting, treating admitted patients with seizures,

住院神經科醫生在醫院環境中工作，治療入院的癲癇患者。

acute demyelinating disease, stroke, complications pre-op or post-op from neurosurgery, neuromuscular

急性脫髓鞘疾病、中風、神經外科手術術前或術後併發症、神經肌肉疾病

disorders, meningitis, encephalitis, and more.

疾病、腦膜炎、腦炎等。

The lifestyle of an inpatient neurologist is similar to that of a hospitalist - it's

住院神經科醫生的生活方式與醫院醫生的生活方式類似--它是

common to work 7 days on and then have 7 days off, or 2 weeks on followed by 2 weeks off.

常見的是工作7天，然後休息7天，或者工作2周，然後休息2周。

Outpatient neurologists work in the clinical setting, managing patient's chronic neurologic

神經科門診醫生在臨床上工作，管理病人的慢性神經系統疾病。

conditions including headache, peripheral nerve disorders, Parkinson's disease, dementia,

症，包括頭痛、周圍神經疾病、帕金森病、痴呆症。

epilepsy disorders, myasthenia, ALS, stroke prevention and rehabilitation, and more.

癲癇病、肌萎縮症、ALS、中風預防和康復等。

As is usually the case in an outpatient practice, you can expect 9 to 5, Monday through Friday,

和通常的門診一樣，您可以期待週一到週五的9點到5點。

regular business hours.

正常營業時間。

As an academic neurologist, you'll be working at an institution affiliated with a medical

作為一名學術神經科醫生，你將在一家醫療機構的附屬機構工作。

school or teaching hospital, which generally means a large tertiary center with comprehensive

學校或教學醫院，一般是指具有綜合性的大型三甲中心。

stroke, epilepsy, and ALS treatment centers.

中風、癲癇和ALS治療中心。

In academic neurology, a fellowship is generally advised, and compared to other practice settings,

在神經內科學術上，一般建議做研究員，相比看其他實踐環境。

you'll be more narrowly focused on that fellowship subspecialization.

你會更狹隘地專注於該獎學金的分專業。

As with any academic setting, you'll also be teaching medical students and residents

與任何學術環境一樣，您也將教授醫學生和住院醫師。

in addition to doing research on the side.

除了兼職做研究外。

Compensation in academia is usually about 30 percent less compared to community or private

與社區或私營企業相比，學術界的報酬通常要低30%左右。

practice.

慣例。

Community neurologists usually have clinic in addition to a weekly call schedule.

社區神經科醫生除了每週的電話安排外，通常還有診所。

They normally see less acute patients either pertaining to general neurology or their fellowship,

他們通常會看一些不太急性的病人，要麼是與普通神經病學有關的，要麼是他們的獎學金。

which is most commonly headache, neurophysiology, neuromuscular, and movement.

其中最常見的是頭痛、神經生理、神經肌肉和運動。

Private practice neurologists focus on less acute neurology, including pathologies such

私人診所的神經科醫生專注於不太急性的神經病學，包括病理學，如：神經內科、神經外科和神經外科。

as headache, neuropathy, less severe Parkinson's disease, and well controlled seizure disorders

如頭痛、神經病變、較輕的帕金森病、控制良好的癲癇病等。

in their clinics.

在他們的診所。

They also usually take call for stroke or general neurology at local hospitals.

他們通常也會在當地醫院接診中風或普通神經科的電話。

While the pay is higher, you're more likely to have more demanding call, needing to service

雖然工資較高，但你更可能有更多的要求的電話，需要服

multiple hospitals in a given radius.

在特定半徑內的多家醫院。

After 4 years of medical school, neurology residency is another 4 years.

醫學院畢業4年後，神經內科住院醫師又是4年。

Your first year in residency, or PGY-1, is an internship in internal medicine.

您在住院醫師的第一年，或PGY-1，是內科的實習。

After all, a strong internal medicine foundation is prerequisite to be successful as a neurologist.

畢竟，要想成功成為一名神經內科醫生，紮實的內科基礎是前提。

During your second through fourth years of residency, you'll be focused exclusively on

在第二年到第四年的住院醫師培訓中，您將專注於

neurology.

神經學。

As a PGY-2, you'll be focusing primarily on inpatient coverage of stroke, general neurology,

作為PGY-2，你將主要關注腦卒中、普通神經內科的住院報道。

epilepsy, and neuro-critical care.

癲癇和神經危重症護理。

As a PGY-3, you'll begin having more outpatient clinic exposure, but still lean towards inpatient,

作為PGY-3，你會開始有更多的門診接觸，但還是傾向於住院病人。

while also begin working on fellowship applications.

同時也開始著手研究獎學金的申請。

As a PGY-4, you'll be more evenly split between inpatient and outpatient, and this

作為PGY-4，你會更均勻地分擔住院和門診的工作，這個

is also when most residents focus on research.

也是大多數居民集中研究的時候。

You can do either a categorical or advanced residency.

你可以做一個斷然的或高級的居留。

Categorical means you do all 4 years at a single program, whereas for advanced programs,

斷然是指你在一個項目上做滿4年，而對於高級項目。

you'll do your intern year as either a preliminary year or transitional year and then do neurology

你會做你的實習一年作為初步或過渡年，然後做神經病學。

residency at a different program.

在不同的項目中擔任住院醫師。

Medical students that apply to neurology are stereotypically the quirky nerds who have

報考神經內科的醫學生，在刻板印象中都是那些古靈精怪的書呆子。

a strong interest in reading, tend to talk a lot, and enjoy explaining to others what

對閱讀有濃厚的興趣，喜歡說很多話，喜歡向別人解釋什麼。

they've learned.

他們已經學會了。

In terms of competitiveness, neurology is considered less competitive, ranking at 16

在競爭力方面，神經內科被認為競爭力較弱，排名16位

out of 22 specialties.

在22個專業中。

The average Step 1 score is 232, average Step 2CK is 245, and match rate is 97%.

Step 1平均分232，Step 2CK平均分245，匹配率97%。

After completing residency, you can subspecialize further with fellowship.

在完成住院醫師資格後，你可以通過獎學金進一步分科。

Vascular neurology is almost entirely inpatient in nature.

血管神經內科幾乎全部是住院病人。

This is the subspecialty for neurologists that love staying on top of research and have

這是神經科醫生的亞專業，他們喜歡保持在研究的最前沿，並有以下特點

a deep interest in vascular anatomy and acute care.

對血管解剖和急診有深厚的興趣。

This is a 1 year fellowship, although some programs are 2 years in duration when research

這是一個為期1年的獎學金，儘管有些項目在研究時是2年的時間。

is involved.

是涉及。

If you love the high acuity of inpatient and love acute lesion localization, then this

如果你喜歡住院病人的高敏度，喜歡急性病變定位，那麼這個

may be the field for you.

可能是你的領域。

But you will be called at odd times for stroke emergencies, which may be unfavorable to many.

但你會在奇數時間被叫去處理中風急症，這可能對很多人不利。

Epilepsy is a 2 year fellowship for the brainiacs of neurology.

癲癇是神經內科的腦力勞動者的2年交情。

You'll be reading EEGs and working with neurosurgeons for either intra-operative EEG monitoring

您將閱讀腦電圖，並與神經外科醫生合作，進行術中腦電圖監測。

or for managing seizure patients with vagal nerve stimulators or responsive neurostimulation

或用迷走神經刺激器或反應性神經刺激器來管理癲癇病人

devices.

設備。

This is primarily an outpatient practice, unless you work at a large epilepsy center,

這主要是門診，除非你在大型癲癇中心工作。

where they do admit patients to the epilepsy monitoring unit to better characterize seizures

在那裡，他們確實把病人送進了癲癇監測室，以便更好地確定癲癇發作的特徵。

and see whether surgical treatment is warranted.

並看是否需要手術治療。

Movement disorders is a 1-2 year fellowship and is purely outpatient in practice.

運動障礙是1-2年的研究，是純門診實踐。

These are the experts in treating Parkinson's, Huntington's, tic disorders, tremors, dystonias,

這些都是治療帕金森症、亨廷頓症、抽搐症、震顫、肌張力障礙的專家。

and more.

以及更多。

This subspecialty comes with a great lifestyle, with a 8-5 practice.

這個亞專業的生活方式很好，八點到五點執業。

Botox injections are often a key procedural aspect of this specialty and can add to the

肉毒桿菌注射往往是本專業的一個關鍵程序環節，可以增加。

practitioner's compensation significantly.

從業人員的報酬大幅。

If you work at a larger center, you'll also help manage devices like deep brain stimulators

如果你在一個較大的中心工作，你還會幫助管理深部腦刺激器等設備。

for Parkinson's tremors with the neurosurgeons.

對於帕金森的震顫與神經外科醫生。

Neuro-critical care is a 2 year fellowship, and is a newer and rapidly growing subspecialty

神經危重症護理是一個為期2年的研究項目，是一個較新的、發展迅速的亞專業。

of neurology.

神經學的。

These are the specialists of extreme neurologic illness such as brain hemorrhages, large strokes,

這些都是腦出血、大面積中風等極端神經系統疾病的專家。

neuromuscular crises, acute spinal cord injury, and dealing with neurosurgery post-operative

神經肌肉危機，急性脊髓損傷，以及處理神經外科術後的問題。

care and complications.

護理和併發症。

This is for those who love the exciting, fast paced nature of the ICU and want to practice

這是為那些喜歡ICU的刺激，快節奏的性質，並希望練習的人。

both neurology and internal medicine elements.

既有神經內科的內容，也有內科的內容。

It's more procedure heavy than other parts of neurology, dealing with more lumbar punctures,

它比神經內科其他部位的程序更重，處理的腰椎穿刺更多。

intubations, central line placements, chest tubes, external ventricular drains, and more.

插管、中心線置入、胸管、室外引流等。

Call can be demanding as the patients are all very sick and can decline rapidly if not

呼叫的要求會很高，因為病人都是病得很重，如果不這樣做的話，病情會迅速下降。

monitored carefully.

仔細監測。

Neuro-interventional surgery and radiology is for those who want to specialize in minimally

神經介入手術和放射學是為那些想專門從事微創手術的人準備的。

invasive procedures for large vessel strokes, aneurysm coiling, and arteriovenous malformations.

大血管卒中、動脈瘤盤繞和動靜脈畸形的侵入性手術。

It's quite demanding, and has a steep learning curve for neurologists because it's purely

它的要求相當高，對神經內科醫生的學習曲線也很陡峭，因為它是純粹的

procedural.

程序性的。

This is an additional 1 or 2 year fellowship for which you can take one of three paths.

這是一個額外的1年或2年的獎學金，你可以選擇三種途徑之一。

Either through neurology followed by vascular neurology or neuro-ICU fellowship, neurosurgery

或者通過神經內科，然後是血管神經內科或神經ICU獎學金，神經外科。

residency, or radiology residency followed by neuroradiology fellowship.

住院醫師，或放射學住院醫師，然後是神經放射學研究員。

It is the most competitive subspecialty of neurology and the lifestyle can be demanding

這是神經內科競爭最激烈的亞專業，生活方式也很苛刻。

as you may be called at odd hours to activate an endovascular team to perform endovascular

因為您可能會在零時被叫去啟動血管內科團隊，進行血管內科手術。

procedures.

程序；

At the same time, it is the highest paying.

同時，它也是報酬最高的。

There are several other fellowship options to choose from as well, including neuro-immunology,

還有一些其他的獎學金選擇，包括神經免疫學。

neuromuscular diseases, neurophysiology, neuro-ophthalmology, neurocognitive and neurodegenerative diseases,

神經肌肉疾病、神經生理學、神經眼科、神經認知和神經退行性疾病；

neuro-oncology, neuro-rehab, headache, sleep, pain, neuro-infectious diseases, and neuro-endocrinology.

神經腫瘤科、神經康復科、頭痛科、睡眠科、疼痛科、神經感染性疾病科、神經內分泌科。

Neurology is a great specialty with a lot to love.

神經內科是一個很好的專業，有很多人喜歡。

About 80% of neurology is outpatient, which means you're less likely to work weekends,

大約80%的神經內科是門診，這意味著你不太可能在週末工作。

and you're more likely to have a regular 8-5 practice.

而你更有可能有一個正常的八五仔練習。

However, note that most private practice neurologists have to take call for local hospitals.

但要注意的是，大多數私人診所的神經科醫生都要為當地醫院接診。

Neurology is concerned with the most fascinating organ system of the human body, and we've

神經病學關注的是人體最迷人的器官系統，我們已

seen dramatic improvements in our understanding of the brain and spinal cord in just the last

我們對大腦和脊髓的理解有了巨大的進步，僅僅在過去的一年裡，我們就看到了這一點。

20 years.

20年了

And that's likely to continue, as neurologic diseases are consistently in the top 3 most

而且這種情況很可能會持續下去，因為神經系統疾病一直處於前三名最

funded diseases by the NIH each year.

每年由美國國立衛生研究院資助的疾病。

If you enjoy building strong longitudinal relationships with your patients, neurology

如果您喜歡與患者建立牢固的縱向關係，神經內科就會成為您的首選。

has you covered.

有你覆蓋。

Most neurology pathologies are chronic in nature, and you'll be seeing your patients

大多數神經內科的病理都是慢性的，你將會看到你的病人。

often for many months to many years.

常常是幾個月到很多年。

While neurology is a great specialty, it's certainly not for everyone.

雖然神經病學是一個很好的專業，但肯定不是每個人都適合。

Despite the immense research funding being poured into the field, neurologic diseases

儘管該領域投入了大量的研究資金，但神經系統疾病

are debilitating in nature as treatment options aren't as robust as they are in something

是衰弱的性質，因為治療方案沒有像他們的東西一樣強大。

like cardiology.

如心內科。

With less favorable outcomes, neurologists may need to be more comfortable with palliative

在結果不太理想的情況下，神經內科醫生可能需要對姑息治療更加得心應手。

and hospice care, which can be emotionally challenging for many and can lead to burnout.

和臨終關懷，這對許多人來說可能是情感上的挑戰，並可能導致倦怠。

Neurology consistently ranks at the top in terms of burnout.

神經內科的倦怠率一直名列前茅。

The lifestyle can be demanding, especially with a community practice.

生活方式的要求會很高，尤其是社區實踐。

In addition to having a busy clinic, you'll have to take stroke call at local hospitals.

除了門診繁忙外，你還要在當地醫院接聽中風電話。

Neurologist compensation is in the lower third of all specialties, making on average $280,000

神經內科醫生薪酬在所有專科中處於較低的三分之一，平均收入28萬元。

per year.

每年。

This is in large part because you're dealing with primarily chronic illnesses and there

這在很大程度上是因為你面對的主要是慢性病，而且有。

are fewer procedures in neurology compared to something like gastroenterology or cardiology.

與胃腸病學或心臟病學等相比，神經科的手術較少。

And because of the wide breadth of neurology, the overwhelming majority of neurologists

而由於神經病學涉及面廣，絕大多數神經病學專家

pursue fellowship.

追求研究金。

That means your training will last at least another 5 or 6 years after medical school,

也就是說，你的培訓在醫學院畢業後至少還要持續5、6年。

which is on the longer end for a non-surgical specialty.

這對於非外科專業來說，是偏長的。

Should you go into neurology?

你應該去神經科嗎？

If you're the type of person that loves the complexity of neuroscience and enjoys using

如果你是那種喜歡神經科學複雜性的人，並且喜歡使用

the physical exam and deductive reasoning to come up with a diagnosis and treatment

體檢和推理，以得出診斷和治療。

plan, neurology may be a good fit.

計劃，神經內科可能是個不錯的選擇。

If you want to be part of a specialty that's rapidly growing, evolving, and focusing more

如果您想成為快速發展、不斷進步的專業的一部分，並更多地關注於以下方面

on holistic longitudinal treatment now rather than the "diagnose and adios" mentality of

而不是現在的 "診斷一下就了事 "的心態。

the past, consider this specialty.

過去，考慮這個專業。

In terms of patient population, you should be comfortable with longitudinal relationships

在患者群體方面，你應該對縱向關係感到滿意。

with sensitive patients who may have debilitating and sometimes terminal illness, which isn't

敏感的病人，他們可能有衰弱的，有時是絕症，這不是

as rosy as some other specialties.

和其他一些特產一樣紅潤。

You'll be their primary provider, guiding them to live the rest of their life meaningfully.

你將成為他們的主要供養人，引導他們有意義地度過餘生。

Those that go into neurology also tend to be on the intellectual side of things, enjoying

進入神經內科的人，也往往是偏向於知識性的，他們喜歡

discussing the nuances of the physical exam, strange labs, and unique imaging findings.

討論體檢的細微差別、奇怪的實驗室和獨特的成像結果。

Big shout out to Dr. Prashanth V and Dr. Masaki N from UC Irvine, and the other neurologists

向加州大學歐文分校的Prashanth V博士和Masaki N博士，以及其他神經科醫生致敬。

at Med School Insiders for helping me with the creation of this video.

在醫學院內部人士幫助我創建這個視頻。

Are you interested in neurology?

你對神經科感興趣嗎？

To get into medical school and match into a strong neurology residency, you'll need

要想進入醫學院，並匹配到一個強勢的神經病學住院醫師，你就需要

to score well on your class tests and standardized exams.

以便在班級測試和標準化考試中取得好成績。

If you need help acing your MCAT, USMLE, or other exams, our tutors can maximize your

如果你需要幫助你通過MCAT、USMLE或其他考試，我們的導師可以最大限度地提高你的成績。

test day performance.

測試日表現。

If you're applying to medical school or neurology residency, our Insiders can share

如果你正在申請醫學院或神經病學住院醫師，我們的業內人士可以分享一下

the ins and outs of what it takes and how to navigate the highly competitive process

如何在競爭激烈的過程中游刃有餘？

most effectively.

最有效的。

We've become the fastest growing company in the industry, and it's no surprise.

我們已經成為行業內發展最快的公司，這並不奇怪。

Our customers love us because we're committed to delivering results, period.

我們的客戶喜歡我們，因為我們致力於提供結果，就這樣。

Learn more at MedSchoolInsiders.com .

瞭解更多資訊，請訪問MedSchoolInsiders.com 。

Thank you all so much for watching!

非常感謝大家的觀看!

If you enjoyed this video, check out So You Want to Be a Neurosurgeon, or another specialty

如果你喜歡這段視頻，請查看 "所以你想成為一名神經外科醫生"，或另一個專業

on our So You Want to Be playlist.