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How to Become a Neurologist/ Neurosurgeon – A Detailed Guide

How to Become a Neurologist

Have you always wanted to be a doctor? Would you be interested in studying and treating disorders related to the human brain? Or maybe the spinal cord? Neurological disorders and diseases are many – such as Parkinson’s disease and Alzheimer’s disease. The possibilities of such disorders and diseases are varied and opportunities are vast in this medical specialty which is emerging to be one of the most popular, especially in recent times with the rising number of patients particularly children coping with rare & unforeseen neurodegenerative disorders in India & overseas. If this tickles the doctor in you, read on to explore who Neurologists and Neurosurgeons are, what they do, how they do it and how to become one.

Neurologists / Neurosurgeons treat patients (through medication or surgery) who are suffering from diseases and disorders that affect the brain, spinal cord, and nerves. Diseases and disorders like: cerebrovascular diseases; demyelinating diseases of the central nervous system (CNS) such as multiple sclerosis; headache disorders; infections of the brain & peripheral nervous system (PNS); movement disorders such as Parkinson’s disease; neurodegenerative disorders such as Alzheimer’s disease and Amyotrophic Lateral Sclerosis; seizure disorders such as epilepsy; spinal cord disorders; speech & language disorders etc.

Why become a Neurologist/ Neurosurgeon?

Neurologists / Neurosurgeons treat patients (through medication or surgery) who are suffering from diseases and disorders that affect the brain, spinal cord, and nerves (Central Nervous System and Peripheral Nervous System). Diseases and disorders like: cerebrovascular diseases; demyelinating diseases of the central nervous system (CNS) such as multiple sclerosis; migrain; infections of the brain & peripheral nervous system (PNS); movement disorders such as Parkinson’s disease; neurodegenerative disorders such as Alzheimer’s disease and Amyotrophic Lateral Sclerosis; seizure disorders such as epilepsy; spinal cord disorders; speech & language disorders etc.

CNS is the term to collectively refer to the brain and the spinal cord.

PNS is the term to collectively refer to all other neural elements, such as all the nerves – sensory nerves and motor nerves.

Commonly treated clinical conditions by the Neurologists and Neurosurgeons

A patient may be referred to a Neurologist for any symptoms that point to the nervous system. These include seizures, confusion, loss of memory, changes in sensation, muscle & coordination problems, headaches, injury to the head or spinal cord and damages to peripheral nervous systems dues to injuries and trauma.

Some of the commonly encountered conditions are neuropathy, stroke, dementia, seizures, attention-deficit/hyperactivity disorder, Tourette’s syndrome, multiple sclerosis, head trauma, sleep disorders, neuromuscular diseases, and various infections or tumors of the nervous system.

Neurologists can also evaluate unresponsive patients on life support to confirm brain death (making a finding of brain death when it is suspected that a patient has died).

Treatment Options

The main diagnostic procedure in neurology is a very thorough history and physical examination.

Treatment options vary depending on the neurological problem. They can include referring the patient to a physiotherapist, prescribing medications, or recommending a surgical procedure. The most common treatment for many neurological diseases is medication, the modality of which is determined through various tests and treatments.

Such as biopsies, Computed Tomography (CT or CAT) scan of the brain, carotid artery ultrasound, electroencephalogram (EEG), electromyography (EMG), lumbar puncture (LP), magnetic resonance imaging (MRI) of the spine and brain, positron emission tomography (PET) scan etc. Surgery may be an option for some patients.

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Neurologist or a Neurosurgeon – Who will you be?

Neurology is a “medical specialty” and neurosurgery is a “surgical specialty”.

All Neurologists are not Neurosurgeons. You will need specific degrees (MS, MCh or higher) to be able to practice as a Neurosurgeon.

Any Neurologist/ Neurosurgeon is a specially trained doctor who has a basic postgraduate level training (MD/MS) in Internal Medicine/ Pathology/ Pediatrics/ Radio-diagnostics/ General Surgery etc. as well as further higher education in either Neuro Surgery or Neurology. A Neurologist who prescribes medication does not usually take on surgical cases, but the reverse may be true.


Some specialize in surgical/operative processes (after MS & M Ch degrees) for management of neurologic disorders through surgery and medication, while some others (after MD & DM/ DNB & FNB) treat neurological diseases primarily through medication.

In India, the degrees are different for being a Neurologist and a Neurosurgeon. In US, for example, you will have to get your MD like all other Doctors of other disciplines and then specialize in Neurology or Neurosurgery through internships (usually for 1 year in either internal medicine or surgery), followed by residencies (3 years of specialty training) and fellowships. In Germany, however, a compulsory year of psychiatry must be done to complete a residency of neurology. In the United Kingdom and Ireland, neurology is a subspecialty of general (internal) medicine.

Preliminary Neurological Diagnosis

Neurologists examine patients who are referred to them by other physicians. The keystone of a neurological diagnosis is the examination of a patient’s history. During a neurological examination, a Neurologist (or a Neurosurgeon) reviews the patient’s health history with special attention to the existing clinical condition.

The patient takes the neurological exam. Typically, this exam tests mental status, muscle coordination, motor strength, function of the cranial nerves (including vision), reflexes, and sensation.

This information helps the doctor determine whether the problem exists in the nervous system and if it does, determining the clinical location of it (localization of the site).

Supplementary diagnostic tests

Ancillary diagnostic tests may be needed to ultimately guide therapy. For example, if a right-handed patient reports an episode of difficulty in speaking, the examiner will search for signs of left hemisphere dysfunction.

The neurologist may order a lumbar puncture to test spinal fluid. An EEG, CAT scan, MRI, sleep studies, EMG, nerve conduction studies, lumbar punctures, PET scan, or angiography may also be ordered and examined.

Apart from the mentioned technologies, advances in genetic testing have made it an important tool in the classification of several inherited neuromuscular diseases. The role of genetic influences is an active area of research currently.

Many Neurologists have advanced specific training

This refers to toadditional training in areas such as stroke, epilepsy, neuromuscular, sleep medicine, pain management, movement disorders or in certain parts of the nervous system or in specific procedures. However, for all practicing Neurologists/ Neurosurgeons, it is essential to possess a basic knowledge of neuroanatomy.

Neuroanatomy is a vast & complex subject about all the building blocks of the brain & the spinal cord and their interconnections. This knowledge is absolutely necessary for the interpretation of clinical findings and for the localization of neurological lesions (any type of abnormal tissue growth in/ on brain tissue).

For example, Clinical Neurophysiologists specialize in the use of EEG and intraoperative monitoring.

Some others may specialize in the use of electrodiagnostic medicine studies – needle EMG and nerve conduction studies (NCSs). Physicians do not typically specialize in all the aspects together i.e. sleep, EEG, EMG, and NCSs. Also, generally, there are different boards to certify specialists in particular diagnostic procedures.

Functional Fields of Work

Clinical / Diagnostic / Operative Care:

Work involves diagnoses, prognoses (how a disease progresses & assessing that progress) and treatment / therapy(by surgery or through administration of medications) provided to patients suffering from neurodegenerative illnesses or clinical conditions some of which are cerebrovascular diseases such as stroke, seizure disorders such as epilepsy, demyelinating diseases of the central nervous system such as multiple sclerosis, movement disorders such as Parkinson’s disease, spinal cord disorders, headache disorders, infections of the brain & peripheral nervous system, etc.

Medical / Clinical Research:

You can pursue a career as a physician-scientist. Work will be completely laboratory-based sometimes involving field collections of biologic samples (human/animal). Researchers often work at academic medical centers, for the pharmaceutical industry, or with the government.  It is important to maximize your research experiences during medical school by participating in a research project, or taking a gap year for a research scholars’ program or participating in summer research internships.

For an example, you may be board certified in Neurology (for a practice license) and an Associate Professor of Medicine as well, simultaneously you may also be a recipient of research grants from different sources and pursue scientific research, say suppose specifically on changes of the retinal structure & microvasculature, neuroimaging techniques,acute sleep loss on diurnal plasma dynamics etc. or potential of monoclonal antibody in migraine therapy  if you are researching on the development of novel screening and therapeutic strategies or new therapies.

Education and Training:

Typically, in medical colleges and universities, all educators are involved in training and educating aspiring doctors. This includes operative techniques & experiences as well as theoretical lectures to develop a deep understanding of clinical and basic sciences surrounding Neurology/ Neurosurgery and its various sub-specialties including the principles of disease investigation, interpretation of diagnostic test results and employed technologies.

What does Neurologist/ Neurosurgeon do?

As a Neurologist/ Neurosurgeon, depending on your functional field of work, you will be engaged with one or more of the following roles and responsibilities: –

Clinical / Diagnostic / Operative Care:

  1. You will be examining a patient (physical examination and primary screening) for diagnosis of and obtaining information on medical/physical conditions, history, and tendencies to ascertain necessary medical attention.
  2. You will be diagnosing neurological disorders and clinical conditions and suggest therapeutic treatments, such as prescribing medicines, in hospital wards, clinics, or operating rooms.
  3. You will be determining the nature of treatment, conferring with or referring to other medical professionals if required, for ensuring safe, effective, and timely treatment as well as continuity of patient care.
  4. You will have to obtain historical data to construct a patient’s medical portfolio and plan for consecutive further treatment sessions as required – advising throughout the prognosis (progression) of a disease.
  5. You will be involvedin recording patient’s condition or progress throughout the tenure of your treatment sessions, writing reports and maintaining proper registers containing patient information(case histories).
  6. You will be managing surgery services, including performing surgeries, planning, arranging, scheduling and coordinating processes, or facilitating procurement of equipment & supplies.
  7. You may participate in seminars, medical congresses, conferences across the world.

Medical Research:

  1. You will plan, organize, coordinate & participate in scientific research projects, in collaborative work on study/experiment design, data analysis, & manuscript preparation for various scientific projects.
  2. You will determine specific goals or objectives to be obtained; evaluate research data and develop & revise techniques or approaches to work problems.
  3. You will design, develop or adapt equipment used in experiments or research to obtain desired results. You will be responsible for laboratory equipment and implementing safety procedures.
  4. You will bring new agents for disease treatment more quickly from the laboratory to clinical trials (testing of laboratory product on human patients diagnosed with multiple tumor types).
  5. You will identify & implement strategies to enhance collaboration between investigators and clinical or research scientists.
  6. You will recruit healthy & affected individuals for a period of close monitoring of their personal clinical response to disease stimulants or to obtain biologic samples from these participants for extensive analysis.
  7. You will independently compose abstracts, technical reports, slide presentations, posters, spreadsheets, and manuscripts for submission to corporate and federal sponsors, conferences, and scientific journals.
  8. You will produce medical illustrations, scientific posters, publication graphics, and slide presentations for national & international meetings.
  9. You may participate in seminars, medical congresses, conferences across the world.

Education and Training:

  1. You will be involved in instructing/teaching to a class of students pursuing postgraduate or higher levels or study in the fields of Medical / Surgical Neurological Sciences or related disciplines.
  2. You will demonstrate techniques or handling of instruments/tools to your students inside an operation theatre and counsel/guide students in the performance of operative experiments.
  3. You may participate in seminars, medical congresses, conferences across the world.

How to become a Neurologist/ Neurosurgeon – Eligibility criteria

  1. After Class 11-12, you must go for your Bachelor of Medicine and Bachelor of Surgery course (MBBS). Various forms of this qualification’s name are MB ChB, MB BChir, BM BCh, BMBS and MB BCh around the globe.
  2. After MBBS, you must go for a Master / post-graduation PG level program like MD, DNB, MS and then complete senior residencies to specialize in various branches of Neurology or Neurosurgery.

DNB is considered equivalent to MD / MS. The only difference is for MD and MS you will be trained in medical colleges with hundreds of patients and for DNB you will be trained in private hospitals (with at least 500 beds).

  1. After post-graduation, you can further proceed with FNB (after DNB), M Ch (for neuro-surgical specialities), DM (for neuro- medicine specialities) or PDCC if you want to higher qualifications or obtain a Ph.D. if you want to be a physician-scientist.
  2. You are also advised to obtain memberships (life/short term) of various associations /  societies such as:
  • Neurological Society of India
  • The Indian Academy of Neurology
  • World Federation of Neurosurgical Societies (WFNS)
  • International Neurotoxicology Association (INA)
  • International Society for Pediatric Neurosurgery (ISPN)
  • National Academy of Neuropsychology (NAN)
  • World Federation of Neurology (WFN)
  • International Child Neurology Association (ICNA)
  • National Institute of Neurological Disorders and Stroke (NINDS)
  • International Neuropsychiatric Association (INA)
  • International Neuropsychological Society (INS)
  • European College of Neuropsychopharmacology (ECNP)
  • International Society for Neurochemistry (ISN)
  • International Society of Musculoskeletal and Neuronal Interactions (ISMNI)
  1. In the UK, MRCP / MRCS / FRCS is mandatory to practice as a Neurologist.

You have to qualify graduation from any medical school (in UK or any other country including India), complete MD/MS (if you are studying in India) and obtain your MRCP / MRCS qualification from any of the Royal Colleges (Edinburgh, Glasgow, London – for medicine/radiation; England, Edinburgh, Glasgow, Ireland – for surgery).

For Medicine, there are 3 Royal Colleges that grant membership certifications: in Edinburgh, Glasgow, and London.

MRCS (for membership) and FRCS (for fellowship) are for practicing surgeons.

For Surgery, membership certificates are granted by any of the 4 Royal Colleges: Royal College of Surgeons of England, the Royal College of Surgeons of Edinburgh, the Royal College of Physicians and Surgeons of Glasgow and the Royal College of Surgeons in Ireland.

MRCS and MRCP are conducted by each college separately. FRCS (only for surgical specialties) is an examination which is jointly conducted by a mutual committee formed by all 4 Royal Colleges of Surgery (called Joint Committee on Intercollegiate Examinations).

So, there are 3 different MRCP exams by 3 different colleges, 4 different MRCS exams by the 4 different colleges and 1 FRCS exam jointly conducted which is the International Fellowship Examination (JSCFE).Each exam has its own format that can be referred to from respective portals of conducting bodies.

Also, if you (an aspiring surgeon) pass MRCS of 1 college or FRCS (the joint exam for Fellowship), you are eligible to be transferred as a member of any RCS by submitting the relevant transfer form.

You can appear for any MRCP or MRCS exams from India. You can also appear for the fellowship examination (JSCFE) exam from India. Exam centers in India include many cities such as New Delhi, Hyderabad, Chennai etc. The fee for New Delhi is the lowest usually. The Indian locations are detailed on the individual websites of the 7 colleges (4 for surgery and 3 for medicine) and those for JSCFE are here: (the dates are subject to change, but the specialties and locations are not)

For JSCFE, you will have a maximum of 7 years to complete the 2 sections of this exam, Section 1 & Section 2. You will have a 2 year period from your 1st attempt with a maximum of 4 attempts for Section 1 and a maximum of 4 attempts with no re-entry for Section 2. Section 1 is further divided into Paper 1 and Paper 2. Section 2 is the clinical component of JSCFE consisting of a series of carefully designed & structured interviews on clinical topics.

  1. US or Canada

All practicing neurologists or neurosurgeons in the US, after MD, go for 1-year internship in either internal medicine or medicine/surgery then at least 3 years of specialty training in an accredited residency program.

Many neurologists also have additional training or interest in one area of neurology, such as stroke, epilepsy, neuromuscular, sleep medicine, pain management, or movement disorders.

If you are targeting the US or Canada, remember, you will have to clear USMLE after you complete an MBBS program in India to be able to directly practice in the US. To study in medical schools in the USA or Canada for an MD degree before practicing there, you will have to clear MCAT. Medical College Admission Test (MCAT) is a compulsory test for anyone who plans to get admission in medical schools of the USA and Canada. MD degrees are followed by 3 to 7 years of residency. Graduates can practice any specialty. Physicians are fully certified after passing board exams.152 MD-granting schools in the United States and 17 in Canada.

MCAT consists of 4 distinct sections that are individually scored. Each section is allotted either 90 or 95 minutes and tests between 50 and 60 questions. Including breaks, the full examination lasts approximately 7.5 hours.

ManyMBBS graduates from India, targeting Psychiatry, directly aim at USMLE instead of going the long way as residencies in the Psychiatry domain are easier to get through with a lower mean USMLE score. After MBBS and USMLE, graduates from India have sequentially completed internships, residencies, fellowships &observership and are currently practicing in the US with a medical license.

However, after your MBBS here if you further want to study in US, then clear MCAT, join medical school in US and then finally appear for USMLE. MCAT is administered 25 times in a year. With a pass in MCAT, they will need to complete a medical degree (MD) in the US or Canada which is for 4 years. Then they can appear for USMLE and get a practice license.

Remember: after passing USMLE once, you cannot repeat it for attempting a better score. Programs usually eliminate candidates with multiple attempts. For this reason, it is essential to do extremely well in the first attempt. Further, your answers will not be evaluated on a population curve basis; you will be marked on the level of difficulty of the items you have attempted during the examination.

Indian graduates from any other discipline (other than MBBS) are also eligible to practice as a Medical Professional in the US but they have to appear for MCAT with a ‘special permission’ from Association of American Medical Colleges (AAMC) (before registering for the exam, mail to [email protected] stating the reasons why you wish to take the exam). If you are specially permitted by AAMC, which is rare, you can then attempt & clear MCAT, then pass 4-year MD, then clear USMLE and then practice in US / Canada.

So, precisely for aspiring Psychiatrists

MBBS in India > USMLE >Internship> Residency > Fellowship >Observership>Practice

Alternatively, a longer router (preferable for medicine specialties other than Psychiatry) is,

MBBS in India > MCAT > Basic Medical Degree (MD) in US / Canada > USMLE> Internship > Residency > Fellowship >Observership> Practice

For non-medical graduates from India,

Bachelor degree (duration is not a factor) > MCAT with special permission> Basic Medical Degree in US / Canada (MD) > USMLE > Internship > Residency > Fellowship >Observership> Practice

Job Opportunities

In India, after a you can get a job as a Consultant Neurologist and after MCh as a Consultant Neurosurgeon in any of the following healthcare establishments:

  • Multi-Specialist Government and private hospitals such as All India Institute of Medical Sciences (AIIMS), Christian Medical College, Apollo, Fortis, Narayana, Kasturba, Tata, Lilavati, Medanta, Kokilaben, King Edward Memorial, Max, Wockhardt, Sterling, Shalby, Medica, King George, Assam Medical College, Columbia Asia, Jaslok, AMRI, and so on.
  • You may also consult patients at various health clinics or set up your own practice after a few years of experience at a super-speciality hospital.

Most jobs for Specialist Consultant Physicians are contractual. Many of the Consultants work in more than one hospital.

  • If you want to pursue a career in teaching along with practice (practice means you will be involved in treating patients), you may join a teaching hospital as an Associate Professor, generally referred to as Medical College and Hospital such as the AIIMS, St. John, Kasturba Medical College, Maulana Azad Medical College, King George’s Medical College, Christian Medical College Vellore, Grant Medical College, Calcutta Medical College, Lady Hardinge Medical College, etc.
  • If you want to pursue a career in Medical / Clinical Research along with practice(practice means you will be involved in treating patients), then you may join any of the medical colleges/organizations which are involved in research such as the National Drug Dependence Treatment Centre, Sri Ganga Ram Hospital, Institute of Human Behaviour & Allied Sciences, AIIMS, JIPMER Pondicherry, Institute of Medical Sciences, BHU, University College of Medical Science, Delhi University, Sri Ramachandra Medical College & Research Institute, Regional Medical Research Centre at Bhubaneswar and Dibrugarh, PGIMER, Chandigarh, IPGMER, Kolkata, etc.

Salary of a Neurologist/ Neurosurgeon

An MD/ DNB joins at about Rs. 75,000 – Rs. 80,000 a month at the beginning. At private hospitals in entry-level positions, one can get about the same or slightly higher.

After your DM/M Ch degrees, you may expect to get about Rs. 80,000 – 1,00,000 or even more a month. Earnings also depend on the number of therapeutic cases handled in a month.

Private hospitals prefer to take people with prior experience. In such cases with 2-3 years of experience, one may get about Rs. 1,00,000-1,20,000 a month.

After MD/MS, one begins first as a Senior Resident and then gradually to Consultant / Reader / Assistant Professor etc. and after DM/MCh, one begins as a Neurologist / Neurosurgeon / Senior Consultant / Senior Researcher or Associate Professor depending on which area you are working in. Salary increases with years of practice/teaching experience and the number of cases handled, that’s all.

After 7 to 10+ years of experience post-residency, you can expect to earn about Rs. 2,00,000 – 5,00,000 or even more a month.

With 10 to 15+ years of experience post residency, you can expect to earn about Rs. 2,50,000 – 10,00,000 or even more a month.

Career progression in Neurologist/ Neurosurgeon

You may grow through the following roles depending on your functional field of work.

•           If you are practicing independently and/or are associated with any public / private sector healthcare provider/hospital/nursing home, there is no discrete designation growth that happens. You will simply have to specialize in your area of interest and work as part of that department in the hospital/clinic / super-specialty establishments etc. Generally, all Consultant Neurologists or Neurosurgeons are associated with some public / private hospitals or healthcare provider and some also practice individually alongside.

You can work in roles such as that of Attending Consultant, Associate Consultant, Consultant Senior Consultant, Deputy Director, Associate Director, Director/Clinical Director, Senior Director, Chief of Division, etc.

  • If you are working in the drug development or formulation departments of research-oriented organizations, you can gradually move up the ladder as Senior, Head of Assay Development, Product Development Leader, Chief/Clinical Chief of Service, etc.
  • If you are working in the R&D departments for pharmaceuticals companies, you can grow from say a Research Associate, to Senior Research Consultant, Principal Investigator, etc. Growth usually takes long and is gradual.

•           Education:

Senior Resident, Reader, Assistant Professor, University Lecturer, Professor, Academic Clinical Lead, Senior Lector, Emeritus Professor, Professor & Head, Head of the School, Fellow of the Academy, Head / Chief / Director of Department. Designation growth is gradual and takes long. Meanwhile, it will be helpful if you gain memberships to various national and international bodies of repute and add them to your bio-profile.

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