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7 Things I Wish I Knew Before Starting Neurology Residency

Leah Croll, MD

Disclosures

July 01, 2021

The beginning of residency is equal parts exciting and terrifying. My experience got better and better as I picked up a handful of key lessons. Here's what I wish I knew before my first day on the job.

1. You will make mistakes.

Some will be big and some will be small, but you will have many, many missteps throughout residency. In the beginning, I thought a "good" resident was a resident who knows it all and never messes up. Now I know that couldn't be further from the truth. No one will think less of you if you slip up; it's an expected and normal part of training! But people will take notice and think more of you if you are able to learn and grow from your mistakes.

2. Trust your exam.

In neurology, the physical exam rules all. Period. It carries more weight in our diagnostic processes than any labs or imaging. Never discount your exam findings — your attendings and fellows rely on them more than you know.

3. You will have some truly awful calls.

A neurology call can get stressful before you've even had a chance to drink your coffee. There will be calls where the stroke code and consult pagers just don't stop going off. You might end up running all over the hospital from one neurologic emergency to another. You will get behind on notes as more and more consults pile up. It will feel hectic and unmanageable. But it won't be impossible. After you've survived a couple of these crazy calls, you'll start to notice a few things: You're getting really good at triage, you're becoming increasingly efficient, and you're learning a ton of neurology.

4. Nothing is more fulfilling than having the specific skill set needed to help your patients.

Here's what will get you through your worst calls: When patients are sick and really need a neurologist, only you can help them. And it feels so good when you do.

5. Neurology will always be humbling, even when you reach the end of your training.

The best advice I ever received? "Neurology is hard." We are very far from completely understanding the complexities of our nervous system and all the diseases that can affect it. That means that you will inevitably get diagnoses wrong. Even on the very last day of your residency. Even if your knowledge of neurology is encyclopedic. Even if you did absolutely everything right for your patient. Your fellows and attendings are in the same boat. We're all learning together and we always will be.

6. It's okay to say that you don't know something.

It's not okay to pretend that you know something when you really don't. That's only a disservice to yourself and to your patients. Besides, most neurologists are more than happy to teach you.

7. You have a unique opportunity to make incredible friendships.

Lean on your co-residents. No one else on the planet knows what it's like to be a neurology resident at your hospital. Every experience you share with your co-residents will bring you even closer. They will know you at your best and at your worst. You will vent together, laugh together, celebrate together. That's really special.

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About Dr. Leah Croll
Leah Croll, MD, is a neurovascular fellow at NYU Langone Health. She was also a neurology resident at NYU. Prior to that, she graduated from NYU Grossman School of Medicine. She is a contributor to the ABC News medical unit. In her free time, she is working on trying all the pastries in New York City, one bakery at a time.
Reach her on Twitter @DrLeahCroll

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