Neurology Fellowships
Written by Joshua A. Budhu, M.D
Neurology is an amazing specialty with many opportunities to subspecialize. There are over 25 unique fellowships for a neurologist, ranging from neurocritical care to sleep medicine. See https://www.aan.com/Fellowship for a complete list. Completing a fellowship does not mean you only see subspeciality patients; many subspecialists continue seeing general neurology patients. Most neurology fellowships are between 1-3 years. Most neurologic subspecialties have changed over the past 20 years as new treatments have become widely available for many diseases. Each subspecialty also offers the opportunity to conduct research, both bench and clinical trials/translational research.
Below are some popular choices.
Vascular – Vascular neurology is a one-year fellowship that focuses on all things stroke. Vascular neurology has changed dramatically over the past few decades, with new treatments such as mechanical thrombectomy for acute ischemic stroke, new antiplatelets and anticoagulation for secondary stroke prevention, and robust research. Vascular neurologists can work both inpatient and outpatient and see patients with ischemic strokes and brain bleeds.
Neuromuscular – Neuromuscular experts are some of the best detectives in medicine and are experts in the peripheral nervous system. They treat diseases of the muscle, peripheral nerves, motor neuron (e.g. ALS), and neuromuscular junction. Neuromuscular physicians commonly perform nerve conduction studies/EMGs. Fellowships usually range from 1-2 years.
Epilepsy – This fellowship will give you advanced training in the diagnosis and treating seizures. Additionally, epilepsy doctors read EEGs. Training is usually a combination of clinical (seeing patients, running an epilepsy monitoring unit) and procedural (learning to read EEGs). This fellowship usually ranges from 1-2 years.
Neuroimmunology – This fellowship will prepare you to take care of those with autoimmune neurological conditions, such as multiple sclerosis. Many new treatments have been developed over the past 20 years leading to better patient care and outcomes. Along with MS, these neurologists take care of many other autoimmune conditions, including recently discovered conditions such as limbic encephalitis and paraneoplastic syndromes.
Cognitive and behavioral neurology – This specialty focuses on diseases that affect cognition, perception, emotion, and behavior, such as Alzheimer’s disease. Other diseases include aphasias, ataxias, dementias, memory disorders, and neuropsychiatric disorders. Like other neurologic subspecialties, there is a lot of research in this field, especially to treat Alzheimer’s disease.
Movement disorders – This fellowship is focused on the diagnosis and treating diseases that cause abnormal movements and postures. These include Parkinson’s disease, Huntington’s disease, and many other diseases that cause chorea, dystonia, myoclonus, and tremors.
Neurocritical care – Neurocritical care is usually a 2-year fellowship that prepares neurologists to become critical care physicians. Neurocritical doctors usually treat neurologic emergencies such as acute brain bleeds, strokes, status epilepticus, severe neurologic infections, and subarachnoid hemorrhages. Most practice is inpatient, and these physicians master all procedures necessary to become intensivists.
Interventional neurology – This is typically a 2-year fellowship that prepares neurologists to perform life-saving interventional procedures such as mechanical thrombectomy. Most fellowships require training in vascular neurology beforehand and many programs also train neurosurgeons and interventional neuroradiologists.
Headache medicine – This fellowship prepares you to diagnose and treat all times of headaches, from migraines to trigeminal autonomic cephalgias. There are many new treatments for headaches and fellowships also provide training in nerve blocks, Botox injections, and trigger point injections.
Neuro-oncology – Neuro-oncologists take care of patients with CNS tumors and treat those with neurologic complications from cancer or cancer therapy. They prescribe chemotherapies, immunotherapies, and targeted therapies. Working closely with neurosurgery, radiation oncology, and medical oncology, these neurologists also conduct bench and clinical research. Fellowships can range from 1-3 years (extra years are for research).
Neuro-ophthalmology – This fellowship prepares neurologists to diagnose and treat neurologic conditions that affect vision. These include optic neuritis (a common manifestation of autoimmune neurologic conditions), giant cell arteritis, idiopathic intracranial hypertension, cranial nerve deficits that affect eye movements, and visual issues due to other neurologic causes such as stroke and brain tumors.
Neuro-infectious disease – These doctors specialize in infectious diseases that affect the brain. These include the neurologic manifestations of HIV and COVID, encephalitis, myelitis, meningitis, and abscesses.
