How to Become a Neurologist: Schooling, Career Path, & Salary

A neurologist is a medical professional who specializes in diagnosing and treating conditions related to the brain and nervous system. This field requires years of extensive training, specialized knowledge, and hands-on experience. Neurologists work with patients experiencing a wide range of neurological conditions, including epilepsy, Alzheimer's disease, multiple sclerosis, brain tumors, and spinal cord injuries.

The path to becoming a neurologist is long, requiring rigorous education and clinical training. This guide outlines the steps involved, from undergraduate studies to medical school, residency, and specialty training. It also explores neurologist salary expectations, job outlook, and career options.

What Does a Neurologist Do?

Neurologists specialize in diagnosing, managing, and treating disorders affecting the central nervous system (brain and spinal cord) and peripheral nervous system (nerves and muscles throughout the body). Their work focuses on conditions related to the brain, spinal cord, blood vessels, and nerves, and they use neurological examinations, diagnostic tests, and medical treatments to manage these disorders. Unlike neurosurgeons, neurologists do not perform surgery but frequently work alongside them to coordinate care for patients who require surgical interventions.

Responsibilities of a Neurologist

Neurologists play a critical role in diagnosing and managing a wide range of neurological conditions, often working with other specialists to provide comprehensive patient care. Their responsibilities include:

1. Conducting Neurological Examinations

Neurologists perform detailed assessments to evaluate a patient’s nervous system function. These examinations assess:

• Cognitive function (memory, speech, problem-solving)
• Reflexes (responses to stimuli, muscle contractions)
• Coordination (ability to perform tasks requiring fine motor control)
• Sensory responses (ability to feel touch, pain, vibration)
• Muscle strength and tone (to detect weakness or abnormalities)

2. Diagnosing and Treating Neurological Conditions

Neurologists manage a broad range of neurological disorders, including:

• Epilepsy – Recurrent seizures caused by abnormal electrical activity in the brain.
• Alzheimer’s disease – A progressive neurodegenerative disorder that affects memory and cognitive function.
• Parkinson’s disease – A movement disorder caused by dopamine deficiency in the brain.
• Multiple sclerosis (MS) – An autoimmune disease that attacks the protective covering of nerves.
• Neurodevelopmental disorders – Conditions like autism and ADHD that affect brain function from early childhood.
• Stroke – A sudden disruption of blood flow to the brain, leading to damage or death of brain cells.
• Peripheral neuropathy – Nerve damage causing weakness, numbness, and pain, often in the hands and feet.
• Spinal cord injuries – Damage to the spinal cord that affects mobility, sensation, or autonomic functions.

Note: Neurologists develop treatment plans using medications, lifestyle modifications, rehabilitation therapies, and in some cases, referrals for surgery when necessary.

3. Ordering and Interpreting Diagnostic Tests

To confirm diagnoses and assess disease progression, neurologists order and interpret various diagnostic tests, including:

• CT scans (Computed Tomography) – Detailed X-ray images of the brain to detect bleeding, tumors, or structural abnormalities.
• MRI scans (Magnetic Resonance Imaging) – High-resolution images of the brain and spinal cord for detecting strokes, MS lesions, or tumors.
• Nerve conduction studies (NCS) – Tests that measure the electrical activity of nerves to diagnose conditions like myasthenia gravis and carpal tunnel syndrome.
• Electromyography (EMG) – Measures electrical activity in muscles to assess neuromuscular disorders.
• Lumbar puncture (Spinal Tap) – A procedure to analyze cerebrospinal fluid for infections, MS, or bleeding in the brain.
• Electroencephalogram (EEG) – Monitors brain waves to diagnose epilepsy and sleep disorders.

4. Performing Specialized Procedures

Neurologists perform minimally invasive procedures to diagnose and manage neurological diseases, including:

• Lumbar punctures – Used to analyze cerebrospinal fluid and detect brain infections, multiple sclerosis, and hemorrhages.
• Muscle biopsies – A small tissue sample is taken to diagnose neuromuscular diseases such as ALS or muscular dystrophy.
• Botox injections – Used for treating migraines, muscle spasms, and dystonia.
• Nerve blocks – Administering anesthetic injections to treat chronic pain conditions.

Note: While neurologists do not perform surgery, they work closely with neurosurgeons to determine if a patient requires surgical intervention for conditions like brain tumors, aneurysms, or spinal cord compression.

5. Collaborating with Other Physicians

Neurologists coordinate with other physicians and specialists to provide comprehensive care. They work alongside:

• Primary care doctors – To manage long-term neurological conditions.
• Neurosurgeons – For surgical interventions when needed.
• Physical therapists and rehabilitation specialists – To help patients recover function after strokes or injuries.
• Psychiatrists and psychologists – To address the mental health aspects of neurological diseases, such as depression in Parkinson’s disease.

6. Providing Long-Term Management for Chronic Conditions

Many neurological disorders require ongoing treatment and monitoring. Neurologists provide long-term care for conditions like:

• Multiple sclerosis (MS) – Managing symptoms with immunosuppressants and physical therapy.
• Epilepsy – Adjusting medications and monitoring seizure activity.
• Parkinson’s disease – Prescribing dopamine-related therapies and coordinating physical therapy.
• Alzheimer’s disease – Managing cognitive decline and providing support for caregivers.

Steps to Becoming a Neurologist

• Step 1: Earn a Bachelor's Degree (4 Years)
• Step 2: Take the Medical College Admission Test (MCAT)
• Step 3: Attend Medical School (4 Years)
• Step 4: Complete a One-Year Internship
• Step 5: Complete a Neurology Residency (3 Years)
• Step 6: Optional Fellowship Training (1-3 Years)
• Step 7: Obtain Board Certification

Education and Training Pathway

1. Earn a Bachelor's Degree

Aspiring neurologists must complete an undergraduate degree before attending medical school. Most students major in biology, chemistry, physics, or another pre-medical field. Coursework includes:

• General and organic chemistry
• Physics
• Biology
• Mathematics
• Psychology

Expert Tip: Strong academic performance is essential, as medical schools have competitive admissions. Students should also gain experience in history taking, patient interaction, and problem-solving through internships or volunteer work.

2. Take the Medical College Admission Test (MCAT)

The Medical College Admission Test (MCAT) is a standardized exam required for medical school admission. It assesses critical thinking, problem-solving, and knowledge in biological and physical sciences. A high MCAT score increases the chances of acceptance into a competitive medical school. This 7.5-hour exam assesses:

• Problem-solving and critical thinking skills
• Knowledge of natural sciences, behavioral sciences, and social sciences
• Understanding of medicine and the human body

Note: Scoring well on the MCAT is important for acceptance into a competitive medical school.

3. Attend Medical School

Medical school lasts four years and is divided into two phases:

• Preclinical Years (Years 1–2): Students study subjects such as internal medicine, neurocritical care, pathology, and pharmacology.
• Clinical Years (Years 3–4): Medical students complete rotations in different medical specialties, including neurology, internal medicine, and surgery.

Note: During medical school, students must pass the United States Medical Licensing Examination (USMLE) Step 1 and Step 2 to continue their training.

4. Complete a One-Year Internship

After medical school, graduates enter a one-year internship in internal medicine. This provides hands-on experience with patient care, diagnosis, and treatment. Interns work in a teaching hospital under supervision.

5. Complete a Neurology Residency Program

Neurology residency lasts three years and focuses on specialized training in:

• Brain and spinal cord disorders
• Neurological symptoms and diagnostic tests
• Treatment of vascular neurology and autonomic disorders
• Spinal cord injuries and peripheral neuropathy

Residents gain extensive training in performing neurological examinations, nerve conduction studies, and lumbar punctures.

6. Optional Fellowship Training (1-3 Years)

Some neurologists pursue additional specialty training through fellowship programs in areas such as:

• Clinical Neurophysiology – Focus on EEG, EMG, and nerve conduction studies
• Vascular Neurology – Specializing in stroke and blood vessel disorders
• Neuromuscular Medicine – Treating muscle and nerve diseases like myasthenia gravis
• Neurocritical Care – Managing critically ill neurological patients
• Sleep Medicine – Diagnosing sleep disorders related to neurological conditions

Fellowship training provides specialized knowledge in treating complex cases. Fellowships last one to four years and can lead to higher salaries.

7. Obtain Board Certification and Medical Licensure

To practice medicine as a neurologist, candidates must pass board certification exams through the American Board of Psychiatry and Neurology (ABPN). Each state also requires a medical license.

Career Path and Work Environment

Becoming a neurologist requires years of specialized training, but it leads to a career in a highly respected and growing field. Neurologists work in various settings, collaborate with other specialists, and play a critical role in diagnosing and treating disorders affecting the brain, spinal cord, and nervous system.

Where Do Neurologists Work?

Neurologists can be found in multiple professional settings, depending on their area of expertise and preferred work environment.

1. Hospitals

Neurologists in general medical and surgical hospitals provide care for patients experiencing severe or acute neurological conditions. They work with hospital teams to manage cases involving stroke, brain injury medicine, neurocritical care, and spinal cord injuries. Many neurologists also work in teaching hospitals, training medical students and residents in neurology and specialized tests.

2. Private Practices and Outpatient Clinics

Some neurologists operate their private practices or work in group medical offices, seeing patients in an outpatient setting. These specialists focus on managing chronic neurological conditions such as multiple sclerosis, peripheral neuropathy, and Parkinson’s disease.

3. Academic Institutions

Neurologists in universities and medical colleges contribute to teaching, research, and medical training. They educate medical students, residents, and fellows while researching new treatments, diagnostic tests, and therapies for neurological conditions.

4. Research Facilities and Clinical Trials

Neurologists involved in research and development focus on brain injury medicine, neural repair, autonomic disorders, and neurodevelopmental disorders. They conduct clinical studies to develop new drugs, improve nerve conduction studies, and enhance diagnostic imaging techniques such as CT scans and MRI scans.

Collaboration with Other Physicians

1. Neurosurgeons

Neurologists refer patients to neurosurgeons for conditions requiring surgical intervention, such as brain tumors, spinal cord injuries, and hydrocephalus. They also assist in preoperative evaluations and help manage post-surgical recovery.

2. Primary Care Doctors

Neurologists collaborate with primary care physicians to ensure patients with chronic neurological conditions receive continuous care. Patients with conditions such as Alzheimer’s disease or epilepsy often require long-term monitoring and medication adjustments.

3. Internal Medicine Specialists and Other Physicians

• Rehabilitation therapists assist in treating patients recovering from stroke, spinal cord injuries, or neurodegenerative diseases.
• Radiologists provide CT scans, MRI scans, and PET scans to help neurologists diagnose and track disease progression.
• Sleep medicine specialists assist with disorders such as narcolepsy, restless leg syndrome, and sleep apnea.

Do Neurologists Perform Surgery?

Neurologists do not perform surgery, but they assist in several key medical procedures that aid in diagnosis and treatment. These include:

• Lumbar punctures – Used to analyze cerebrospinal fluid (CSF) for conditions such as multiple sclerosis, meningitis, and neuro-infections.
• Muscle biopsies – Help diagnose neuromuscular medicine disorders like myasthenia gravis or ALS.
• Electroencephalogram (EEG) monitoring – Used for diagnosing seizures and epilepsy.
• Botox injections – Used to treat chronic migraines, muscle spasms, and dystonia.

Neurologist Salary and Job Outlook

Average Neurologist Salary by State

Salaries for neurologists vary based on location, demand, and experience level. According to ZipRecruiter, some of the highest-paying states for neurologists include:

The national average salary for a neurologist is $277,632 per year, with top earners making over $433,625 annually.

Highest Paying Work Environments for Neurologists

Certain work settings offer higher salaries for neurologists, particularly those specializing in clinical neurophysiology, vascular neurology, and neuromuscular medicine. According to Bureau of Labor Statistics (BLS) data, the highest-paying industries include:

Job Outlook for Neurologists

Increase in Neurological Disorders

• Aging populations are experiencing higher rates of Alzheimer’s disease, Parkinson’s disease, and stroke.
• Chronic conditions like multiple sclerosis and peripheral neuropathy require ongoing treatment.

Advances in Medical Technology

• New diagnostic tests and treatment options are improving patient outcomes.
• The use of MRI, CT scans, and nerve conduction studies has made early diagnosis more effective.

Shortage of Neurologists

• Many rural and underserved areas lack access to neurology specialists.
• The Association of American Medical Colleges (AAMC) predicts a shortage of neurologists due to retirements and increased patient demand.

Bottom Line

Becoming a neurologist requires years of education, extensive training, and specialized knowledge, but it leads to a rewarding career focused on diagnosing and treating neurological conditions affecting the brain, spinal cord, and nervous system. With a growing demand for specialists, especially as neurodegenerative diseases and chronic neurological disorders increase, neurologists play a critical role in patient care, research, and medical advancements. While neurologists do not perform surgery, they conduct neurological examinations, order diagnostic tests, and develop long-term treatment plans in collaboration with primary care doctors, neurosurgeons, and other physicians. Salaries vary based on location and work setting, with the highest earnings found in outpatient care centers and private practice. Whether working in hospitals, academic institutions, or research facilities, neurologists have a strong job outlook and continue to make a significant impact on medical science and patient health.

Becoming a neurologist starts with getting into the right medical school. Preparing for the MCAT, writing applications, and going through interviews can feel stressful, but you don’t have to do it alone. A medical school admission coach offers one-on-one help to improve your application, write strong essays, and get ready for interviews.

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FAQs

What type of Neurologist gets paid the most?

• Neurologists specializing in neurocritical care, vascular neurology, and neuromuscular medicine tend to earn the highest salaries. Pain medicine neurologists also make competitive pay. Those working in outpatient care centers or private practice usually earn more than hospital-based neurologists.

Is it hard to become a Neurologist?

• Yes, becoming a neurologist is challenging and takes over a decade of education and training. It requires four years of college, four years of medical school, a one-year internship, and a three-year residency. Some choose to complete additional fellowship training. The process is long, but it can be rewarding for those interested in the brain and nervous system.

How many years of school for a Neurologist?

• It takes at least 12 years after high school to become a neurologist. This includes four years of undergraduate study, four years of medical school, a one-year internship, and three years of residency. Fellowship training can add another one to three years.

Do Neurologists go to med school?

• Yes, neurologists must attend medical school after earning a bachelor’s degree. They take the MCAT, complete four years of medical school, and then enter a residency program for hands-on training in diagnosing and treating neurological conditions.