Career Opportunities & Outlook
The career outlook for dual-boarded neurologist-psychiatrists is excellent. Most people who pursue this path choose to stay in academics. They often become leaders in academia, prominent researchers, or clinicians with a special niche that allows them to become experts in an area of their choice.
A large percentage of these physicians continue to practice in both specialties, and there is plenty of reason to do so. For example, in patients with epilepsy, a significant amount also suffer from psychogenic non-epileptic seizures. These patients are most often seen by practitioners of both specialties.
Another example is Multiple Sclerosis. Individuals with MS have a 50 percent chance of at least one lifetime episode of clinical depression, versus seventeen percent in the general population. They also have a two to threefold risk of being diagnosed with bipolar or psychotic disorders. In addition, some of the common treatments for MS (such as interferon) can actually exacerbate psychiatric conditions. These patients provide a clinical challenge for providers in either specialty, and may be particularly well-served by practitioners trained in both disciplines.
Future of the Field
In regard to the future of the combined approach, Dr. Joseph Martin, a neurologist and former Dean of Harvard Medical School may have said it best:
“Neurology and psychiatry have, for much of the past century, been separated by an artificial wall created by the divergence of their philosophical approaches and research and treatment methods. Scientific advances in recent decades have made it clear that this separation is arbitrary and counterproductive. Neurologic and psychiatric research are moving closer together in the tools they use, the questions they ask, and the theoretical frameworks they employ. The interests of neurology and psychiatry converge within the framework of modern neuroscience. Further progress in understanding brain diseases and behavior demands fuller collaboration and integration of these fields. Leaders in academic medicine and science must work to break down the barriers between disciplines.”
The Integration of Neurology, Psychiatry, and Neuroscience in the 21st Century
Joseph B. Martin
American Journal of Psychiatry 2002 159:5, 695-704