Have You Got The Nerve For Neurology?

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Dr James Cellini, DVM, DACVIM (Neurology) didn’t take the straight road to his Board Certification in Neurology but he learnt a lot along the way! Here is his path to specialisation

You can follow Dr Cellini on his Instagram, Tiktok and YouTube, for great insights into his career, outlook and life!

My path to veterinary neurology is somewhat unique. In veterinary school I struggled with academic focus for the first three years, and subsequently failed to identify a passion. I spent many credit hours taking courses on every animal classification you can think of. Large animal, small animal, exotic animal, zoo animal, aquatic animal, you name it. Even dead animal (pathology). Despite my best attempts, nothing really spoke to me and I struggled after a while to find motivation in this field. I began my clinical rotations on neurology simply because my friends were taking it as a means to get letters of recommendations (they are also now neurologists). 

Towards the beginning of my neurology clinical rotation I saw a case of a dog with severe vestibular dysfunction. The kind where a dog can’t stand up and just rolls and rolls with its head cocked to one side. Pure unrelenting vertigo. The 3rd year resident and I examined the dog and he went through the localization and differentials with me. Things made sense enough, but when I listened to him then explain it to the owner, I realized that with a ten minute exam (five if I wasn’t there slowing him down) we were able to accomplish two things – 1) explain where the problem was, down to individual brainstem nuclei, and 2) use this information to give an owner an understanding as well, which helped put her at ease. At that moment I realized neurology is unique among the specialties. With a short neurologic exam and nothing else, you can tell someone precisely where their pet has a problem, and the differentials flow from there. It was after this “localization realization” I realized neurology was for me. 

But the road to becoming a neurologist wasn’t easy. My rotating internship was filled with emergency and overnight work, and there were as many grumpy specialists as there were emergencies. Ever try calling a disgruntled 60 year old neurologist to help you with a case late on a saturday night? I’d advise against it. My neurology internship was even tougher. Transporting inpatients in my car from one hospital to another, mopping the orthopedic OR’s and scrubbing instruments at the end of each day were somehow the norm. As were 80+ hour work weeks and a whopping $24,000/year salary.

After two years of internships I was beyond burned out. I wasn’t even sure I wanted to be a vet anymore. I ended up working as a swing shift ER doctor in Albuquerque for the next two years. In retrospect this was a much needed break for me. The hours were perfect for me at the time – 4pm to 2am, 3 to 4 days a week. Many shifts I’d see 2-3 patients the entire time (ER was different in 2011 and this was Albquerque, New Mexico after all).  But after two years of ER work I got restless and stumbled upon an amazing opportunity for a residency position at a private practice nearby. I couldn’t turn the offer down and before I knew it I was a neurology resident, well on my way to officially reaching the goal. 

Little did I know the next three years would make my internships look like kindergarten. My “mentor” was anything but, and by the end of residency I was enduring panic attacks and yet again questioning whether or not I wanted anything to do with this entire field. I eventually made it through those three years, and managed to pass both of my board exams on the first try each time, and was officially DACVIM in 2017. The goal was finally met.

Looking back, I’m not exactly sure what kept me going. I like to think that the cases where I was able to make a positive impact, had something to do with it. There are few things as satisfying as helping a dachshund walk again, or resolving neck pain in a french bulldog. Learning how to achieve this goal was and still is an enjoyable process for me. I still remember vividly the ones I was able to help. Even today, with the grind that is private practice, I’m continuously reinforced by the times in which I am able to resolve a pet’s pain, or help them regain their mobility. I view comfort and mobility as key drivers in quality of life, and practicing veterinary neurology allows me to address these concerns in pets on a daily basis. I view it as a privilege to be able to directly impact animal welfare in this way, and this helps me get through the frequent insanity of private practice.

If I had to give advice to my younger self, it would be to invest in Tesla as a startup company.  If I had to give advice directly related to my career in veterinary medicine, it would be simply to try and focus on how the difficult years are, at the end of the day, temporary. Nothing lasts forever. And despite how miserable you may be now, when you’re 40 you’ll have a family you adore and be able to support thanks to all this hard work. You’ll get opportunities not everyone in veterinary medicine has access to, and frankly, it’ll be cool being able to call yourself a neurologist!

Going forward, I plan on working in private practice until retirement. It is certainly not perfect and has its challenges, but it affords me an amazing quality of life. I’ve been able to pay off my student loans before the age of 40, have kids, pursue hobbies like travel, real estate investing, and social media content creation. I’d be lying if I said I had no complaints, but in reality this career has given me everything I want and most importantly, need, in life. Would I recommend it for everyone? No. But if you do want to pursue specialization in veterinary medicine, it is usually very much worth the extra time and effort. It’s just hard to know that when you’re mopping floors as a doctor.

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