A Day in the Life of a Neurohospitalist PA

I'm Brie Marks, and I have been a practicing PA for 5.5 years. I graduated from DeSales University in eastern Pennsylvania in 2014, and I currently love my job in inpatient neurology and neurological acute care. As a neurohospitalist PA, I work in the hospital only. I actually haven't spent any time in an outpatient office since my clinical rotations.

Our health network includes multiple hospitals, so I split my time between our main academic hub and our community hospitals. I have always been fascinated by the brain and neuroscience, and neurology is a perfect fit because it is both highly specialized, focusing on one body system, and incredibly broad. Common conditions I see on the inpatient service include stroke, seizure, intracranial hemorrhages, spinal cord injuries, infections of the brain and spinal cord, autoimmune diseases, and neurodegenerative diseases like Parkinson's disease and ALS.

My day depends on my location. At our main hospital, I meet my team for rounds at 8am, where we discuss all our patients and divide them between the advanced practitioners (PAs and NPs) and the attending physicians. Then I see new consults and follow ups, prioritizing the sickest patients or those being discharged that day. On our service, the advanced practitioner usually does all the chart review, touches base with the primary team, reviews the imaging, performs the history and physical, and develops a diagnosis and plan, then staffs that patient with the attending.

At a community hospital, I run the list myself, deciding which patients to see, then either meet the attending in person later that day or speak with them by phone. I work about 40 hours a week, roughly 8am to 4pm. I take my turn with holidays and weekends, which is standard for inpatient work, and when I work a weekend I get a weekday off before and after. I take no call, so once I leave the building I am not contacted after hours. I'm salaried, so while I don't get paid extra for staying late, I also can leave early for appointments, and it tends to even out.

On my team I am quite autonomous, but I always feel the support of my fellow APs and physicians. We meet frequently as a team to discuss difficult cases, both to brainstorm and to learn. At our main hospital, the attending usually speaks to the patient after I have examined them, which gives the patient a chance to ask any new questions. If there is an emergency or a stroke alert at a community hospital, I respond independently and then contact my attending with my assessment. As a PA on the neuro service, I feel heard and respected as a provider in my own right, while still having my team to learn from.

Neurology is an incredible field, and I would encourage students not to be intimidated by the neuro exam or the complexity of the material covered in PA school. If you are passionate about it, you can absolutely master it on the job. There are so many paths, including neurohospitalist work, general outpatient neurology, or subspecialties like epilepsy, multiple sclerosis, movement disorders, and headache.

Neurology is a rewarding field with real autonomy and a manageable inpatient schedule, even if the material feels daunting in school. If you are exploring specialties, keep an open mind about neuro. And if you want help thinking through career paths as a future PA, our resources are here for you.