How to become a neurologist

1. 1Finish a bachelor's degree and premed requirements

   Time: 4 yearsCost: Varies by collegeSources 1

   Medical schools accept any major as long as you complete the required sciences, usually biology, general and organic chemistry, physics and math. Students drawn to neurology often major in neuroscience, biology or psychology and look for research in a neuroscience lab. Clinical exposure counts: volunteer on a stroke or rehabilitation unit, or shadow a neurologist in clinic. Combined bachelor's-MD programs take 6 to 8 years in total.

2. 2Take the MCAT and get into medical school

   Time: About 1 yearCost: $360 MCAT registration for the 2027 testing year ($145 with Fee Assistance)Sources 2, 1, 3

   Nearly every US medical school requires MCAT scores. Apply to LCME-accredited MD schools, COCA-accredited DO schools, or both; graduates of either can enter ACGME neurology residencies. Medical schools look at grades, MCAT scores, clinical and research experience, and letters. Applicants who qualify for the AAMC Fee Assistance Program pay a reduced MCAT fee.

3. 3Complete medical school and pass the first licensing exams

   Time: 4 yearsCost: $297,745 (public) to $408,150 (private) median 4-year cost of attendanceSources 5, 3, 4

   Years one and two cover the basic sciences, including neuroanatomy and neurophysiology. Years three and four are clinical rotations; take a neurology clerkship and sub-internship early enough to get strong letters from neurologists. MD students pass USMLE Step 1 and Step 2 CK, at $695 each. DO students pass COMLEX-USA Level 1 and Level 2-CE, at $745 each.

4. 4Complete a PGY-1 year and three years of neurology residency

   Time: 4 yearsCost: Paid as a residentSources 6, 3, 4

   ABPN requires a full ACGME-accredited PGY-1 year followed by 36 months of neurology residency. You can do this in a four-year categorical neurology program, where the first year includes at least six months of internal medicine, or a separate preliminary year followed by three years of neurology. During residency you must pass five clinical skills evaluations (NEX exams), and you usually take USMLE Step 3 or COMLEX Level 3.

5. 5Get a state medical license

   Time: During or after residencyCost: State feesSources 1, 6, 8

   All states license physicians, and boards set their own rules on background checks, how much residency is required and renewal. Most require graduation from an accredited school, passing the USMLE or COMLEX sequence and residency training. ABPN requires an active, full and unrestricted medical license before it will let you sit for the neurology certification exam, so apply early.

6. 6Pass the ABPN neurology board exam and consider a fellowship

   Time: Exam after residency; fellowship 1-3 yearsCost: $1,945 ABPN exam feeSources 6, 7, 1

   The ABPN neurology certification exam is computer-based and given at Pearson VUE centers. The initial certification fee is $1,945, and continuing certification costs $175 a year for one certificate. Many neurologists add a fellowship in a subspecialty ABPN recognizes, such as vascular neurology, epilepsy, clinical neurophysiology, neuromuscular medicine, neurocritical care or sleep medicine; subspecialty exams cost $1,900.

Programs, tuition and graduates’ earnings

U.S. Department of Education, College Scorecard (most recent cohorts, released 2026-10-15). Scorecard groups programs by 4-digit field, so a row can include related programs. Tuition is the median published undergraduate tuition and fees of the colleges offering the program (shown only for undergraduate credentials); debt is the median of programs’ median federal loan debt at completion; earnings are the national median for the field and credential four years after completion.

Requirements differ by state. Check your state’s rules in the CareerOneStop License Finder (U.S. Department of Labor) before you enroll.

Neurological examination

Locating a lesion from patterns of weakness, reflex changes and sensory loss is the core skill that guides every test a neurologist orders.

Interpreting tests

Neurologists read EEGs and nerve studies themselves and must judge MRI findings against the exam, since incidental findings are common.

Speed in emergencies

In acute stroke, clot-dissolving treatment works only within a short window, so decisions are made in minutes.

Delivering hard news

Diagnoses such as ALS, glioblastoma or early-onset dementia must be explained honestly and with care to patients and families.

Long-term patient management

Epilepsy, multiple sclerosis and Parkinson's require years of medication adjustments and coordination with therapists.

O*NET 31.0 rates these skills as most important for the occupation: active listening, reading comprehension, speaking, critical thinking, writing.

Training cost

$302K–$413K

Before financial aid

Time

12-13 years

Typical path

Median pay

$248,560

All US jobs: $50,980

Payback once qualified

1.5–2.1 yrs

Pay above the all-jobs median vs. cost

Low: AAMC median 4-year cost of attendance at public medical schools, class of 2026 ($297,745), plus the MCAT ($360), USMLE Step 1, Step 2 CK and Step 3 ($695 + $695 + $955) and the ABPN initial certification exam fee ($1,945). High: the private-school median ($408,150) plus the MCAT, COMLEX-USA Levels 1-3 ($745 + $745 + $950) and the ABPN fee. Cost of attendance includes living expenses. Not included: college costs, application costs, license fees and loan interest. Residents are paid. College Scorecard median federal debt for medical graduates is $208,644.

Rough guide only: ignores taxes, aid, interest and earnings given up during training. How we calculate it.

• Neurology subspecialist$244,180 median

  A fellowship in an ABPN subspecialty such as vascular neurology, epilepsy or neurocritical care, followed by a subspecialty exam.

• Academic neurologist$82,250 median

  Neurologists at medical schools combine patient care with teaching and research; many complete a research fellowship and build a grant record.

• Child neurologist$210,040 median

  Physicians who want to treat children follow a separate five-year path that includes general pediatrics and 36 months of child neurology, certified by ABPN with special qualification in child neurology.

• Medical director or physician executive$123,860 median

  Experienced neurologists can lead stroke programs, neuroscience service lines or hospital departments, sometimes adding a management degree.