Abstract
Objective: We aimed to develop a program director-derived model of essential components of child neurology residency training.
Methods: All 79 child neurology residency programs in the United States were invited to submit a block diagram with 48 months of required rotations, the minimum clinical requirement across all approved pathways. These block diagrams were then analyzed for consensus. Program directors were anonymously surveyed regarding whether a child neurology resident could be adequately trained using the consensus curriculum if implemented in either a 4- or a 5-year training program, and whether 4 years of residency could provide adequate training.
Results: Fifty of 79 residency programs (63%) submitted a block diagram (54% in pediatrics departments, 46% in neurology departments). Greater than 75% of program directors recommended the following rotations with the average number of months recommended across all program directors in parentheses: pediatric inpatient/hospital medicine (3), pediatric non-consult intensive care (3), healthy newborn (0.5), pediatric acute/emergency care (1), genetics (1), child development (1), child neurology inpatient/consults (8), child neurology general outpatient (4), child psychiatry (1), adult neurology inpatient/consults (3), neurology specialties outpatient (4), electroencephalography (2), neuroradiology (1), and electives (7). Of the program directors (53 of 79, 67%) who completed the post-survey, 87% agreed that these requirements would be adequate, and 89% agreed that child neurologists could be adequately trained for independent practice within 4 years.
Interpretation: The program director consensus supports modification of existing child neurology training requirements, with general agreement that 4 years of clinical training would be adequate.
Cohen BH, Gilbert DL, Xixis K, Banwell BL, Singh A, Pagano LM, Brooks-Kayal A, Kirkpatrick L, Schor NF, Mar SS, Crowder D, Terrell M, Kang PB. Education Research: The Future of Child Neurology Residency Training: The Perspective of a Child Neurology Society Task Force. Neurol Educ. 2026 Jun 12;5(2):e200331. doi: 10.1212/NE9.0000000000200331. PMID: 42311783; PMCID: PMC13271257.
Abstract
Background and objectives: Postgraduate residency in the United States is complex, and each medical field faces unique educational challenges. Child neurology has had a distinct identity for decades, yet its training curriculum originated from a joint venture of 2 larger and older fields, pediatrics and neurology. The traditional five-year training sequence consists of 2 years of pediatrics, 1 year of adult neurology, and 2 years of child neurology, as well as all other educational experiences, including electives. The contents of each major component have changed, in some instances dramatically, over the years, yet the original basic structure remains.
Methods: In anticipation of upcoming reviews of the child neurology training curriculum, the Child Neurology Society (CNS) convened a task force to review key aspects of this training curriculum. The task force members were surveyed anonymously both before and after a series of discussions to consider the current and expected educational needs of child neurologists in the mid-21st century, following a modified Delphi approach.
Results: The consensus was that child neurology has matured immensely as a field, with substantial subspecialization becoming common at major academic medical centers. There was significant variability in the availability of pediatric neurologic subspecialty training in fields such as neurogenetics and neuromuscular neurology across the United States. The preponderant view of the Task Force was that the child neurology training curriculum should be reviewed and potentially modified in accordance with the evolving educational needs of child neurologists, particularly with regard to general pediatrics and adult neurology training. The spectrum of faculty expertise and curricular emphasis across programs, viewed as a strength of training options, precluded reaching consensus on details of appropriate changes.
Discussion: The findings of the task force indicate that there will be a need for ongoing evaluation and updating of the child neurology training curriculum in future years. Before the next formal review of the child neurology training curriculum by the Accreditation Council for Graduate Medical Education, we recommend a robust discussion among multiple stakeholders, including accreditation bodies, medical specialty boards, and professional societies such as the CNS that represent child neurologists in practice and in training.
Abstract
Child neurology training has undergone minimal change over the decades, despite a rapid growth in subspecialty knowledge, patient volumes, and complexity. The current 5-year structure, which was established due to necessary historical compromises between pediatrics and neurology, is increasingly misaligned with modern clinical practice and educational priorities. Most child neurologists no longer pursue dual pediatrics certification, and few provide neurologic care to adult patients. Meanwhile, the field has expanded significantly in complexity and volume, making it a large enough specialty to sustain an independent curriculum. We propose a streamlined 4-year categorical residency model that integrates relevant components of pediatrics and adult neurology while centering training around child neurology from the start. This model, which aligns better with structures seen in comparable specialties, prioritizes flexibility and increases the opportunities for longitudinal mentorship and professional development. Thoughtful planning and collaboration will be essential to surmount challenges during the transition, including changes in board certification and alterations to institutional funding. Modernizing child neurology training is essential to better prepare future specialists, support recruitment and resident development, and meet the evolving needs of children with neurologic disorders.
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