The Accreditation Council for Graduate Medical Education (ACGME) requires three years of training in neurology—one full year of adult neurology and two years of child neurology. For the two years of child neurology, the ACGME requires one year of core clinical child neurology and one year of ‘flexible’ training.
Adult Neurology consists of rotations on the general adult neurology service, the adult stroke service, the neurologic intensive care unit, outpatient adult specials, and adult electives. Adult specials is an outpatient rotation with exposure to a wide variety of subspecialty clinics including Neuro-oncology clinic, Multiple Sclerosis clinic, Cognitive clinic, ALS/Huntington’s Disease multi-disciplinary clinic, Epilepsy clinic, and Movement disorders clinic. Adult electives are available in Epilepsy, Electroencephalogram (EEG), Neuromuscular, Electromyography (EMG), Movement Disorders, Neuroimmunology, Neurodegenerative Disorders, Cognitive Disorders, Headache, Neuropsychology, Neuro-oncology, Neuropathology, Neuroradiology, Neuro-ophthalmology, Neurosurgery, Neurovascular/Stroke, Pain, Physical Medicine and Rehabilitation, and Neurology-Related Research. A night float system is largely in place for call coverage. Residents have 4 weeks of vacation during this year. A continuity clinic is required on average one half-day per week. For this requirement, residents participate in child neurology continuity clinic which gives our residents early exposure to the pediatric neurology population.
Example Block Schedule
The first full year of child neurology is primarily spent on the inpatient service. This allows for mastery of the fundamentals of acute child neurology problems earlier during the child neurology years. Adult neurology residents also rotate on the service simultaneously with the child neurology resident serving as the team leader. Inpatient service includes time on the primary child neurology service, the child neurology consult service serving the ICUs, general wards teams, other specialty teams, and emergency department. Scheduled admissions to the child neurology service include admissions for headache management, admissions to the pediatric epilepsy monitoring unit, and admissions for initiation of the ketogenic diet. A half day continuity clinic experience in child neurology continues throughout the PGY4 year. In addition, a longitudinal half day clinic in developmental pediatrics is completed this year. Core child neurology elective choices include Epilepsy, Electroencephalogram (EEG), Epilepsy Monitoring Unit (EMU), Neuromuscular, Electromyography (EMG), Movement Disorders, Neuroimmunology, Neuropsychology, Neuro-oncology, Neuropathology, Neuroradiology, Neuro-ophthalmology, Neurosurgery. Residents have 4 weeks of vacation during this year. There is no in-house call. All call during this year is home call. The PGY4 child neurology resident covers a total of 12 weekends per year.
Example Block Schedule
The last year of child neurology training is devoted to building on and diversifying basic child neurology knowledge. This year includes some inpatient service time but primarily consists of outpatient rotations as well as electives. Core outpatient rotations are comprised of a variety of clinical experiences with choices including Pediatric Neurosurgery, Neuroimmunology, Neuromuscular, Neurocutaneous disorders, Neonatal neurology, Neuro-oncology, Movement Disorders, Epilepsy and Diet therapies, Concussion and Acquired brain injury, Developmental pediatrics, and Physical Medicine and Rehabilitation. Non-core child neurology elective choices include Epilepsy, Electroencephalogram (EEG), Epilepsy Monitoring Unit (EMU), Neuromuscular, Electromyography (EMG), Movement Disorders, Neuroimmunology, Neuropsychology, Neuro-oncology, Neuropathology, Neuroradiology, Neuro-ophthalmology, Neurosurgery, Neurovascular/Stroke, Genetics and Metabolism, Developmental and Behavioral Pediatrics, Genetics and Metabolism, Physical Medicine and Rehabilitation, and Basic or Clinical Science Research. A half day continuity clinic experience continues throughout this year in child neurology. Additionally, residents meet the psychiatry rotation requirement for graduation through an additional half day clinic longitudinal experience in psychiatry this year. Residents have 4 weeks of vacation during this year. There is no in-house call. All call during this year is home call. The PGY5 child neurology resident covers a total of 8 weekends per year.
Example Block Schedule
Rural Southwest Virginia Field Clinics
This is a unique opportunity to participate in a long-standing outreach clinic to underserved populations in Southwest Virginia. Attendings, fellows, and residents travel down to the SWVA region once a month on a rotating schedule for 2 full day clinics. The child neurology resident typically makes the trip to this clinic twice during PGY5 year.
Additional Highlighted Educational Experiences and Requirements
Daily Noon Conference Didactics
Child Neurology Journal Club Monthly
Pediatric Neuroradiology Conference Bi-Monthly
PGY5 Grand Rounds Presentation
Participation in Scholarly Activity
Participation in Quality Improvement
Attendance at one regional or national conference during training
Our program meets the requirements needed for graduation in child neurology from an ACGME-accredited institution and meets the requirements to allow graduates to take the Neurology Board with Special Qualification in Child Neurology. However, we highly support individual interests whether in specific clinical areas or whether in research. We will make every effort to create a residency experience that allows for flexibility to explore the specific interests of our trainees.