Dear Colleagues:

I hope and trust your various winters of discontent are now made glorious sum-mer, as we all transition from the end of one residency year to the beginning of another.

I thought it might be useful, as I near the final six months of my term as President, to review what we have accomplished together over the last eighteen months.

From an educational perspective, this has been a productive time. The Universal Curriculum was finished, and through the strong efforts of that group has been turned into both a document hat is useful in and of itself, but also projects onto the Child Neurology and Neurodevelopmental Disabilities Milestones. Thus, we have two inter-related metrics which both allow us to monitor resident progress towards the independent practice of child neurology or NDD, as well as a way that we can assure the public and regulatory agencies that we are indeed faithful guarantors of the trust placed in us to train and form the next generation of specialists across the country.

We have also changed our annual meeting to include Continuing Medical Education for educators, and have focused on those parts of formation we all find challenging – last year, teaching Quality Improvement in a meaningful fashion within a training program, this year, teaching systems-based practice. In concert with the Educational SIG of the CNS, we can look forward to being a meeting where medical educators can find connection, interaction, and new ideas.

From a structural perspective, we have undertaken a review of our finances, by former and current secretary-treasurers Suresh Kotagal and Steve Leber. They determined that we are essentially a revenue-neutral organization, that is, our dues and other sources of incomes cover the expenses we incur, and the CNS incurs on our behalf through staff and meeting support. We have also identified trends that are concerning, such as a decline in incomes form dues, suggesting ways we will need to move ahead in the near term.

We incorporated Program Coordinators as a new class of member in the PCN. While that group is evolving an organizational structure of its own, our collaboration and close coordination are essential to the efficient function of our training programs in an era of increased regulatory oversight and public scrutiny. Our meetings have been enhanced by their participation.

We have also named a task force to review our by-laws and the way they reflect the organization we are becoming. While we have revised portions of the by-laws over the years, the fundamental document dates from the early last quarter of the last century. Time makes ancient good uncouth, and it was felt by the officers that we needed a document that reflected the realities of academic child neurology in the early twenty-first century and poised us for the challenges ahead. The task force will therefore not limit itself to the by-laws alone, but undertake a comprehensive look at our governance and structure, and determine if they are structured to meet the needs of the times.

We have now been through two full years of the new ACGME RRC guidelines for adult training in child neurology. As you recollect, programs were given increased freedom to arrange the adult neurology time spent by their child neurology trainees in a fashion that fit their local needs. Only six months of inpatient adult neurology are now required, and outpatient rotations in which >50% of the time is spent seeing adults (regardless of hospital setting – i.e., adult or pediatric) were to be counted as fulfilling the adult requirement.

We have no comprehensive data regarding the way these changes have been implemented across the country. The ACGME RRC has asked us to obtain these data, and so programs will be obtaining a census form over the next several months with questions regarding the local options that have been exercised. This is not a survey, in the sense that we would accept some percentage of programs responding as somehow representative, but is to be a comprehensive census. Please answer promptly once you have received the form for your program; we will stay in touch until we have heard from all programs in Child Neurology and NDD.

Finally, I would like to call your attention to the annual lectureship being established at the University of Virginia in honor of Rob Rust, one of the premier neurologic educators of his generation. While the lecture will be seated at U. Va., the CNS and PCN are working on efforts to digitize the lectures, once established, and then share them through the website for our membership. Rob, who has given so much to child neurology and in particular to the formation of child neurologists, is one of the best we have. I urge you to join me in supporting this lecture-ship established in his honor. Links to a letter and pledge form from the University of Virginia are available on the CNS website.

I am looking forward to seeing you in Vancouver.


David K. Urion, M.D., FAAN