Dear Colleagues – Fall 2016

By David Urion, MD, FAAN

David Urion, MD, FAAN

From a structural perspective, we have undertaken a review of our finances, led 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 income from dues, suggesting ways we will need to move ahead in the near term.

We have successfully 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 anticipate that the task force will present its recommendations for consideration over the next six months, and thus be ready for consideration and adoption by the meeting next year.

We have now been through two full years of the new ACGME RRC guidelines for adult training in child neurology, and we have seen child neurology recognized as a core specialty by the Residency Review Committee of the ACGME. 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. In addition, the Council of Pediatric Subspecialties (CoPS) now requires pediatric subspecialties to begin fellowship programs offset from 1 July; they have asked us for specific information as to how this might impact Child Neurology and NDD training programs. The ABPN has asked us how the change to core status may impact the fiscal situation of Child Neurology and NDD programs, since some may have depended upon affiliated adult programs for part of their intrinsic financial support, and this change in status may thus have changed this.

Thus, the ACGME, CoPS, and ABPN have asked us for these data, and none of the various questionnaires sent over the last several years, independently, by the Child Neurology Society, or any other organized body, capture all the impacts these changes have had on our training programs. By the time you read this, programs will have received a census form from the PCN with a comprehensive set of questions regarding the local options that have been exercised in these various domains. 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. The data thus obtained will be shared with the entirety of the PCN membership, and used to answer the questions posed to us by these other bodies.

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 and the programs you represent to support this effort.

I am looking forward to seeing you in Vancouver. It has been a pleasure, and a privilege beyond any deserved, to have served as the president of this organization for the last two years. I know that my successor, Dr. Gary Clark will serve the academic programs we represent with devotion, vigor, and care.