Focus on a Universal Curriculum and Case Based Teaching Series – April/May 2013

By Philip L. Pearl, MD

Phillip Pearl, MD

This year’s PCN activities are focused on establishing a content-based universal curriculum for child neurology trainees including a case based teaching series. This work will be coordinated with the efforts of the ACGME to provide a milestones approach to curriculum development. As presented during the annual meeting, the monograph edited by Dr. Rob Rust in Seminars in Pediatric Neurology has catapulted us with a terrific start, as the contributors already weighed in on a thoughtful approach to our question: What should a child neurologist know by the conclusion of training? There is a vast amount of information, as the graduating child neurology fellow is still a generalist in our field. Further sub-specialization is typically obtained from extended training in clinical or research fellowships or targeted experiences.

In addition to Dr. Rust’s leadership in this venture, we have initiated collection of instructive cases with the leadership of Dr. Ira Bergman along with the CNS Case Based Sharing Project spearheaded by Drs. Barry Kosofsky, Joe Pinter, and Mickey Segal. A motion was passed at the fall meeting to strongly endorse that all program directors, representing the membership of the PCN, solicit at least a single case submission from each child neurology and neurodevelopmental disabilities fellow to post as a teaching case. The cases will be linked to the curriculum, and we will be seeking these actively later this summer.

Drs. Amy Brooks-Kayal and Howard Goodkin are working on the connection between child neurology training and medical students, with an eye toward early mentoring and identification of research opportunities for medical students with a career interest in pediatric neurology.

The PCN has been involved for some time in discussing the constitutive elements of child neurology training. This has been especially active over the last year during the course of ACGME-wide revisions of training program requirements. I am pleased to share that the Neurology RRC has been very receptive to input from both the PCN and CNS organizationally and individuals who have spoken and written about this issue. We have made important progress in the proposed requirements for child neurology and NDD programs to limit adult neurology inpatient rotations to six months, establish a minimum of three outpatient clinic months, and have up to three months of electives geared toward an individual trainee’s interests and career development with oversight by the child neurology training program director. In addition, there is a recommendation for the sponsoring institution to provide time and funding to support at least 20% FTE for our program directors and an additional 1%per trainee. This is analogous to the support for adult neurology “core” program training directors and we have been able to bring this level of support to child neurology training programs. The proposed revisions are currently posted for public comment.