Summer/Fall 2014

By Phillip L. Pearl, MD

Phillip Pearl, MD

I write this PCN Report as the outgoing president, with some reflection as to our progress and direction over the past two years. The term began in a tumultuous time of debate as to the quantitative and qualitative expectations and purpose of the adult neurology training. We have moved beyond that to new program requirements that were implemented as of this July 2014, where the concerns about diminishing returns on repeated adult stroke rotation shave been replaced by a refreshing approach limiting inpatient adult rotations to six months and maximizing elective and clinic opportunities in another six months. Electives are now expanded to the breadth of clinical neuroscience, allowing for exposure and training in related disciplines including neuroradiology, neurophysiology, neuropathology, genetics, and others.

We subsequently forged ahead to preparation of a universal curriculum, the first draft of which has been written and edited by the Executive Committee and now forwarded to the undergraduate Education Committee for linkage to the ACGME prepared milestones. Both the curriculum and milestones are in mature stages of development and we hope will be soon ready for prime time for further input and utilization by our membership. The Curriculum was patterned after Rob Rust’s masterful editing of the Seminars in Pediatric Neurology, as presented by Dr. Rust at the PCN meeting two years ago. The Curriculum presents goals and objectives in these areas:

Overview – Child Neurology Training: History, Examination, Formulation; Adult Neurology; Ataxia; Cerebral Palsy; Critical Care; Demyelinative; Developing Brain; Developmental Disorders; Developmental Neuroscience; Epilepsy; Ethics; Genetics; Headache; Imaging; Infectious Diseases; Inflammatory Non-infectious/Autoimmune; Metabolic; Movement Disorders; Neonatal; Neurocutaneous; Neuro-imaging; Neuromuscular; Neuro-oncology; Pathology; Pediatrics; Psychiatry; Sleep Medicine; Traumatic Brain Injury; Vascular; Visual System.

At this fall’s meeting of the PCN, we will delve more into utilization of milestones, with different approaches to operationalizing them and using creative, user friendly, web based evaluation systems so that the development of trainees can be tracked in the areas of clinical competence and professional entrustable activities. Individuals from multiple institutions will present their approaches, with fresh material for all.

The PCN was asked for input as to what placement was optimal for child neurology, between departments of neurology and pediatrics. With an 80% response, the academic programs are about split between primary affiliations in neurology and pediatrics, and furthermore with nearly 80% responding they would not change their present affiliation. While nearly all PCN members who responded have ABPN board certification in child neurology, 60% have board certification in pediatrics and < 10% of those who will require recertification in pediatrics indicated plans to do so. The median number of half-day clinics for child neurologists in academic programs without other sources of funding was six. The complete results can be reviewed in Pediatric Neurology(reference below).

This year a pilot program for child neurology program coordinators will be held adjacent to the PCN afternoon meeting with the hope of synergizing and vitalizing efforts between program directors and coordinators. A selection committee comprised of three PCN and two CNS representatives reviewed six outstanding candidates nominated by their trainees and peers for the Blue Bird Circle Award for Outstanding Program Director to be presented on Friday morning at the CNS Annual Meeting. Dr.Steve Leber, from the university of Michigan, was selected to be the second training director to be so honored; last year’s inaugural award was presented to Harvey Singer. The administration of the match has been revised and is now a combined effort between the PCN and CNS. To round out the year, we anticipate an upcoming election for an open Councilor position, and congratulate Amy Brooks-Kayal on the completion of her term. I wish to thank there remaining Executive Committee: Suresh Kotagal (Secretary-Treasurer),Howard Goodkin (Councilor), and David urion (Councilor and President Elect) for their excellent advice and support.

There is perhaps no better feeling in winding down organizational leadership than to know that the baton is being passed to greater heights and I am confident of this with my successor, David Urion. It has been a privilege serving the PCN.


Reference: Pearl PL, McConnell ER, Fernandez R, Brooks-Kayal A. Survey of the Professors of Child Neurology: Neurology vs Pediatrics Home for Child Neurology. Pediatr Neurol 2014 June 4 [Epub ahead of print].