Adult Neurology Rotations for Child Neurology Residents: Exploring the Resident Perspective
Stella Deng MD 1, Cullen Marshall MD2, Donald Gilbert MD MS2, Hannah Jackson2, David Wolf MD PhD3, Robert Thompson-Stone MD1
1Division of Child Neurology, University of Rochester, 2Division of Child Neurology, Cincinnati Children's Hospital Medical Center, 3Division of Pediatric Neurology, Emory University/CHOA
Objective:
We aimed to identify how child neurology residencies meet ACGME adult neurology training requirements and explore the impact on residents. We hope to identify ways adult neurology training can be structured to be most beneficial for resident education, professional development, and wellness.   
Background:

In 2014 the ACGME Neurology Residency Review Committee modified the 12-month adult neurology training requirements for child neurology certification, giving program directors more scheduling flexibility.  However, information about how these requirements have been implemented and how they have impacted residents is limited. 

Design/Methods:

All child neurology program directors in the United States were contacted through email to distribute a RedCap survey to their residents. Survey responses were collected from September to October 2020. Descriptive statistics with frequencies were calculated, and comparisons were analyzed using t-test calculations.

Results:

109 child neurology residents participated in the survey (28.4% PGY-3, 37.6% PGY-4, and 33.9% PGY-5 residents). 22.4% had all adult rotations during the PGY-3 year, and 77.6% had adult rotations spread throughout residency. 63% and 56.5% utilized non-clinical rotations in EEG and EMG, respectively, whereas only about 45% utilized neuroradiology and neuropathology as options to fulfill the adult requirement. Adult neurology training had a small positive impact on resident autonomy and a negative impact on resident wellness regardless of training structure. However, residents with 12 months of adult training during the PGY-3 year scored worse on burn out, mood changes, work-life balance, and social wellbeing (p<0.05). 47.8% of residents with 12 months adult training in the PGY-3 year liked their training format versus 59.8% with training spread out.

Conclusions:

Adult neurology training was found to negatively affect resident wellness, with a larger negative impact when adult training was completed in 12 months during the PGY-3 year. Residencies could consider reducing the number of adult training months during the PGY-3 year.