Objective:

To survey program directors (PDs) of adult neurology residency training programs in the United States to better understand the scope of formal residency didactics.

Background:

Didactics are a core element of residency education, and include lectures, case-based discussions, self-directed modules, and other elements. Information about curricular design could enable multi-institutional collaboration and implementation of best practices.

Design/Methods:

An anonymous, web-based survey on the design and implementation of didactics was emailed to every PD of a US-based adult neurology residency program listed on the AMA FRIEDA™ database. Surveys were sent in April 2023 with reminders in May and July.

Results:

76/181 (42%) of PDs responded with details about their formal curriculum, with broad reach, but an over-representation of large, academic-affiliated programs. Mean scheduled hours per week were 5.2 (SD ± 2.0) for conferences, 1.1±1.6 for morning report, 1.2±1.1 per month for Professor’s rounds. 63% of programs followed a noon conference versus academic half-day or other schedule, though this varied by affiliation (p=0.009), region (p=0.003), and class size (p=0.022) – being most prevalent among larger Northeast academic centers. Residents did not “hold the pager” during didactics at 20% of programs, varying by affiliation (p=0.007) and region (p=0.032). Mean estimated attendance was 63% overall and did not vary significantly by scheduling model or region. Factors associated with increased attendance included fewer didactic hours, residents not holding a pager, rural location, smaller class size, and academic-community hybrid affiliation.  There was a wide variety of didactic types, but faculty-led lectures were most common. 74% of programs encouraged or mandated use of external asynchronous educational materials and 65% offered internal materials.

Conclusions:

There are many approaches to neurology resident didactics. Survey responses provide insight into the diversity of practices and factors influencing the design and attendance of didactics. Further investigation into existing practices may help facilitate future program innovation nationwide.