Growing shortages of training opportunities constrain clerkship capacity, while site variability undermines educational comparability and perpetuates neurophobia, weakening neurology training pipeline.
In this prospective observational study, third- and fourth-year students at a public medical school completed a 6-week overlapping neurology clerkship formed by staggering two 4-week rotations. During the overlap (weeks 3–4 of 6), two groups alternated identical active-learning didactic and clinical weeks, maintaining curricular equivalence while avoiding oversaturation of clinical services. Anonymous student pre- and post-clerkship surveys, NBME scores, residency outcomes, faculty evaluations, and coordinator feedback were analyzed qualitatively and quantitatively.
622 students completed the neurology clerkship between June 2021 and April 2025; 504 pre-surveys (81%) and 455 post-surveys (73%) were analyzed. Capacity at the primary site increased by 42.9% despite losing two clinical sites. Most respondents were third-year students (61%), female (60%), and identified as Asian (38%) or White (36%). Student perceived competence rose sharply: confidence in performing the neurologic exam increased from 27% to 93.8%, and in managing neurologic emergencies from 31.7% to 91.6%. Students expressed a a more positive perspective of neurologic outcomes (33.3% vs 48.1%) and greater interest in neurology careers (23.2% vs 31.6%), with match rates rising from 1.9/year (2010–2019) to 6.3/year (2022–2025). Faculty (18/25, 72%) reported their teaching was valued (88%), were satisfied (72%), and 94% intended to continue teaching. Faculty perceived strong student competence, and the coordinator reported manageable scheduling and positive interactions.
A 6-week neurology clerkship, consisting of two staggered 4-week rotations with alternating didactic and clinical weeks during the overlap, expanded capacity, improved learner competence and satisfaction, and increased neurology match rates. This model supports comparable, guideline-based training and strengthens the neurology pipeline, particularly in resource-limited settings.