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January 08, 2019; 92 (2) Contemporary Issues

Neurology residency training in 2017

A survey of preparation, perspectives, and plans

View ORCID ProfileAbhimanyu Mahajan, Carolyn Cahill, Eugene Scharf, Sahil Gupta, Stephanie Ahrens, Elizabeth Joe, Logan Schneider
First published December 5, 2018, DOI: https://doi.org/10.1212/WNL.0000000000006739
Abhimanyu Mahajan
From the Department of Neurology (A.M.), Henry Ford Hospital, Detroit, MI; Insights Department (C.C.), American Academy of Neurology, Minneapolis; Department of Neurology (E.S.), Mayo Clinic, Rochester, MN; Department of Neurology (S.G.), University of Alabama at Birmingham; Department of Pediatrics (S.A.), Nationwide Children's Hospital, Columbus, OH; Department of Neurology (E.J.), University of Southern California, Los Angeles; Department of Psychiatry and Behavioral Sciences (L.S.), Stanford Center for Sleep Sciences and Medicine, Palo Alto, CA.
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Carolyn Cahill
From the Department of Neurology (A.M.), Henry Ford Hospital, Detroit, MI; Insights Department (C.C.), American Academy of Neurology, Minneapolis; Department of Neurology (E.S.), Mayo Clinic, Rochester, MN; Department of Neurology (S.G.), University of Alabama at Birmingham; Department of Pediatrics (S.A.), Nationwide Children's Hospital, Columbus, OH; Department of Neurology (E.J.), University of Southern California, Los Angeles; Department of Psychiatry and Behavioral Sciences (L.S.), Stanford Center for Sleep Sciences and Medicine, Palo Alto, CA.
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Eugene Scharf
From the Department of Neurology (A.M.), Henry Ford Hospital, Detroit, MI; Insights Department (C.C.), American Academy of Neurology, Minneapolis; Department of Neurology (E.S.), Mayo Clinic, Rochester, MN; Department of Neurology (S.G.), University of Alabama at Birmingham; Department of Pediatrics (S.A.), Nationwide Children's Hospital, Columbus, OH; Department of Neurology (E.J.), University of Southern California, Los Angeles; Department of Psychiatry and Behavioral Sciences (L.S.), Stanford Center for Sleep Sciences and Medicine, Palo Alto, CA.
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Sahil Gupta
From the Department of Neurology (A.M.), Henry Ford Hospital, Detroit, MI; Insights Department (C.C.), American Academy of Neurology, Minneapolis; Department of Neurology (E.S.), Mayo Clinic, Rochester, MN; Department of Neurology (S.G.), University of Alabama at Birmingham; Department of Pediatrics (S.A.), Nationwide Children's Hospital, Columbus, OH; Department of Neurology (E.J.), University of Southern California, Los Angeles; Department of Psychiatry and Behavioral Sciences (L.S.), Stanford Center for Sleep Sciences and Medicine, Palo Alto, CA.
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Stephanie Ahrens
From the Department of Neurology (A.M.), Henry Ford Hospital, Detroit, MI; Insights Department (C.C.), American Academy of Neurology, Minneapolis; Department of Neurology (E.S.), Mayo Clinic, Rochester, MN; Department of Neurology (S.G.), University of Alabama at Birmingham; Department of Pediatrics (S.A.), Nationwide Children's Hospital, Columbus, OH; Department of Neurology (E.J.), University of Southern California, Los Angeles; Department of Psychiatry and Behavioral Sciences (L.S.), Stanford Center for Sleep Sciences and Medicine, Palo Alto, CA.
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Elizabeth Joe
From the Department of Neurology (A.M.), Henry Ford Hospital, Detroit, MI; Insights Department (C.C.), American Academy of Neurology, Minneapolis; Department of Neurology (E.S.), Mayo Clinic, Rochester, MN; Department of Neurology (S.G.), University of Alabama at Birmingham; Department of Pediatrics (S.A.), Nationwide Children's Hospital, Columbus, OH; Department of Neurology (E.J.), University of Southern California, Los Angeles; Department of Psychiatry and Behavioral Sciences (L.S.), Stanford Center for Sleep Sciences and Medicine, Palo Alto, CA.
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Logan Schneider
From the Department of Neurology (A.M.), Henry Ford Hospital, Detroit, MI; Insights Department (C.C.), American Academy of Neurology, Minneapolis; Department of Neurology (E.S.), Mayo Clinic, Rochester, MN; Department of Neurology (S.G.), University of Alabama at Birmingham; Department of Pediatrics (S.A.), Nationwide Children's Hospital, Columbus, OH; Department of Neurology (E.J.), University of Southern California, Los Angeles; Department of Psychiatry and Behavioral Sciences (L.S.), Stanford Center for Sleep Sciences and Medicine, Palo Alto, CA.
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Citation
Neurology residency training in 2017
A survey of preparation, perspectives, and plans
Abhimanyu Mahajan, Carolyn Cahill, Eugene Scharf, Sahil Gupta, Stephanie Ahrens, Elizabeth Joe, Logan Schneider
Neurology Jan 2019, 92 (2) 76-83; DOI: 10.1212/WNL.0000000000006739

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This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.

Abstract

Objective To survey graduating US neurology residents on the topics of debt, fellowship interview process, future plans, and their readiness for practice and business management tasks.

Methods An electronic survey was sent to all US American Academy of Neurology member adult and child neurology residents graduating in June 2017.

Results The response rate was 23.4% (n = 159). Of the 143 residents who provided information about student loans, 57% reported having debt (median $180,000). Ninety percent of respondents reported plans to pursue a fellowship after residency; 57% intended to stay at their home institution for additional training. Among respondents from adult neurology programs, 87% preferred to begin the fellowship application process after the first 6 months of the third postgraduate year. Almost half (46%) of adult neurology program residents felt they did not have enough outpatient exposure prior to making fellowship decisions compared to 14% of child neurology trainees. Although reported readiness to perform specific tasks (coding and office management) increased since 2007 (p < 0.05), only 36% of all respondents reported receiving business management training during residency.

Conclusion Trainees completing residency report considerable educational debt. A large majority of residents feel the fellowship application process occurs too early. Despite improvements over recent years, the majority of residents continue to feel ill-prepared for specific practice management tasks. These results suggest a need to better understand the effect of educational debt on career choices, an examination of the timing of the fellowship application process, and the incorporation of additional business management training during residency.

Glossary

AAN=
American Academy of Neurology;
CNRF=
Consortium of Neurology Residents and Fellows;
IRB=
institutional review board;
RVU=
relative value unit

Footnotes

  • Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.

  • Received June 4, 2018.
  • Accepted in final form August 2, 2018.
  • © 2018 American Academy of Neurology
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Letters: Rapid online correspondence

  • Author response to Drs. Ratliff and Shanker
    • Abhimanyu Mahajan, Movement disorders fellow, University of Cincinnati
    Submitted January 02, 2019
  • Fellowship applications
    • Jeffrey B. Ratliff, Neurologist, Thomas Jefferson University
    • Vicki L. Shanker, Neurologist, Mount Sinai Downtown
    Submitted December 14, 2018
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