Pediatric Neurology

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Noelle

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I need help. I have decided that I want to go into pediatric neurology and don't have nearly the information I need to begin applying next year. Unfortunately there isn't anyone at my school that is familiar with peds neuro. Since there is no central application agency for peds neuro its making my quest for info more difficult. One of my most pressing questions is the following...Do I only apply to pediatric programs that ALSO have a peds neuro fellowship in hopes that that will increase my chances of getting into their peds programs. I've heard that peds neuro is far from competitive. Also, if I apply to a peds program that does NOT have a peds neuro fellowship do I hide the fact that I will most likely leave after PGY 2 since peds neuro fellowship only requires two years of peds residency? If ANYONE has any idea on this subject or the name or website of someone who might it would be greatly appreciated.

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I don't know much about it, but I think you can apply for the fellowship as a med student outside the match, and apply to residency for the match. I think you generally let the programs know that you are leaving, and they will treat you as a transition spot (they then would get an extra year, instead of one less!). I'd get in touch with a few peds neuro fellowship directors-they'll be more able to give you specifics, and get you in touch with current residents.
 
Breaking news: my advisory dean just informed me that the NRMP is mandating that child neuro programs start participating in a match process, either with them or with SF Match. This is to begin in the upcoming application cycle.

As far as the preliminary pediatric residency goes, one of the child neuro residents at my school tells me that approximately half of the folks going into the field do a full three year peds residency; the other half fast-track it and do two. The possibility of fast-tracking is very much school-dependent, it seems. The pediatric residency PD at my school basically told me to "not mention" my desire to go into child neuro when interviewing for pediatric residency spots, otherwise I might not match. Other schools are reportedly more tolerant, however.

I agree with notstudying that the best bet is to talk to PDs from individual child neuro programs and see what they advise. I'll be going to the child neuro society conference in October and hope to glean alot of information there for when I apply a year and a half from now.
 
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Omores, thanks SO much for your reply! I am at a loss for information. There is one good peds neurologist at my school but he trained at LA children's hospital and completed a three year peds residency. I would like to do it in five years if possible and I would actually like to get to one of the NC schools (or at least southeastern coast). Do you know much about the competitiveness of peds neuro? I am not a stellar student but I LOVE neuro and I love kids. I can't see myself doing anything else. Do you think there will be many of the peds neuro programs at the CNS meeting? Maybe I should go.

I will also be applying next year. It would make life so much easier if they really do have to centralize the application process. So do you know if most programs want you to apply for a pgy3 position at the same time you apply for pgy1 in peds? Also do you know if programs "can get you in" to their peds program for 2 years (or 3 yrs) if they accept you into their peds neuro program?

I can't thank you enough. I feel like I'm flying blind since no one at my school can seem to help.
 
Yup, the lack of information -- especially consistent information -- is a major pain. My school does have a child neuro program, so at least there are more people to ask!

According to the child neuro PD at my school, the field is not competitive. If you've got the interest, you should be able to get a spot somewhere. He and others associated with the program say that the major problem is doing 2/3 of a peds residency. At my school, the two departments aren't the least bit cooperative with each other. There seems to be some bad blood between them. In fact, their lack of cooperation is apparently somewhat notorious in the field. I've heard that at other schools, however, the two departments may actually help each other out by setting aside peds slots for folks in the program -- that would be nice.

I do think it would be difficult to do 2/3 of a peds residency at a place without an affiliated child neuro program, though. The one exception to that is peds programs that offer 1 year pediatric internships. There aren't many of these places -- check the FRIEDA website -- but I do know that UNC Chapel Hill has this option. Then you could shift over to Duke for the child neuro part.

I have no idea how the centralized application thingie is going to work. One of the problems is that peds uses the NRMP match, but adult neuro uses the SF match. I would hope that they'd end up agreeing on NRMP, but who knows. All I've heard at this point is that NRMP is mandating they use something by this year -- it's always possible that the programs will worm their way out of it, though. I think I'll e-mail the PD for Duke and see what he knows about it. Will post back here when I find something out.

The most common way to apply is what you mentioned: PGY1 and PGY3 during your last year of medical school. I don't know what happens if you can't secure a fast track position, though. Do you just end up postponing the PGY3 until PGY4? Hmmm.

One of the residents at my school says the CNS conference was a great opportunity for her to meet other residents and compare stories about the application process -- so I think it'd be really good for prospective information too. And I'm sure that most programs are well represented. The whole department at my school goes...
 
Update: heard back from the PD, who forward a copy of the e-mail he received from the presidents of PCN and CNS*.

It's a go: child neurology will use the SF match starting in January 2005. This does not affect people who have already signed for positions. And yes, MS4s will use it for PGY3 positions. Don't know what the implications of that are -- what happens if you don't end up scoring a fast-track peds position in the NRMP? Are you pretty much locked into bailing out of whatever program you're in after 2 years? (Rhetorical questions...)

If anyone wants a copy of the e-mail, PM me. Noelle, I've already sent you one.

* Professors of Child Neurology and Child Neurology Society
 
omores...Can you please forward a copy of that email to me.I am very much interested in pediatric neurology and dont have much information...Thanks
 
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hi omores,

sorry to haggle you with requests, but i'd appreciate it too if you could possibly forward me the letter about the new match system for pediatric neurology. i'm really interested in this field as well. thanks
 
Noelle said:
Omores, thanks SO much for your reply! I am at a loss for information. There is one good peds neurologist at my school but he trained at LA children's hospital and completed a three year peds residency. I would like to do it in five years if possible and I would actually like to get to one of the NC schools (or at least southeastern coast). Do you know much about the competitiveness of peds neuro? I am not a stellar student but I LOVE neuro and I love kids. I can't see myself doing anything else. Do you think there will be many of the peds neuro programs at the CNS meeting? Maybe I should go.

I will also be applying next year. It would make life so much easier if they really do have to centralize the application process. So do you know if most programs want you to apply for a pgy3 position at the same time you apply for pgy1 in peds? Also do you know if programs "can get you in" to their peds program for 2 years (or 3 yrs) if they accept you into their peds neuro program?

I can't thank you enough. I feel like I'm flying blind since no one at my school can seem to help.
Noelle - In 2004's match, both peds Neuro and peds matched on regular NRMP match day, and if you fast track the 2+3 year program, you'll most likely do both the residency and fellowship at one institution. Peds Neuro as a field is not competitive; in Los Angeles, there is a 6-month waiting list for new patients simply because of lack of supply. However, the fast track is very competitive. If you're interested in the fast track, especially now that peds Neuro will match early with SF match, contact the individual institutions (CHLA being one).

Also, Noelle, do a pediatric neurology rotation before deciding that as a career. It's great that you love kids and that you love neurology. However, you will see more kids dying and being killed by abuse than any other specialty (except perhaps Hem/Onc or ER). You'll be the one telling parent after parent that their child will die of a brain tumor, and you'll be the one to confirm brain death in any child who goes in that direction. That's one of the reasons I couldn't do Peds Neuro and stuck with a 3-year peds residency with a different fellowship.

Best of luck in your choices.

-Todd MS-IV (CHLA-bound :))
 
Hey Taz,

Do you happen to know, anecdotally, of other peds programs that allow fast track besides CHLA? I'll be sure to do my own research when I'm closer to applying, but just wondered if you were aware of any particular programs that I should keep in the back of my mind until then.

And are there folks competing for fast track positions that are going into other fields? I heard somewhere that pediatric psychiatry also uses fast track.

Cheers!
 
Omores, I know that Indiana University has a fast track. It's posted on their peds neuro website. Thanks again for all the info it's been extremely helpful.

Taz, I actually did a peds neuro rotation with the best one in our city. He actually trained at CHLA. He raved about it. It was my first 4th year elective. It allowed me to see that you do help many children. There are of course very sad things you see and have to deal with but I think it will be a extremely rewarding field. Thanks also to you for the info you provided.
 
Omores, I don't know much about peds neurology programs, unfortunately. You'll have to find out elsewhere, perhaps FREIDA from the AMA.

Noelle...good luck in the application process then!
 
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omores said:
Update: heard back from the PD, who forward a copy of the e-mail he received from the presidents of PCN and CNS*.

It's a go: child neurology will use the SF match starting in January 2005. This does not affect people who have already signed for positions. And yes, MS4s will use it for PGY3 positions.

SF Match starting in 1/05...does this mean that fourth years that are set to graduate in 2006 will be the first group to use the SF match? or does it mean that fourth years in the class of 2005 will be using it as well? I am not clear on this, as peds neuro will have to be up and running on the SF Match web site by 8/04 in order for students who are graduating in 2005 to participate in it for peds neuro.

Thanks.
 
This confuses me too. From what I recall, the NRMP stipulated that the child neuro programs have to begin using a match process for the 2005 match. But in the notice announcing that child neuro programs have decided to use SF match, there's a line that says that in order to comply with the NRMP's stipulation, they'll begin in January 2005.

This could mean that for the upcoming cycle, you'd apply to programs separately, as before, but then use the match from your submission of a rank order list onwards.

It could also mean that they intend to have the match process set up for the 2005 match, but won't begin using it until that autumn (i.e., for the 2006 match).

Or it could mean something else entirely...
 
Hmmm. Received an update stating that the match will apply to positions beginning 2005, 2006 and 2007. The 2007 positions would be for those graduating in 2005 i.e., the upcoming match cycle.

I'll forward this new message to everyone who asked for the first one.
 
Harvey Singer, president of the Professors of Child Neurology and PD of the Hopkins program, confirmed that the match starts this year (I e-mailed him):

"Our plan is to have a target date in the early fall (Sept) for applications, however, applicants can continue to apply after that date. Rank lists will be due sometime in early January 2005. Our goal is to provide trainees with match results prior to NRMP deadlines for pediatrics or medicine."

Will keep you posted.
 
Pediatric neurology is a fellowship in NEUROLOGY not pediatrics. To do P. Neurology, do a neorology residency and then a pediatric neurology fellowship.
 
Leukocyte said:
Pediatric neurology is a fellowship in NEUROLOGY not pediatrics. To do P. Neurology, do a neorology residency and then a pediatric neurology fellowship.

While that seems like a very effectual approach for this specialty, there's more than one way to skin a cat. I'm looking at a program that has you do 2 years of general pediatrics (typically, but I take it - not always), then you do one year of adult neurology, one year of pediatric neurology, and then one year of neuroscience courses. Their program is certified by the American Board of Psychiatry and Neurology. I'm inclined to believe that this would give you a broad base of instruction and experience.
 
"Pediatric neurology is a fellowship in NEUROLOGY not pediatrics. To do P. Neurology, do a neorology residency and then a pediatric neurology fellowship.
__________________
Actually, no:

Answer on FAQ at the American Board of Psychiatry & Neurology site
http://www.abpn.com/certification/faqneurology.html#10 :

What Are the Board's Specific Training Requirements for Certification in Child Neurology?
Three patterns of training are acceptable for two of the five years of training:

1. General Pediatrics
The usual pathway is two years of training in general pediatrics in an ACGME-accredited program. This is the only pathway that allows the applicant admission for examination by both the American Board of Pediatrics and the ABPN.

OR

2. General Pediatrics/Basic Neurosciences Research
One year of training in general pediatrics in an ACGME-accredited program and one year of research in the basic neurosciences. The basic neuroscience pathway was created as an alternative track for residents who are planning a research career in academic child neurology. The year of basic neuroscience must provide training in a research discipline related to child neurology and is intended to increase the trainee's knowledge base and competitiveness for federal and nonfederal grant support. The trainee must make at least an 80% time commitment to basic neuroscience during this year of training.

For the purpose of this training track, the term "basic neuroscience" is defined as laboratory research related to the cellular or molecular basis of neurologic diseases. Examples of relevant basic disciplines include molecular neurogenetics, neurochemistry, neuropharmacology, neurophysiology, neuroanatomy, neuroimmunology, developmental neurobiology, biophysics, and cell biology.

Effective for residents entering residency training in child neurology as of July 1, 2003: The neuroscience training track must be approved prior to entry into residency training in child neurology. A form to guide the applicant's description of the research, his or her role, skills to be acquired, and the likely outcomes (e.g., presentations, peer reviewed manuscripts) is part of the information to be provided. Credit will be given for basic neuroscience training obtained as part of an integrated clinical neuroscience program leading to certification in neurology with special qualification in child neurology. Credit cannot be obtained for basic neurosciences training obtained as part of a degree-granting program (e.g., Ph.D.).

Residents entering child neurology training prior to July 1, 2003, must have this training track approved by the Board prior to completion of the five years of training.

A program director who intends to propose a neuroscience research training track for a resident should contact the Credentials Department at the Board office to request the proposal form. The form may also be downloaded from the ABPN web site, www.abpn.com. This form along with letters from the mentor (and child neurology program director, if a different individual) must be submitted describing the research and explaining how the year of neuroscience relates to child neurology and to the trainee's academic career. Documentation must include exact dates of training (from month/day/year to month/day/year).

OR

3. General Pediatrics/Internal Medicine
One year of training in general pediatrics and one year of training in internal medicine in ACGME-accredited programs. An acceptable alternative to the one-year of internal medicine is a full year of ACGME-accredited training that includes a minimum of six months of internal medicine, the details of which must be documented by the training director. The composition of these six months may not include rotations in neurology, family practice, pediatrics, or emergency medicine. To ensure that these six months constitute a high quality experience, they should emphasize progressive responsibility for the resident. At least two of the additional six months must be spent in internal medicine, pediatrics, family practice and/or emergency medicine. For candidates entering child neurology residency training on or after July 1, 2002, at least two of the additional six months must be spent in internal medicine, pediatrics, family medicine, and/or emergency medicine. No more than two of the remaining four months may be spent in neurology.

AND

In addition, all candidates will be required to complete three full years of postgraduate, specialized residency training in a child neurology program accredited by the ACGME.
 
Ok, I think you are right.

I thought child neurology was under neorology because at www.acgme.org and FREIDA, Child Neurology was listed under Neurology. There was no listing under Pediatrics. :confused:
 
understandable confusion since child neurology IS under neurology. The first year of the fellowship is actually in adult neuro, followed by two years in child. But, as it says above, by doing the 2 yrs of peds first route, you can also sit for the peds boards.
 
i have been searching for info on peds neuro and the match.
does anyone know anything more than what i just read?
how do we know about fast track v not? and if it is the SF match, are we then able to do the 2 peds at that school?
thanks for sharing info!
any advice on good programs and what not would also be apreciated.
lsu NO does the 2 years and the programs are very cooperative etc...
great people too.
thanks for any advice you have
 
A friend of mine did a fast track general pedi residency at Colorado in Denver and then a fellowship in Pedi Neuro at UCSF. He's now faculty at Colorado again.
 
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