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Semin Neurol
DOI: 10.1055/a-2767-2331
Review Article

A Categorical 4-Year Child Neurology Residency: It's Time

Authors

  • Robert Thompson-Stone

    1   Department of Neurology, Golisano Children's Hospital, University of Rochester, Rochester, New York, United States

  • Rachel Gottlieb-Smith

    2   Department of Pediatrics, C.S. Mott Children's Hospital, University of Michigan, Ann Arbor, Michigan, United States

  • Danny A. Rogers

    3   Department of Neurology, University of New Mexico Children's Hospital, University of New Mexico, Albuquerque, New Mexico, United States

  • Kathryn Xixis

    4   Department of Neurology, University of Virginia School of Medicine, University of Virginia, Charlottesville, Virginia, United States

  • Rachel Pearson

    5   Department of Pediatrics, University of California, Irvine, Children's Hospital Orange County, Part of Rady Children's Health, Irvine, California, United States

  • Lindsay Pagano

    6   Department of Pediatrics, Monroe Carell Jr Children's Hospital at Vanderbilt, Vanderbilt University, Nashville, Tennessee, United States

  • Margie Ream

    7   Department of Pediatrics, Division of Neurology, Nationwide Children's Hospital, The Ohio State University, Columbus, Ohio, United States
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Abstract

Child neurology training has undergone minimal change over the decades, despite a rapid growth in subspecialty knowledge, patient volumes, and complexity. The current 5-year structure, which was established due to necessary historical compromises between pediatrics and neurology, is increasingly misaligned with modern clinical practice and educational priorities. Most child neurologists no longer pursue dual pediatrics certification, and few provide neurologic care to adult patients. Meanwhile, the field has expanded significantly in complexity and volume, making it a large enough specialty to sustain an independent curriculum. We propose a streamlined 4-year categorical residency model that integrates relevant components of pediatrics and adult neurology while centering training around child neurology from the start. This model, which aligns better with structures seen in comparable specialties, prioritizes flexibility and increases the opportunities for longitudinal mentorship and professional development. Thoughtful planning and collaboration will be essential to surmount challenges during the transition, including changes in board certification and alterations to institutional funding. Modernizing child neurology training is essential to better prepare future specialists, support recruitment and resident development, and meet the evolving needs of children with neurologic disorders.

Keywords

child neurology - residency - graduate medicale ducation


Publication History

Received: 23 July 2025

Accepted: 08 December 2025

Accepted Manuscript online:
11 December 2025

Article published online:
29 December 2025

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