The Future of Child Neurology Residency Training

Dr. Dara Albert talks with Dr. Bruce Cohen about the future of child neurology residency training, exploring current models, consensus areas, and challenges in evolving the curriculum to meet future healthcare needs.

Read the related article in Neurology® Education.

Disclosures can be found at Neurology.org.

Podcast Transcript:

Dr. Jose Merino: This is Jose Merino, editor-in-chief of the Neurology Family of Journals. The Neurology Podcast provides practical information to neurologists and other clinicians to help them provide better care for their patients. Thanks for listening and have a great week.

Dr. Dara Albert talks with Dr. Bruce Cohen: Hi, this is Dara Albert from Nationwide Children's Hospital and Ohio State University. I am delighted to be joined today by fellow Ohioan, Bruce Cohen, a child neurologist at Akron Children's Hospital and an expert in the care of children and adults with mitochondrial disorders. Bruce is the lead author of a paper published in June 2026 called Education Research: The Future of Child Neurology Residency Training: The Perspective of a Child Neurology Society Task Force. Child neurology occupies this unique space at the intersection between pediatrics and adult neurology and pediatric neurology. And really there are a few topics in our field that generate as much discussion amongst child neurologists as how we should train the next generation. You get 10 child neurologists in the room, maybe there's 15 different opinions on how we should do this. Recognizing that there's a lot of evolution in our field, the Child Neurology Society, or CNS as I'm going to refer to it, assembled a task force to explore whether the current training models continue to meet the needs of our trainees, practicing physicians, and the patients that they serve. And we're going to talk about the results of that task force and what was published in the paper. Before we dive into that though, I do want to note that Bruce is joining us today as a representative of the task force and its findings. And while he contributed to this work, the perspectives and recommendations outlined in the paper are going to reflect the collective views of the task force and may not always fully align with his individual opinions. So Bruce, welcome to the podcast.

Dr. Bruce Cohen: Thanks. It's great to be here.

Dr. Dara Albert talks with Dr. Bruce Cohen: Absolutely. Let's start with a little history. Many may not be as familiar with how child neurology training developed in the United States. Can you tell us a little bit more about the current training model, how it came to be, and how it has evolved over the decades?

Dr. Bruce Cohen: The current training model is about 50 years old. 50 years ago, there was no CAT scans or MRI scans or genetic testing. We had pneumoencephalograms. So there really have been major changes in the last 50 years in how we take care of children with neurological problems and how we treat them. And one would expect that the training needs would change as well over that timeframe. So here we are today to discuss the differences of opinions among my colleagues.

Dr. Dara Albert talks with Dr. Bruce Cohen: It's hard to imagine doing an encephalogram these days. We've come a long way from that.

Dr. Bruce Cohen: Well, it just shows my age. I remember taking tours of medical school, seeing the pneumoencephalogram suite. It was still up and running when I was in training. It doesn't seem that long ago. It was in the 1980s, but they still had the chair.

Dr. Dara Albert talks with Dr. Bruce Cohen: Wow. Why did the Child Neurology Society or CNS feel that this task force was needed at this particular moment? What questions or challenges were you hoping to address?

Dr. Bruce Cohen: So we know the ACGME is going to go on their 10-year cycle and look into the training requirements of child neurology in 2027. They're getting set up to do that. And it was just seemingly an appropriate time at the end of my term as president of the Child Neurology Society, which ended in 2023 to set up this task force just to see what we could contribute to the body of knowledge and the differences of opinions. I didn't really expect us to reach a consensus when we set up this task force, but I just wanted to lay out the differences of opinions that are out there.

Dr. Dara Albert talks with Dr. Bruce Cohen: Yes. And we will definitely get into the opinions that came up as part of this task force. But before we talk about that, one of the strengths of this effort was the attempt to bring together a variety of perspectives. Can you walk us through how the task force was assembled, how you approached building consensus around these complex issues during discussions?

Dr. Bruce Cohen: So the task force was assembled over a period of a month or so. I don't think I lost any friends by not asking them to join the task force, but I certainly got a lot of calls asking me why I didn't appoint them to the task force. But we started out with nine task force members that were mainly people that have dedicated their lives to education of child neurologists or have been some authoritative positions in the field of child neurology. But we needed to balance those appointed members of the task force with younger and more diverse group of individuals, some right out of training. We also tried to get people who practice mainly in a private practice environment. We didn't really succeed on that in terms of balancing that aspect of the membership, but we basically asked for volunteers and we got 65 applications or four additional members of the task force. We did have some diversity. Nine were female, 10 were white, 12 had US board certifications through the American Board of Psychiatry and Neurology. And initial certification ranging from 1988 to 2022, one was certified through the Royal College of Physicians and Surgeons of Canada. In the meantime, since the initial certification was 14 years with a range of two to 36 years, 12 members were currently clinically active in academic or hospital-based practices. So we did have a bit of diversity. We didn't get the private practice applicants that we hoped to have gotten. And so we may have missed a bit in terms of what those opinions may have been. We also had some diversity among the sub-subspecialty education of the members. We had one person trained in developmental disabilities, three trained in epilepsy neurophysiology, one in neuromuscular neurology. And again, the majority having held positions of authority within the child neurology, either child neurology training or child neurology national administration as officers in the CNS or AAN child neurology section. Eight of the members either currently or formally were residency program directors.

Dr. Dara Albert talks with Dr. Bruce Cohen: Seems like a nice slice through a lot of different aspects of our field, although as you mentioned, not as much in private practice, but otherwise a good diversity of experience and time out from training and all of that. That's awesome. So it seems from reading the paper that the task force met and had discussions around these topics and tried to form consensus, identify lack of consensus around a lot of topics related to child neurology training. So I'm curious, where did the task force find the strongest consensus or areas of agreement and where were the opinions most divided?

Dr. Bruce Cohen: Going back a little bit to maybe your first question is how are child neurologists trained in the first place? The majority of child neurologists enter a two and sometimes three year pediatric training program, but currently the majority have two years of genera