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Pediatric Neurology

This is an incredibly rewarding sub-specialty that has some differences from all of the other pediatric subspecialties when it comes to residency applications.

Child Neurology has a separate application process from Pediatrics, something important to know if you think you might be interested. The history behind that has to do with the fact that Child Neurology spun out of Adult Neurology some years ago, as opposed to out of Pediatrics. As such, your training has a strong emphasis on neurology at all ages as opposed to just in kids. You do 2 years of general pediatrics (just like any other categorical resident), followed by 3 years of neurology (2 years of peds neuro, 1 year of adult neuro). It sounds like a lot of adult time, BUT it’s important—you become an expert in the neuro exam during that adult time, get a much better handle on localization, and see a lot of pathology you’ll only see rarely in kids. Plus, at the end of the day you will be taking the Adult Neurology boards (with a special certification in Child Neurology). Places are becoming 50/50 on whether the Child Neuro people take Peds boards after their training (you aren’t eligible until you finish all 5 years, and some people are saying it’s just not worth it, but some people still do).

During your pediatrics years, you are treated just like a categorical resident, the programs put a big emphasis on treating you just like one of their own. It is definitely a lot to squeeze 3 years of peds into 2, but the ACGME has clear requirements about what you need to get done in those 2 years and programs make it happen. You mostly lose supervisory time and some elective time, but given you already know what your specialty will be, it’s not too big of a deal, and you will definitely get a lot of supervisory time in your neuro years.

Most programs are now categorical—do all 5 years in one place, a few places still have “advanced” (2 years of peds in one place, 3 years of neuro in another). This gets complicated with ERAS, but feel free to ask questions of fellow applicants or those from previous years (it’s been in flux over the past few years). Most places have you do the year of adult neurology right after your 2 peds years (definitely scary to manage atrial fib and HTN after all that time away from adults!), but the adult neuro residents will definitely help you (and you will help them when they come to peds). Some do a whole straight year of adult neuro, some split 6 mos and then 6 mos. later—definitely ask the programs, this can be a big difference by institution. Then finally in your last 2 years you get to do what you really came for! Many places have a lot of elective time in that last year to do research or focus on sub-specialties within neurology, whether you are thinking private practice or fellowship.

Top programs—Boston Children’s, CHOP, Children’s National Medical Center, Baylor, St. Louis Children’s, Cincinnati Children’s, Johns Hopkins, Cleveland Clinic, Stanford

It’s a lot to think about this early in your career, but if you love the brain and love kids, DEFINITELY consider this awesome specialty.

Last Revision: May 3, 2018