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Outpatient training in neurology

History and future challenges

From the Department of Neurology (M.A.N., M.S.V.E.), College of Physicians and Surgeons, Columbia University, and the Columbia University Medical Center of New York-Presbyterian Hospital; and Gertrude H. Sergievsky Center (M.S.V.E.), College of Physicians and Surgeons, Columbia University, New York, NY.

Address correspondence and reprint requests to Dr. Mitchell S.V. Elkind, Neurological Institute, 710 West 168th Street, New York, NY 10032; e-mail: mse13{at}columbia.edu

Abstract.

The organization of neurology as a specialty and of neurology training specifically has evolved tremendously over the last 130 years. Originally primarily an outpatient specialty, the focus of training shifted to inpatient neurology in the early 20th century when accreditation of programs required training in newly established inpatient-based neurologic departments. Now and in the near future, the growth of neurologic critical care and the expansion of neurology intensive care units may require even more inpatient responsibilities in neurology residency programs. Contrary to these trends in training, most community neurology practice is still focused on outpatients, and surveys of neurologists have consistently indicated a need for more outpatient exposure in neurology training. This article briefly reviews the history of neurology training, discusses current challenges to outpatient training, and recommends possible solutions for the future.

Footnotes

Disclosure: The authors report no conflicts of interest.

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