Introduction
Neurology residents will rotate on the Pediatric Neurology for a total of 3 months, which will be incorporated in their first and second years of Neurology training (PGY-2 and PGY-3). The rotation encompasses both inpatient and outpatient care, as well as a consulting service. Since the clinical rotation will not provide practical experience in all pediatric neurological diseases, it is expected that the resident will supplement their experience with reading. Interested Adult Neurology residents may also elect to spend extra time on Pediatric Neurology, with additional inpatient and/or outpatient exposure.
The Pediatric Neurology consult team consists of an attending pediatric neurologist, the adult Neurology resident rotating on the Pediatric Neurology service, sometimes a child neurology resident (PGY-4 or PGY- 5) and one or more medical students. The team may also include a Pediatric resident electing to obtain formal training in Pediatric Neurology. An advanced practicing provider (APP) is also assigned to support the inpatient pediatric neurology team.
Most pediatric neurology clinics occur in the same outpatient space as the adult neurology clinic. Some specialty clinics occur in the American Family Children’s Hospital (AFCH). A variety of different clinics run throughout the week, including:
- General pediatric neurology
- New-onset epilepsy
- Complex epilepsy
- Ketogenic diet
- Neuro-oncology
- Neurocutaneous disorders
- Neuromuscular disorders
When rotating in the outpatient clinic, neurology residents will be assigned to specific clinics throughout the week; a schedule will be provided at the beginning of the week. The resident will work with an attending pediatric neurologist, seeing new patients and follow ups, and documenting on those encounters.
Goals
- Describe normal developmental milestones.
- Become proficient in performing and interpreting a thorough neurologic examination in children of all ages.
- Offer age-appropriate interpretations of tests such as neuroimaging, CSF, and EEG.
- Complete a reasonable differential diagnose and manage common neurologic disorders seen in children.
- Diagnose and manage neurologic emergencies in children and be able to perform telephone triage when on call.
Objectives and Evaluation Matrix
As with all of the neurology rotations, the specific objectives are reflected in the entrustable professional activities and individual milestones listed below. These form the basis for the end-of-rotation evaluation. (Please see the section End-of-Rotation Evaluations above for the list of milestone abbreviations).
| Rotation Objectives | ||
| Upon completion of the curriculum, residents will . . . | ||
| # | Description | Milestones |
| 1 | Evaluate and manage children presenting with headaches | PC1, PC2, PC3, PC4, PC6, PC8, PC12, MK1, MK2 |
| 2 | Evaluate and manage pediatric patients with developmental delay | PC1, PC2, PC3, PC4, PC8, MK1, MK2 |
| 3 | Evaluate and manage children with common neurometabolic and neurogenetic disorders | PC1, PC2, PC3, PC4, PC8, MK1, MK2 |
| 4 | Evaluate and manage pediatric patients with common neuromuscular disorders | PC1, PC2, PC3, PC4, PC10, MK1, MK2 |
| 5 | Evaluate and manage neurologic complications of pediatric cancer and its treatment | PC1, PC2, PC3, PC4, PC8, MK1, MK2 |
| 6 | Evaluate and manage common pediatric epilepsy syndromes | PC1, PC2, PC3, PC4, PC8, PC9, PC12, MK1, MK2 |
| 7 | Manage status epilepticus in infants and children | PC1, PC2, PC3, PC5, PC6, PC8, PC9, MK1, MK2 |
| 8 | Represent the pediatric neurology service during interdisciplinary care conferences and family meetings. | SP3, SP4, PR1, PR2, IC3, IC4 |
| Milestones | ||
| Please grade the resident on any of the following milestones you were able to evaluate during this rotation: | ||
| PL1, PL2, PR1, PR2, PR3, IC1, IC2 | ||
Work Hours
The estimated average number of work hours per week is 55-65.
It is the responsibility of each resident to be in constant communication with the supervisory attending and program director regarding work hours. In the event that any of the ACGME work hours regulations are in jeopardy of being violated, the attending physician and/or program director must be notified immediately. It will be that attending’s responsibility to rectify the situation immediately by appropriate means.
Suggested References
Aicardi, J., Bax, M., & Gillberg, C. (2009). Diseases of the nervous system in childhood. London: Mac Keith Press.
Daroff, R. B., & Bradley, W. G. (2012). Bradley’s neurology in clinical practice. Philadelphia, Pa.: Elsevier/Saunders.
Pina-Garza, J. E., & Fenichel, G. M. (2013). Fenichel’s clinical pediatric neurology : a signs and symptoms approach.
Latest revision: 05-14-2021
