Saint Louis University’s subspecialty child neurology residency is a three-year program with a prerequisite of either a two-year residency in pediatrics or one year of pediatric residency coupled with one year of residency training in internal medicine in the United States.
Seven full-time neurologists and two pediatric nurse practitioners train residents in child neurology, principally at SSM Health Cardinal Glennon Children's Hospital, a renowned 190-bed tertiary care center.
We have specialty clinics in epilepsy, cerebral palsy, neurofibromatosis and tuberous sclerosis, neuromuscular disorders, headache, high-risk nursery follow-up and concussion.
The Child Neurology Program participates in the National Residency Matching Program (NRMP). All prospective applicants must register with NRMP.
This program qualifies a physician for certification in neurology with special competence in child neurology. Twelve of the 36 months are spent on the adult neurology service. An additional 12 months are devoted to the study of clinical child neurology in the ambulatory and in-patient settings.
The ambulatory program provides residents with an opportunity to rotate through clinics in general child neurology, neurofibromatosis, neuro-oncology, neonatolgy, myelodysplasia and neuromuscular disorders. The final 12 months are spent in the study of neuropathology, neuroradiology, clinical neurophysiology or clinical research. While on the ward rotation, residents make daily rounds with the attending child neurologist and attend all regularly scheduled conferences of the SLU’s Department of Neurology.
Each resident is expected to participate in a faculty-sponsored research project. Research activities of the faculty are focused on neonatal neurological problems, sleep disorders and pediatric brain tumors.
The child neurology training program exists to both educate and train physicians to be independent practitioners. For that reason, guided and gradual assumption of responsibility for patient care, as well as the other aspects of child neurology practice are, a vital part of the program. As a faculty, we encourage this assumption of responsibility as a resident’s knowledge and experience, skill and judgment permit. Supervision and evaluation are designed and implemented with this goal in mind.
Attending physicians always retain final responsibility for the diagnosis and management of patients seen by the neurology service, but we recognize that there is often more than one acceptable approach to diagnosis and management. We seek to educate our successors, not train our replicas.
Physicians are responsible for practicing within their limits of educational and professional development as perceived and informed by faculty guidance and self-assessment. Residents have access to advice and assistance of the supervising physician on each rotation at any time and may request the presence of the attending physician for any emergency or other urgent situation when necessary. Consultation and advice may be sought from any member of the faculty but final responsibility and thus decisions for an individual patient’s care rest with the attending physician of record.
After hours and weekend on-call responsibility is shared by fellows. Responsibilities include management of neurology service patients, as well as coverage of consults both in-patient and in the emergency room for pediatric patients. Duty hours are in strict compliance with ACGME guidelines.
Comparison of a resident’s growing knowledge, skill and competence with both the standards of the profession and the progress of peers is a valuable part of the educational program. Careful and timely feedback is designed to encourage the resident by demonstrating achievement and guide by identifying areas yet to be mastered. We accomplish this by:
Each resident is entitled to the protection of fair process procedures as established by the Department of Neurology and the Saint Louis University School of Medicine in matters pertaining to academic grievances.
Our curriculum draws on educational and other guidelines developed by the professors of child neurology and the Child Neurology Society. Rather than a statement or definition of what a child neurologist should know and do, we see it as a guide to the basic skills and knowledge that will give our graduates the ability to competently and safely practice our specialty, confident in their abilities and ready to continue the lifelong learning and professional development that is the practice of child neurology. Rather than a limit, our curriculum is a foundation on which to build a career.
We support and encourage residents’ interest in both basic and clinical research with an infrastructure of conference and mentoring relationships, as well as opportunities for collaboration with researchers in both the Department of Neurology and the Department of Pediatrics. We have active research projects in the areas of epilepsy, antiepileptic drugs in children, headache, sleep, pain control and moyamoya disease.
Each year, residents — guided by a member of the faculty — research and present short scholarly work on interesting cases, conditions, new approaches or our institution’s experience with an aspect of neurologic disease. While designed to teach both scholarly skills and discipline, these presentations also teach communication skills and principles of lifelong self-directed learning and have led to publications in the medical literature.
Residents also prepare and present case studies and other brief scholarly works to their peers and fellow child neurologists at the annual Missouri Valley Child Neurology Colloquium each year.
The department director acts as mentor, encouraging and guiding the residents’ development of research skills and individual projects.
SLU’s child neurology program is based at SSM Health Cardinal Glennon Children’s Hospital, a 190-bed acute care hospital with single patient rooms, 60-bed NICU, 11-bed PICU, surgical suite and radiology facilities, including CT, MRI and a 22-room emergency department.
The neurophysiology lab is equipped for EEG, EMG/NCV and EP studies. There is a two-bed sleep/polysomnography laboratory, as well as an additional two beds which are dedicated to epilepsy monitoring. Laboratory test results are readily available by computer throughout the institution’s clinics, wards, specialty units and offices.
SSM Health Cardinal Glennon Hospital also houses our pediatric outpatient clinics, conference rooms, and the child neurology faculty and resident offices.
The child neurology program continuously monitors and evaluates its structure and performance in order to provide an excellent educational program. Study and critical review of current methods allows retention of what is worthwhile, improvement when indicated and possible innovation as opportunities arise. This is accomplished through the following mechanisms:
The Division of Child Neurology in the Department of Neurology is dedicated to the ideals of Saint Louis University, SSM Health Cardinal Glennon Children’s Medical Center and our profession in the areas of research, service and education.
We endeavor to demonstrate our commitment by pursuing and disseminating both new knowledge and greater understanding of the nervous system, the diseases of childhood that afflict it, as well as the methods of diagnosing and treating them. We seek, adapt and implement the finest methods of delivering and practicing clinical child neurology.
In those areas where opportunity and our abilities allow, we endeavor to set the standard for others to follow. We recruit, train and educate those who wish to join our profession to first become our peers and then to surpass us in knowledge and accomplishment.