Child Neurology Residency Program

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 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.

Eligibility Criteria

  • Medical degree
      • U.S. or Royal Canadian medical school graduates must have passed USMLE I and II
      • Graduates of Osteopathic schools must have passed USMLE I or NBME I
      • International Medical Graduates must have a current ECFMG certificate
  • Successful completion of two years of postgraduate training which may consist of:
      • Two years of ACGME approved training in pediatrics or one year of ACGME approved training in pediatrics
      • One year of training in basic neuroscience or one year of PGY I level training in an approved residency as otherwise specified in the ACGME requirements for resident training in neurology.
  • Eligibility for a Missouri medical license
  • Successful completion of a personal interview

The Child Neurology Program participates in the National Residency Matching Program (NRMP). All prospective applicants must register with NRMP.

Child Neurology Training

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.

Supervision

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.

The Resident 

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.

On-Call Schedule

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.

Resident Evaluation

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:

  • Discussion of individual cases and general topics during and as part of clinical care rendered in both in-patient and out-patient settings by supervising faculty.
  • Completion of a written evaluation form for each rotation that identifies specific goals of the rotation and progress in meeting them.
  • Monthly review of resident progress and performance by the faculty as a group.
  • Semi-annual review of evaluations and discussion of future training directions and possible modifications with the program director.
  • Immediate resident notification of any evaluation, written complaint or other concerns that would adversely affect successful advancement in the program.
  • Bi-annual mock board examinations by the faculty.
  • Yearly participation in the in-service examination of the American Board of Psychiatry and Neurology.

Fair Process

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.

Curriculum

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.

Clinical Assignments

Year 1

  • Adult neurology: 12 months
  • Continuity clinic: One half day during the first year

Year 2

  • Child neurology: Four months
  • EEG/Neurophys: Two months
  • Subspecialty clinic: Two months
  • Electives: Four months
  • Continuity clinic: Two half days a week during second and third year.

Year 3

  • Child neurology: Four months
  • Child psychiatry: One month 
  • EEG/Neurophys: Two months
  • Neuro-rehabilitation: One month
  • Elective: Two months
  • Subspecialty clinic: Two months
  • Continuity clinic: Two half days a week during second and third year.
Child Neurology Subspecialty Clinics
  • Brain tumor
  • Cognitive neurology
  • Epilepsy
  • Headache
  • Movement disorder
  • Neurofibromatosis
  • Neurogenetics
  • Tuberous sclerosis
  • Neuromuscle 
Formal Didactic Program
  • Teaching rounds: Daily
  • Neurology teaching conference: Noon on Monday through Friday
  • Child Neurology Journal Club: Every Friday
  • Child Neurology Case Presentation: Every Friday
  • Neurology Grand Rounds: Weekly
  • Pediatric Grand Rounds: Weekly
  • Mock oral board exams: Yearly
  • Clinical skills assessment: Yearly
  • Boot camp: Daily during the month of July
  • AFIP neuropathology course: Once
  • Fellows conference: Every Thursday

Research and Scholarly Activity

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.

Facilities

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.

Program Evaluation

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 program director, faculty and residents meet annually to review the program’s goals, objectives and performance. Topics include but are not necessarily limited to:
      • Program resources
      • Faculty support
      • Supporting institutions
      • Volume and variety of patients
      • Teaching methods and effectiveness
      • Clinic and ward supervision
      • Methods and timing of evaluation
  • The Office of Graduate Medical Education conducts a review of the program at the mid-point of each accreditation cycle of the ACGME. This in-house evaluation is carried out by reviewers from outside the Department of Neurology but from within Saint Louis University School of Medicine. Faculty and resident interviews are conducted and the information gained, along with the program’s strengths and weaknesses, are provided in a written report to the program director, director of child neurology, chairman of the Department of Neurology and the associate dean in charge of Graduate Medical Education.
  • The program maintains accreditation by the Accreditation Council of Graduate Medical Education and thus undergoes regular evaluation by the Neurology Residency Review Committee. This provides both documentation and confirmation of the program’s organization and performance, as well as identification of opportunities for innovation or improvement — both in comparison to accepted independent, national norms for all training programs.

Mission Statement

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.