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.
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:
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.
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:
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
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.
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.