Pediatric Neurology Detailed Curriculum

The curriculum is designed to meet RRC guidelines for training in Child Neurology and the Goals and Objectives of our training program. 

Requirements include 12 months of clinical adult neurology, 12 months of clinical child neurology, and 12 months referred to as the flexible year.

View an example of a Pediatric Neurology Resident Schedule

Organization / structure of the curriculum

Year 1

  • GME and Neurology orientation to review all relevant house officer policies and institutional mandates and resources;
  • Receive and review program curriculum;
  • Complete Michigan Medicine Mandatory education programs (on-line);
  • Rotations: two month(s) of Pediatric Neurology; 10 months (including vacation) of Adult Neurology;
  • Weekly Pediatric Neurology continuity clinic (1/2 day).

Year 2

  • Two month(s) of Adult Neurology; 2 month(s) of electives (one month of EEG is recommended); 
  • 8 months of general Child Neurology (including vacation);
  • Weekly Pediatric Neurology continuity clinic.

Year 3

    • Two month(s) of general Child Neurology, including a Senior Ward month; 10 months of the following obligatory and elective components (including vacation). 
    • Weekly Pediatric Neurology continuity clinic;
    • The obligatory components are formulated to meet RRC requirements for training in Child Neurology. Obligatory components include:
      • one month of Child Psychiatry (out-patient and/or consultation liaison service), 
      • one month of Pediatric Physical Medicine and Rehabilitation (out-patient), 
      • one month of Neuropathology,
      • two months of EEG/electrophysiology (can reduce to one month, if one month in Year 2),
      • Pediatric Neurosurgery rotation (focuses on out-patient clinic evaluations and  Neurology/Neurosurgery Pediatric Brain  Tumor clinics),
      • Pediatric Neuromuscular Clinic rotation,
      • Bioethics – this can be met in a variety ways, depending on resident’s interests,
      • Educator experience – preparation and presentation of three formal lectures,
      • Academic experience – this can be met by participation in a research project or preparation of a manuscript (case report or review article) for publication; preparation of an IRB application is strongly encouraged. 
    • The remainder of Year 3 is devoted to elective rotations (see Year 3 Clinical Child Neurology optional rotations described below).

* In Years 2 and 3, on all Pediatric Neurology general and elective rotations, residents take call a maximum of one in three nights from home for Pediatric Neurology. 

** As long as all requirements are met over the three-year period, the chronology of each year of training may be modified. 

Resident Responsibilities:

Year 1 - Adult Neurology

The Pediatric Neurology resident will function as a junior resident in Neurology.

Residents will be included in the Department of Neurology orientation program, and receive the Department of Neurology Resident Orientation Guide.

  • Inpatient assignment on neurology service at University Hospital 6 months inpatient, 6 months outpatient and electives
  • Inpatient Wards - 8 weeks
  • Day Float - 4 weeks
  • Consultation - 10 weeks
  • Neuro ICU - 4 weeks
  • Outpatient Clinic - 14 weeks 
  • Child Neurology Clinic – ½ day per week 
  • Vacation - 4 weeks 

While caring for patients, the trainee will also be exposed to all pertinent ancillary diagnostic procedures, including lumbar puncture, EEG/evoked potentials, EMG/NCS, neuro-CT/MRI/angiography/ultrasonography.

Trainees will attend regular conferences including clinical case discussions, basic science conferences, grand rounds, and other didactic conferences.

Year 2 - Clinical Child Neurology

Inpatient and outpatient responsibilities throughout the year, primarily as separate inpatient and outpatient rotations

Inpatient consulting includes evaluation of a broad range of routine, intensive care, and Neonatal intensive care problems 

Outpatient experience includes: 

  • Emergency department consultations throughout the year 
  • Child neurology continuity clinic – ½ day per week 
  • General pediatric neurology new patient clinics: two ½ days/week 

Trainees will attend regular conferences including clinical case discussions, basic science conferences, grand rounds, and other didactic conferences. 

Over Years 2 and 3, trainee will be responsible for at least 2 Morbidity and Mortality conference presentations.

Over Years 2 and 3, trainee will be responsible for at least 4 Journal Club presentations.

Year 3 - Clinical Child Neurology

In addition to the required rotations described above, additional optional rotations in year 3 include:

    1. Neuro-ophthalmology
    2. Neuroradiology
    3. Pediatric Palliative Care
    4. Pediatric Genetics
    5. Developmental / Behavioral Neurology
    6. Additional Electrophysiology
    7. EMG/neuromuscular (1 month: clinic/lab observation; 3 month minimum if individual wants to perform EMG’s)
    8. Sleep medicine 
    9. Neuroanatomy review
    10. Pediatric Neurology sub-specialty clinic rotation - This one-month rotation provides the resident with opportunities to participate in a broad range of Pediatric sub-specialty clinics staffed by members of the division and other pediatric sub-specialists with relevant expertise.
    11. All residents participate in Quality Improvement activities
    12. Academic experience options:
      • Research project. Residents can participate in a broad range of clinical and basic research projects with any member of the University of Michigan faculty. Criteria will include matching of skills and experience of candidate with proposed elective experience, availability of an appropriate mentor, and delineation of a well-defined and feasible project.
      • If a resident does not participate in a research project, he/she will be expected to prepare a case report or review article for publication with a member of the faculty. 
    13. Teaching experiences. Residents will prepare and present at least 3 formal one-hour lectures, including a Pediatric noon conference on a required topic,  a Neonatal Neurology lecture on an assigned topic, and Neurology Grand Rounds. These lectures will each be reviewed with a faculty member, who will provide constructive comments, to enhance teaching skills, prior to the presentation.
    14. Trainee will attend a national clinical or scientific meeting relevant to Child Neurology.
    15. Other elective rotations may be included to meet specific trainee interests. 

Curriculum to address other aspects of core competencies

Inter-personal Skills and Communication - Our major focus is on teaching communication with other health professionals. The major venues include the out-patient clinic (where all referral letters written by trainees are reviewed by attending MD’s), and the in-patient consultation service (where attending MD’s supervise and provide feedback to trainees) regarding interactions with primary teams, communication of recommendations, and written consultations - which are all reviewed and edited electronically. Development of our skills as clinicians is also a focus of our divisional teaching conferences.

Formal guidance in preparation of dictations is provided in the Pediatric Neurology orientation manual.

In addition, we request regular feedback from our division nurses, regarding the trainees ability to effectively communicate both with them and with patients. All patient contacts are documented in the electronic medical record, and reviewed and signed by an attending MD.

Professionalism - All new trainees are required  to complete the institutional mandatories at the onset of training. These web-based instructional programs include “self-tests” to verify understanding of principles. HIPAA-related issues are regularly reviewed in the context of patient care. If specific deficits are identified during monthly evaluations, the faculty will address and attempt to remediate these deficits.

Quality Improvement activities  - An integral component of the monthly Pediatric Neurology/Neuroradiology conference is to ensure that physicians from both services have the opportunity to review abnormal studies, in particular those cases in which the interpretation is complex. This conference serves as a Quality Improvement activity, and residents are expected to participate throughout Years 2 and 3 of training.

The residents receive training in QI during their Pediatrics residency as well as during their Child Neurology year. They engage in individual or group QI projects. Trainees are responsible for quarterly Morbidity and Morality conferences.

BioethicsResidents are required to attend at least 8 Bioethics Rounds, Pediatric Ethics committee meetings, or other similar programs during their training..

Formal didactic sessions in pediatric pain management and end-of-life care, monitoring alertness and fatigue 

Residents as teachers In Year 3, residents are expected to prepare and present at least 3 didactic lectures, geared to pediatric or neurology residents. The resident will select a faculty mentor, and review the  presentation at least one week prior to the scheduled presentation date.

Practice-Based Learning - Continued emphasis on scholarship and learning is essential to the development and maturation of a child neurologist in training. Continued attendance and participation in teaching conferences, case discussions, grand rounds, and basic science seminars is important throughout the entire training period. 

Trainees are expected to learn how to use Internet resources to enhance learning and communications throughout their training. A major focus for our program is to ensure that all trainees are aware of and are able to utilize electronic resources (PubMed, Child-Neuro list-server, electronic journals) to keep abreast of advances in the field, and to obtain patient-specific information. 

Participation in journal club enhances resident awareness of topical publications, and enables them to learn how to critically review publications. Dr. Joshi  serves as the statistics consultant.

System-Based Learning - Trainees received a manual and are expected to complete a test regarding Risk Prevention Skills, prepared by the Risk Management Office. 

Billing issues, and determination of appropriate billing levels, are an integral component of patient evaluations. 

In the clinic, issues related to insurance coverage for testing and for referrals are addressed for every patient. 

Trainees are encouraged to join the Child Neurology Society; the division pays junior membership fees.

Trainees should gain familiarity with American Academy of Neurology practice guidelines relevant to Child Neurology.