Neurology With Special Qualification In Child Neurology

[Tarja Rabito]

TheABPN has made changes in the credentialing process effective for residents who entered residency training in neurology on or after July 1, 2007 (PGY-1) or July 1, 2008 (PGY-2). Some of the clinical skills evaluations that were conducted previously in the Part II oral examination are now taking place within the residency program and the residents will be required to submit documentation of satisfactory performance in the evaluation of clinical skills as part of the ABPN credentialing process. Assessment of other clinical skills has been integrated into the computerized Certification examination beginning in 2011.

All applicants for the child neurology certification examination must successfully complete five clinical skills evaluations that comply with the standards set forth in the document Requirements for Clinical Skills Evaluation of Residents in Neurology and Child Neurology.

In addition to documentation of their pediatrics and residency training, all physicians must submit documentation from the program director of an ACGME accredited child neurology program verifying completion of the five clinical skills evaluations will be completed by July 31 in the year of the exam administration you plan to sit for. Physicians who do not provide acceptable documentation of successful completion of the five clinical skills evaluations by the deadline will be denied an opportunity to sit for the certification examination. For physicians in the preCERT system, verification of training is done in preCERT.

Physicians who entered child neurology training prior to July 1, 2007 (PGY-1) or July 1, 2008 will not have completed the clinical skills evaluations that are currently required during residency training. Such physicians will be required to complete the required five clinical skills evaluations in an ACGME-accredited program and comply with the standards set forth in the document Requirements for Clinical Skills Evaluation in Neurology and Child Neurology before they will be admitted to the certification examination. Evaluations must be completed by July 31, in the year of the exam administration you plan to sit for.

Neurology with special qualification in child neurology is a specialty that involves the specialization in neurology with special skills in diagnosis and treatment of neurologic disorders of the neonatal period, infancy, early childhood, and adolescence.

Subspecialties in neurology/child neurology include; brain injury medicine, clinical neurophysiology, epilepsy, hospice and palliative medicine, neurodevelopmental disabilities, neuromuscular medicine, pain medicine, sleep medicine, and vascular neurology.

References to residency refer to entry at the second year of postgraduate (PGY-2) training, unless otherwise stated. Residency training must be in the specialty in which the applicant seeks certification, except for residents who are in an approved combined training program. Training programs approved by the residency review committees and accredited by the ACGME can be found on the ACGME website at www.acgme.org. The ABPN training and leave of absence policies are located on the Policies page.

Full-time residency training must be completed in no more than two blocks. If completed in two blocks, the blocks must not be more than five years apart and the shorter block must not be less than six months long. One-year full-time equivalent of subspecialty residency training must be completed in a continuous block of not less than one- half time.

To ensure continuity of training, the Board requires that at least two of the three years (i.e., at least 24 of 36 calendar months) of child neurology residency training, excluding the PGY-1 year, be spent in a single program. The two-year minimum also excludes training in pediatrics, internal medicine, family medicine, or the Basic Neuroscience (BNS) Pathway research year.

Also, it is encouraged that the training director of the first program send the training director of the second program a letter detailing the training satisfactorily completed, including exact dates (month/day/year to month/day/year) of training, and areas of training that are deficient. After reviewing this documentation, the training director of the second program should inform the resident whether or not the second program will be able to provide the resident with the experience necessary to remove the deficits before the transfer occurs.

The usual pathway is two years of training in general pediatrics in an ACGME-accredited program. This is the only pathway that allows the applicant admission for examination by both the American Board of Pediatrics (ABP) and the ABPN. Admission to ABP examination requires specific pediatric rotations. Residents who wish to be certified by the ABP should refer to the ABP website, www.abp.org, for the specific rotation requirements.

All requirements must be met, and documentation must be received by September 1 in the year of the exam administration you plan to sit for. Please contact the Board for additional information at crede...@abpn.org.

Applicants who submit a training license with their application must update their active, full, unrestricted medical license in their ABPN Physician Portal account by September 1 in the year they wish to sit for the examination. Applicants who do not update their full, unrestricted medical license by September 1 in the same year of the examination, will be denied sitting for the Child Neurology Certification Examination.

Prior to July 31, the ABPN must receive written notification from the program director that the resident will not finish training by August 30 but will finish no later than September 30 of the year of the exam administration. The program director must confirm to ABPN via the preCERT system that training has been successfully completed immediately after the resident has finished training.

Once approved, ABPN will email the applicant scheduling instructions that allows them to schedule the certification exam. Off-cycle applicants must sit for certification within three weeks of being approved. This may require sitting for the examination in mid to late October. Applicants are responsible for updating their email address through their ABPN Physician Portal account to ensure they receive the instructions in a timely manner. The Board will be unable to extend examination dates due to an incorrect email address on file.

Please note that ABPN does not guarantee the availability of locations, dates and/or times of Pearson VUE test centers. If an applicant cannot schedule an appointment that initially suits their needs, the applicant should make the best appointment he/she can at that time. The applicant may then contact Pearson VUE periodically to reschedule if a more suitable appointment becomes available.

ABPN will not allow a candidate to sit for the certification examination if training has not been completed by September 30 in the year of the certification examination. For residents that will be completing training October 1 thru December 31 in the year of the certification examination, please have the program director contact our office at crede...@abpn.org for additional information.

Candidates may apply for certification in another specialty. A candidate may have more than one application on file with the Board if the applications are for certification in different specialties or subspecialties. Candidates completing training both in psychiatry and in neurology or child neurology may apply to sit for examinations in both specialties.

The ABPN has approved programs for combined training in psychiatry and neurology. Residents interested in completing a combined residency training program in psychiatry and neurology should complete their training in one of the ABPN approved combined psychiatry and neurology training programs.

Program directors should contact the Board office for a copy of the combined psychiatry/neurology guidelines. The respective program director(s) should submit a proposal to the Board office, no later than the beginning of the PGY-3, detailing the training proposed for the resident. As stipulated in the combined training guidelines, the resident is required to complete a PGY-1 that meets the requirements for neurology.

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The discipline of Pediatric Neurology, also called Child Neurology, encompasses disorders of the brain, spinal cord, peripheral nerve and muscle affecting infants, children and adolescents. The variety of patients seen by a child neurologist varies from those with common, relatively straightforward conditions, such as cerebral palsy or migraine, to those with rare or complex conditions, such as metabolic or degenerative disorders. This robust variety of conditions allows child neurologists to structure their scientific or clinical careers according to their clinical or research interests.

Given their shortage, child neurologists have exciting opportunities in private practice or academics throughout the world. The number of child neurologists in the U.S. is estimated to be at least 20% below the national needs, although many believe that this is a conservative estimate.

The majority of child neurologists have active clinical practices, either as private practitioners or in an academic setting. In general, approximately 40% to 50% of the patients in a typical child neurology practice have epilepsy, 20% have developmental delay or learning or behavioral issues, and 20% have headaches. The remaining patients have unusual conditions, such as metabolic, genetic or syndromic disorders. In many centers, individual clinical practices are highly specialized and address specific conditions, such as pediatric stroke, migraine, intractable epilepsy, or rare metabolic or degenerative conditions. Child neurologists can subspecialize in such areas as neonatal neurology, epilepsy, headache, neurogenetics, neurodevelopmental disabilities, or pediatric neuromuscular diseases. Child neurologists often evaluate and manage children with neurobehavioral disorders, including Tourette syndrome, attention deficit hyperactivity disorder or autism spectrum disorder. Many academic child neurologists enter careers in laboratory-based or clinical/translational research. Thus, divisions of child neurology can be a home for individuals with MD/PhD degrees or other advanced research training. As neurogenetics has moved from the era of identifying single gene disorders to the studies of complex traits, such as autism spectrum disorder and Tourette syndrome, opportunities for both basic and clinical research in child neurology continue to expand. New and emerging therapies require child neurologists who will join teams of investigators as they identify evidence-based approaches for many neurological conditions.

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