Pediatric Neurology

What does a Pediatric Neurologist do?
What are the career opportunities?
What Board(s) certifies Child Neurologists?
What is the lifestyle of a Child Neurologist?
What is the compensation of a Child Neurologist?
How do I become a Child Neurologist?
Where do I find out about available programs?
When do I apply?
Why should I choose to become a Pediatric Neurologist?

What does a Pediatric Neurologist do?
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.

What are the career opportunities?
Given their shortage, child neurologists have exciting opportunities in private practice or academics throughout the world. The number of Child Neurologists in the US 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, epileptology, 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.

What Board(s) certifies Child Neurologists?
Child Neurologists are certified by the American Board of Psychiatry and Neurology (ABPN) as having special qualification in Child Neurology. Many Child Neurologists also obtain Board Certification in Pediatrics through the American Board of Pediatrics (ABP). A special agreement exists between the ABP and the ABPN whereby an applicant can fulfill the training requirements of both organizations. To ensure that trainees receive comprehensive training in pediatrics, the ABP requires two years of training in general pediatrics. Click here for more information.

What is the lifestyle of a Child Neurologist?
Child neurologists lead rewarding lives through service to their patients and dedication to pediatric neuroscience. The hours can be long, but the practice life of a Child Neurologist can be enriched through community service, advocacy and scholarly activities. Because most Child Neurologists enter group practices, call is typically taken at home and can be distributed, allowing balance in personal and professional lives.

What is the compensation of a Child Neurologist?
The salaries and benefits provided to a Child Neurologist vary according to the nature of the clinical practice. In general, Child Neurologists in private practice earn more than those in academic environments. Practices that emphasize and derive compensation from procedures, such as electroencephalography (EEG) or neuroimaging, can provide substantial income to the members of the group. A child neurologist’s salary and benefits allow a very comfortable lifestyle.

How do I become a Child Neurologist?
Child neurologists enter training via a match administered by the National Resident Matching Program (NRMP). Trainees can enter the match at several points: during their fourth year of medical school (the most common pathway), after 1, 2 or 3 years of pediatric training, or after the completion of pediatric residency. Prerequisites for training in child neurology consist of 2 years of residency training in pediatrics, 1 year of residency training in general internal medicine and 1 year of residency training in pediatrics or 1 year of pediatrics plus 1 year of basic neuroscience (e.g., PhD) training. These prerequisites allow considerable flexibility in the educational preparation for child neurology. For additional information click here

Where do I find out about available programs?
Information about careers and programs can also be obtained from the website of the Child Neurology Society.

When do I apply?
The child neurology match occurs simultaneously with the regular residency match process. The process ensures that fourth year students matching in child neurology can obtain two years of training in a pediatric program. There are three different options for child neurology and pediatrics training:

  • Option 1: A combined five-year child neurology program. An institution offering this program has a single match list for both pediatrics and child neurology training and matches the candidates for a full five years of residency training (two years in pediatrics followed by three years in child neurology). When the candidate uses this option on their NRMP ranking list, a separate preliminary pediatrics residency list does not appear and is not needed.
  • Option 2: A linked preliminary pediatrics and child neurology program. The child neurology and pediatrics residency programs have separate rank lists. The candidate matches into the child neurology program for post-graduate years three through five and will only match into the two-year preliminary pediatric program if the candidate is ranked by both programs. When the candidate uses this option on the NRMP ranking list, a separate list for the preliminary pediatric residency program with the institution appears and must be completed.
  • Option 3: Separate preliminary pediatric and neurology residency programs. In this option, the candidate must create two separate rank lists, one for the two year preliminary pediatric residency program and another for the three year child neurology program.

Why should I choose to become a Pediatric Neurologist?
Pediatric neurology provides rewarding career opportunities for those interested in the child development and pediatric neuroscience, whether in clinical child neurology or basic neurobiology. Given the persisting shortage of Child Neurologists, job opportunities abound throughout the US for satisfying careers in practice or academic environments.

For more information about Pediatric Neurology, visit these websites:
NRMP
ACGME
American Board of Pediatrics
American Board of Psychiatry and Neurology
Child Neurology Society
American Academy of Neurology Child Neurology Section
American Academy of Pediatrics Section on Neurology
Child Neurology Foundation

Subspecialty Journals
Developmental Medicine and Child Neurology
Journal of Child Neurology
Neuropediatrics
Pediatric Neurology

Return to Subspecialty Descriptions

Neurodevelopmental Disorders

NDD is a neurology-based subspecialty that focuses on the evaluation, diagnosis, and management of infants, children, adolescents and adults with neurodevelopmental and related disabilities.  Neurodevelopmental disabilities commonly occur in the setting of neurological disorders, and a specialist in NDD is well trained to manage all aspects of the patient.  Examples of patients managed by an NDD specialist would include a young child with autism who additionally have epilepsy and neurobehavioral impairments or a teenager with Tourette’s syndrome and comorbidities of attention deficit/hyperactivity disorder.  Other examples of neurodevelopmental disabilities include cognitive disorders such as intellectual disability, specific learning disabilities, motor disorders such as cerebral palsy and developmental coordination disorder, and the special sensory deficits of blindness and deafness. The NDD specialist works to identify underlying causes including genetic conditions, metabolic disorders, trauma, hypoxic-ischemic injury, toxins, immunologic disorders, endocrinopathies, and neoplastic disorders.  The practice of NDD is inherently interdisciplinary and focuses on the conditions that impact the developing nervous system. Through a developmental lens, NDD residency provides broad training in clinical care as well as research.

Specialists in NDD have an extensive range of career options within education, research, and clinical practice. The basic construct of NDD allows for board eligibility in Pediatrics, Child Neurology and Neurodevelopmental Disabilities. Therefore, the line of work typically is in multidisciplinary and/or interdisciplinary settings involving the evaluation of and care plans for infants, children, and adolescents with a wide range of neurologic and developmental conditions resulting in long-term health, developmental and social consequences. NDD specialists rely on developmental neuroscience in order to guide the diagnostic evaluation and the ongoing medical and habilitative care of the conditions outlined above. NDD specialists provide continued monitoring of outcomes and complications. In addition, they participate and lead research into the causes and treatments of these conditions.

There are many career opportunities for NDD specialists nationally. This is a young and versatile sub-specialty, with a great demand for its services. There is increasing demand for both child neurology and developmental pediatric specialists in academic settings, and neurodevelopmental specialists provide a perfect combination of these abilities. The increased identification of neurogenetic disorders and higher survival rates among high risk newborns with neurologic disabilities have led to high demand for properly trained NDD specialists. Such specialists can find practice careers in both inpatient and outpatient settings.  Many are largely involved in educational activities involving medical students and residents. Due to their common involvement in multidisciplinary clinics, there are many opportunities for collaborative research in the field.

NDD specialists are eligible for board certification in three specialties: Pediatrics (governed by the American Board of Pediatrics); Neurology with Special Qualifications in Child Neurology (governed by the American Board of Psychiatry and Neurology, ABPN); and Neurodevelopmental Disabilities (also governed by the ABPN).

While NDD specialists typically have hospital appointments where they often participate in inpatient care of patients with acute neurologic disease (whether in consult, primary inpatient or neurocritical/neonatal neurology services), most of their clinical activities involve outpatient interdisciplinary clinics, such as clinics for autism, cerebral palsy, neurogenetics, and complex care patients, and many others. Call responsibilities are variable based on the size and scope of the practice, such as whether it is an academic or non-academic institution and the role of residents and fellows within the institution. Weekend and evening on-call responsibilities are a component of most positions and typically involve home-call and it is usually not excessive.

Compensation is close to salaries in child neurology and general pediatrics. The compensation allows for a comfortable lifestyle.

NDD programs are typically combined residency programs. Trainees can enter the match at several points: during their fourth year of medical school (the most common pathway), after 2 or 3 years of pediatrics training, or after the completion of pediatric residency. Currently, you must complete at a minimum two years of general pediatrics residency, one year of adult neurology rotations (as a component to both Child Neurology and NDD training), and a combined 18 months of child neurology and 18 months of NDD training–thus a total of 6 years. NDD residency programs participate in the common application through ERAS and NRMP residency match.

Information about NDD programs programs is available through Freida and through the ACGME. Additional information is available at http://www.nddtraining.org/ or through the website of the Child Neurology Society. Click here https://www.childneurologysociety.org/careers/getting-in/training-programs – CNS

Candidates should begin the search process as soon as they have identified NDD as their career choice. Programs can be researched as described above, and individual program directors can be contacted for information. The match process begins at the beginning of the fourth year of medical school, with applications completed and any necessary interviews taking place that fall and winter.

  • Option 1: A combined six-year neurodevelopmental disabilities program. An institution offering this program has a single match list for both pediatrics and NDD training and matches the candidates for the full six years of residency training. When the candidate uses this option on their NRMP ranking list, a separate preliminary pediatrics residency list does not appear and is not needed.
  • Option 2: A linked preliminary pediatrics and NDD program. The NDD and pediatrics residency programs have separate rank lists. The candidate matches into the NDD program for post-graduate years three through six and will only match into the two-year preliminary pediatrics program if both programs rank the candidate. When the candidate uses this option on the NRMP ranking list, a separate list for the preliminary pediatric residency program with the institution appears and must be completed.
  • Option 3: Separate preliminary pediatric and NDD residency programs. In this option, the candidate must create two separate rank lists, one for the two-year preliminary pediatric residency program and another for the four-year NDD program.
  • Option 4: Separate full pediatric residency and NDD residency programs. Some programs have an option for senior pediatric trainees to apply during their third year of postgraduate training, via ERAS, directly to a four-year NDD training program. The trainee must have completed- or be in line to complete- a pediatrics residency, and would apply therefore only apply to the NDD program.

For many and varied reasons individuals who choose to pursue NDD acquired special personal interests in neurology, in children and their development, and in disabilities. A career in NDD can provide you with diagnostic challenges, teaching opportunities, and collaborative research opportunities in the new field of neurodevelopmental medicine. The intrinsic longitudinal nature of a career in NDD allows for close connections with families and community or government-level advocacy and leadership roles. The academic, research, and education/training career options are highly exciting and rewarding.

For more information regarding Residency Training in Neurodevelopmental Disabilities, please visit these websites:
http://www.nddtraining.org/
Child Neurology Society
American Board of Psychiatry and Neurology

Subspecialty journals
-Developmental Medicine and Child Neurology

Below is a list of suggested (not mandatory) rotations that a medical student or resident could consider if they are thinking about applying to NDD residency.

  • Child neurology
  • Developmental and behavioral pediatrics
  • Genetics
  • Pediatric physical medicine and rehabilitation
  • Complex care pediatrics
  • Experiences with allied professionals such as psychologists, speech and language pathologists, audiologists, occupational and physical therapists, medical social workers, and advocacy and community based agencies serving children and families with special NDD-related health care needs.

Child Neurology/Basic Neuroscience

What is the Child Neurology/Basic Neuroscience Residency Training Track?

The basic neuroscience pathway was created as an alternative track for medical students, residents, and PhD/MD scientists who are planning a research career in academic child neurology and developmental neuroscience. This residency training helps them become experts in clinical child neurology and equipped to pursue a career in basic and translational neuroscience research.

This residency training requires only 1 year training in general pediatrics in an ACGME-accredited program, 1 year in adult neurology, 2 years in clinical child neurology, and 1 year of research in the basic neurosciences, for a total of 5 years. The year of basic neuroscience must provide training in a research discipline related to child neurology and is intended to increase the trainee’s knowledge base and competitiveness for federal and nonfederal grant support. The trainee must make at least an 80% time commitment to basic neuroscience during this year of training.

For the purpose of this training track, “basic neuroscience” is defined as laboratory research related to the cellular or molecular basis of neurologic diseases. Examples of relevant basic disciplines include molecular neurogenetics, neurochemistry, neuropharmacology, neurophysiology, neuroanatomy, neuroimmunology, developmental neurobiology, biophysics, and cell biology.

Child Neurology/Neuroscience Residency Programs participate in the common application through ERAS and NRMP residency match.