Finding Flourishing in Neurology

Abstract

In this second issue of Neurology ® Education, readers will find articles grouped in 3 sections. Each section addresses a timely question for educators in clinical neuroscience, including the following:(1) how can simulation be used to optimally teach or assess learners, (2) how can residency training adapt to increase the breadth and depth of outpatient exposure, and (3) what are important educational gaps that need to be addressed for epilepsy fellows and for well-being in neurology broadly?At its inception over a century ago, training in neurology was exclusively an outpatient experience. Clinical neurology was essentially taught through weekly clinics in the ambulatory setting. 1 In the early 20th century, a transition began toward more inpatient exposure because training models shifted from individual apprenticeship to board certification and standardized internships in hospitals. Academic departments were built around inpatient wards and training followed suite. The need to increase outpatient exposure is not new. As early as the 1930s, clinicians and educators called for increasing outpatient encounters for trainees. 2 Multiple reports in the 1990s showed that residents were spending less than 25% of their training in outpatient clinics despite most neurologists practicing more than 80% or more in the ambulatory setting. [3][4][5] In fact, 57% of neurologists at that time even favored adding an extra year of residency to accommodate more outpatient experiences. 6 What has happened in the last 30 years? Despite expanded requirements for outpatient training by residency review committees and increased numbers of outpatient rotations in residency, many of the same challenges remain.