Opinion and Special Article: The Need for Specialized Training in Women's Neurology

Abstract

Women’s Neurology is an emerging subspecialty that focuses on neurologic disorders across a woman’s lifetime. This new domain recognizes that both health and disease are directly impacted by hormonal and reproductive changes throughout the lifespan. This field includes neurologic diseases with a higher prevalence in women, as well as diseases that require specialized management during pregnancy, postpartum, lactation, and menopause. A survey was sent to United States neurology residency program directors to understand the state of training in the area. Their responses highlighted an urgent need for additional education in this field for neurology residents. Here, we discuss the educational gaps in this area, the clinical benefits of a women’s neurology discipline, the instructional gaps in this area, and provide practical recommendations for training programs in women’s neurology using two innovative fellowship programs.

Emerging Subspecialties in Neurology: Women's Neurology

“…9 A recent survey of American neurology residency program directors similarly identified gaps in training and clinical care specific to sex and gender issues. 10 Work is underway to establish a women's neurology residency training curriculum at the AAN to integrate evidence-based sex-and gender-specific learning objectives. Specialties such as stroke, epilepsy, multiple sclerosis, headache, neuromuscular, and neuro-oncology have made progress in this field with specific examples highlighted in the Table . Emerging areas with sex-and genderspecific considerations include neurodegenerative diseases such as dementia and movement disorders as focus in this field expands beyond reproductive health.…”

“…Graduates of women's neurology training have published on gaps in neurology research and education and advancing best-evidence clinical practice for women's neurologic care. 3,6,10 A women's neurology specialist could follow numerous career possibilities including community, academic, or hybrid practice models. Community- or regional-based clinics with a focus on women's health have been established by women's neurology graduates across the United States.…”

Women’s Neurology: Why We Need a Subspecialty for Half the Population

“…LaHue and colleagues recently published an article in the journal Neurology, highlighting the need for specialized training in women's neurology. 1 Currently, the University of Toronto offers the only Canadian training program for Women's Neurology. Still in its early years of development, as people learn about this specialty, a common question is why a subspecialty is needed for 50% of our population.…”

“…Despite these important sex- and gender-specific issues, only 44% of US residency program directors felt that trainees were sufficiently prepared to care for neurological conditions in pregnancy. 1 From the perspectives of neuroscience research, clinical care, and education, efforts to address sex and gender disparities are needed.…”