Subspecialty training of neurology residents and junior neurologists in the Baltic States

Abstract

Background Neurology is a field of increasing subspecialization. There is no published data regarding the proportion of neurology subspecialists in the Baltic States. The aim of this cross‐sectional study was to identify factors associated with neurology subspecialty choice, to examine possible differences between neurology residents’ and junior neurologists’ view of subspecialty, and to assess perceived subspecialty acquisition opportunities and subspecialty attractiveness. Methods The research was conducted as an anonymous online survey between December 28, 2020, and January 24, 2021 of neurology residents and neurologists who completed their residency during the last 5 years in the Baltic States. Results In total, 72 residents and 65 neurologists participated. “Cerebrovascular diseases” and “multiple sclerosis and autoimmune diseases of the nervous system” were rated as the two most attractive subspecialties by residents, whereas “headache” and “clinical neurophysiology” were the most attractive among junior neurologists. “Vertigo and dizziness” and “dementia” were ranked the least attractive among both groups. “Cerebrovascular diseases” were perceived as having the most acquisition opportunities. The two most common determinants of subspecialty choice were “medical content of the subspecialty" and "influence of mentor during undergraduate studies or residency”. Conclusions Two‐thirds of junior neurologists subspecialize in at least one subspecialty, and one‐third of residents are already determined to pursue subspecialty training. Junior neurologists rated most outpatient‐related subspecialties as more attractive than neurology residents. Between the Baltic States’ universities, there was a significant difference in the number of residents who were determined to pursue subspecialty training.

Shaping neurology subspecialty training in Europe

“…One of the most common factors perceived to shape subspecialty choice is the influence of a mentor during undergraduate studies or residency [4]. Although we need caution in generalizing the results of this study to other European countries, this finding reinforces that encouraging mentorship and appropriate guidance might impact career choices of neurology residents and provide a positive educational environment.…”

“…Additionally, the discrepancy between neurological conditions and trained subspecialty providers might become even more evident over time, given that certain subspecialties with low attractiveness such as cognitive disorders [4,5] do not match the growing demand [3]; therefore, dedicated strategies are necessary to potentially improve recruitment for underselected fellowships [6].…”

“…In this issue of the European Journal of Neurology , Jokubaitis et al address this problem. In their study, only 26% of residents and young neurologists participated in subspeciality training in their country or in foreign institutions, with 72% claiming to have specialized through self‐learning [4]. This finding is not surprising, because although the core neurology curriculum for neurology residency has a well‐defined structure, with variable applicability in the different European countries [7], postresidency training is more variable, and often relies on self‐learning, which might also influence the choice of certain underrepresented fields of neurology.…”