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May 31, 2022; 98 (22) Contemporary Issues in Practice, Education, & Research

The Neurology Fellowship Application Conundrum

Finding Common Ground

View ORCID ProfileZachary N. London, View ORCID ProfileAbhimanyu Mahajan, Carolyn Cahill, View ORCID ProfileJaffar Khan, Erica A. Schuyler, View ORCID ProfileRaymond S. Price
First published April 20, 2022, DOI: https://doi.org/10.1212/WNL.0000000000200717
Zachary N. London
From the Department of Neurology, Division of Neuromuscular Medicine (Z.N.L.), University of Michigan School of Medicine, Ann Arbor; Rush Parkinson's Disease and Movement Disorders Program (A.M.), Department of Neurological Sciences, Rush University Medical Center, Chicago, IL; Member Insights Department (C.C.), American Academy of Neurology, Minneapolis, MN; Emory University School of Medicine (J.K.), Department of Neurology, Atlanta, GA; Hartford HealthCare Ayer Neuroscience Institute (E.A.S.), CT; and Department of Neurology, Division of General Neurology (R.S.P.), University of Pennsylvania Perelman School of Medicine, Philadelphia.
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Abhimanyu Mahajan
From the Department of Neurology, Division of Neuromuscular Medicine (Z.N.L.), University of Michigan School of Medicine, Ann Arbor; Rush Parkinson's Disease and Movement Disorders Program (A.M.), Department of Neurological Sciences, Rush University Medical Center, Chicago, IL; Member Insights Department (C.C.), American Academy of Neurology, Minneapolis, MN; Emory University School of Medicine (J.K.), Department of Neurology, Atlanta, GA; Hartford HealthCare Ayer Neuroscience Institute (E.A.S.), CT; and Department of Neurology, Division of General Neurology (R.S.P.), University of Pennsylvania Perelman School of Medicine, Philadelphia.
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Carolyn Cahill
From the Department of Neurology, Division of Neuromuscular Medicine (Z.N.L.), University of Michigan School of Medicine, Ann Arbor; Rush Parkinson's Disease and Movement Disorders Program (A.M.), Department of Neurological Sciences, Rush University Medical Center, Chicago, IL; Member Insights Department (C.C.), American Academy of Neurology, Minneapolis, MN; Emory University School of Medicine (J.K.), Department of Neurology, Atlanta, GA; Hartford HealthCare Ayer Neuroscience Institute (E.A.S.), CT; and Department of Neurology, Division of General Neurology (R.S.P.), University of Pennsylvania Perelman School of Medicine, Philadelphia.
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Jaffar Khan
From the Department of Neurology, Division of Neuromuscular Medicine (Z.N.L.), University of Michigan School of Medicine, Ann Arbor; Rush Parkinson's Disease and Movement Disorders Program (A.M.), Department of Neurological Sciences, Rush University Medical Center, Chicago, IL; Member Insights Department (C.C.), American Academy of Neurology, Minneapolis, MN; Emory University School of Medicine (J.K.), Department of Neurology, Atlanta, GA; Hartford HealthCare Ayer Neuroscience Institute (E.A.S.), CT; and Department of Neurology, Division of General Neurology (R.S.P.), University of Pennsylvania Perelman School of Medicine, Philadelphia.
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Erica A. Schuyler
From the Department of Neurology, Division of Neuromuscular Medicine (Z.N.L.), University of Michigan School of Medicine, Ann Arbor; Rush Parkinson's Disease and Movement Disorders Program (A.M.), Department of Neurological Sciences, Rush University Medical Center, Chicago, IL; Member Insights Department (C.C.), American Academy of Neurology, Minneapolis, MN; Emory University School of Medicine (J.K.), Department of Neurology, Atlanta, GA; Hartford HealthCare Ayer Neuroscience Institute (E.A.S.), CT; and Department of Neurology, Division of General Neurology (R.S.P.), University of Pennsylvania Perelman School of Medicine, Philadelphia.
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Raymond S. Price
From the Department of Neurology, Division of Neuromuscular Medicine (Z.N.L.), University of Michigan School of Medicine, Ann Arbor; Rush Parkinson's Disease and Movement Disorders Program (A.M.), Department of Neurological Sciences, Rush University Medical Center, Chicago, IL; Member Insights Department (C.C.), American Academy of Neurology, Minneapolis, MN; Emory University School of Medicine (J.K.), Department of Neurology, Atlanta, GA; Hartford HealthCare Ayer Neuroscience Institute (E.A.S.), CT; and Department of Neurology, Division of General Neurology (R.S.P.), University of Pennsylvania Perelman School of Medicine, Philadelphia.
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Citation
The Neurology Fellowship Application Conundrum
Finding Common Ground
Zachary N. London, Abhimanyu Mahajan, Carolyn Cahill, Jaffar Khan, Erica A. Schuyler, Raymond S. Price
Neurology May 2022, 98 (22) 929-937; DOI: 10.1212/WNL.0000000000200717

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Abstract

For many neurologic subspecialties, the fellowship application process begins early in the first half of the second year of neurology-specific training (PGY3 for adult neurology residents and PGY4 for child neurology residents). In 2019, the American Academy of Neurology (AAN) published a position statement recommending communication between fellowship candidates and training programs begin no sooner than March 1 of the penultimate year of training and that programs offer fellowship positions no sooner than August 1 of the final year of training. A few pilot subspecialties adopted this timeline for 2021 recruitment for positions beginning in 2022. All United States–based AAN-affiliated neurology and child neurology residents who recently completed the fellowship application process received a survey about their fellowship application experience. Of the 291 residents who responded to the survey, 96% agree that applications should not be submitted before March 1 of the penultimate year of training and 72% believe that August 1 of the final year is a reasonable time to begin offering positions. Nearly half (49%) of residents believe that there is too little time for subspecialty/clinical exposure before applying for fellowship and 88% feel the current process and timeline are stressful. Residents who applied to programs in pilot subspecialties report more time to choose, less stress, and a lower number of time-pressured offers. A large majority of residents (89%) prefer to submit a single application through a centralized system. The survey results suggest that residents who just completed the fellowship application process agree with the AAN recommended timeline for all subspecialties and that all neurology subspecialties should consider adopting a fellowship match. Programs can help facilitate a better fellowship application experience by providing earlier exposure to a broad range of neurologic subspecialties and ensure that residents are given opportunities to attend national meetings and participate in appropriately scoped scholarly endeavors.

Glossary

AAN=
American Academy of Neurology;
AANEM=
American Association of Neuromuscular & Electrodiagnostic Medicine;
ACGME=
Accreditation Council for Graduate Medical Education;
ERAS=
Electronic Residency Application Service;
IRB=
institutional review board

Footnotes

  • Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.

  • Submitted and externally peer reviewed. The handling editor was Roy Strowd III, MD, Med, MS.

  • Editorial, page 917

  • Received October 21, 2021.
  • Accepted in final form March 23, 2022.
  • © 2022 American Academy of Neurology
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  • Article
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    • New Fellowship Pilots
    • Survey of Neurology Residents
    • Establishing a New Fellowship Timeline
    • Centralizing the Process
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    • Limitations and Future Directions
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