Training the future neurology workforce

Objective: To address training demands on future neurologists, the American Academy of Neurology (AAN) surveyed its US members as to their views about training the future neurology workforce. Methods: The survey was mailed to 575 US neurologists and 425 residents/fellows. Respondents (54%) were aske d about their perceptions of current and future educational programs and se ttings needed to improve practice competence; issues related to subspeciali zation; and the role of non-neurologists in providing neurologic care. View s of neurologists were compared with those of neurology residents/fellows. Results: Most respondents support additional training in outpatient, commun ity, and staff model health maintenance organization settings. The majority of respondents oppose a required fifth year of training or a yearly compet ency examination, but neurologists who have a subspecialty interest and res idents/fellows favor elective certification and higher fees by subspecialis ts. General neurologists oppose these ideas. Most neurologists feel that pr imary care physicians, nurse practitioners, and physician assistants can ma nage uncomplicated neurologic problems, although residents/fellows are less willing to accept the role of nonphysician providers for neurologic servic es. Conclusions: Neurology educational programs should consider addressing deficiencies that today's practitioners perceive, Increasing subspecializat ion, although favored by most neurologists, creates a challenge for the neu rologic community as neurologists without subspecialty training see this tr end as a threat to their livelihood.