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Becoming a child neurologist in the United States.

In recent years, the Child Neurology Society and the American Board of Psychiatry and Neurology have taken some steps forward to ease the process of becoming a child neurologist. This includes decreasing the length of the residency by combining pediatrics and child neurology programs into a 5-year package. Applicants can also join the programs after 1 year of neuroscience research and 1 year of internship in pediatrics. Despite all the attempts to encourage medical students to join child neurology programs, it seems that there is not enough understanding and cooperation between the pediatrics and child neurology programs during the recruitment process, and applicants still face a lot of problems during the application season. Most programs offer a 3-year child neurology residency and leave the first 2 years of preliminary pediatric residency to the applicant to fight for it! Application via 2 different matching systems (San Francisco Match and Electronic Residency Application Service [ERAS]) makes the process more complicated. One can match in a child neurology program and fail to secure a 2-year pediatric residency simply because the pediatric residency program is not willing to have a resident who will leave after 2 years, or because pediatrics and pediatric neurology residency programs in the same institution have different requirements for applicants. Therefore, in some cases even if the program offers a 5-year spot, the applicant could meet the requirements of 1 program but not some of the other requirements of the program; this includes the visa requirements for foreign graduates. Unlike the 1-year preliminary or transitional residencies in internal medicine and surgery, preliminary pediatric residency has no place in pediatric residency programs. Unfortunately, this leaves some candidates with no other option than breaching their ethical obligation with pediatric programs and exiting the program after 2 years. It seems logical at this time to think of a solution for the roller coaster of child neurology residency application in the United States. I trust that the Child Neurology Society and the Professors of Child Neurology can come up with a better strategy for the application process.