How are residents trained in neuropathology? A survey of neurology program directors in the United States

To understand the current state of neuropathology education during neurology residency training in the United States, we electronically distributed a 16-item survey to 150 adult and 70 child neurology program directors (PDs). The survey inquired about their residency program characteristics, neuropathology curriculum and assessment methods, trainee performance in the subject and attitude about neuropathology education. Descriptive analysis was used to summarize categorical variables as frequencies and percentages and continuous as means and standard deviations. We conducted a series of Mann-Whitney U and Fisher’s exact tests to evaluate differences between various program characteristics. Sixty-four (29%) PDs responded to the survey, including 45 (30%) adult and 19 (27%) child neurology PDs. Thirty-one programs required a dedicated neuropathology rotation typically during the latter years of the program. Residency in-service training exam (RITE) was the main assessment tool (92%) for assessing the trainee’s knowledge in neuropathology. Overall, 87% of the PDs agreed that neuropathology is essential and 85% agreed that there is a clear need for a defined neuropathology curriculum during residency training. There was no difference in the RITE scores between programs with and without a dedicated neuropathology rotation. We conclude that a neuropathology rotation was felt to be essential even though the RITE scores did not differ between programs with and without a dedicated rotation. Alternative evaluation methods and neuropathology training techniques such as web modules, virtual reality may be helpful tools to optimize training and need consideration.