Abstract
BackgroundThe specialty of Neurology is faced with a fundamental problem of economics: supply and demand. The projected increase in provider supply is unlikely to keep up with projected increases in patient-care demand. Many large academic centers have used residents to meet this patient-care demand. However, the conflict between education of residents and patient-care needs has created a hindrance to both of those missions. Many specialties have been using advanced practice clinicians (APCs) to help address the need for patient care. In the setting of a residency program, this availability of APCs can help to alleviate patient-care demands for the resident and allow for better allocated educational time. Neurology has not historically been a popular choice for APCs and a standardized educational curriculum for a Neurology APC has not been established.MethodsThe authors share an example curriculum recently implemented for training new inpatient Neurology APCs. This curriculum includes a 12-week program complete with rotations through various subspecialties and proposes fundamental lecture topics for use in education. The authors share their expectations for clinical duties that evolve over the course of the 12-week program in conjunction with expectations for increasing clinical knowledge as well as efficiency in system utilization.ConclusionThe addition of APCs to support a busy inpatient Neurology practice has obvious beneficial implications but the integration and education of this new staff must be structured and well-designed to support the confidence of the APC in both their knowledge and their role as an indispensable member of the care team.
Highlights
The current number of US neurologists is considered unacceptable in view of the increase in age-related neurologic diseases in the population
>10,000 hours of patient care and study in a given specialty as a practical prerequisite for independent practice. Given these concerns and the expanding clinical need, we developed a specialized training program for neurology advanced practice clinicians (APCs) as described here
The two APCs who have completed our program believe the training to have been valuable both from an educational standpoint and from an operational standpoint; allowing time for a new hire to adjust to the work-flow and intricacies of a new hospital system resulted in satisfaction amongst the APCs who felt better equipped to function as an independent member of the team at the completion of orientation
Summary
The current number of US neurologists is considered unacceptable in view of the increase in age-related neurologic diseases in the population. Many large academic medical centers have relied on neurology trainees such as residents and fellows to help with meeting the needs of the population This has created a conflict between education and patient. This concern can be best addressed by the addition of well-trained advanced practice clinicians (APCs) who can offset the clinical workload. In this context, APCs include physician assistants (PA) and certified registered nurse practitioners (CRNP); both of whom have varying degrees of autonomy in each state but will be collectively referred to as APCs in this article. Neurology has not historically been a popular choice for APCs and a standardized educational curriculum for a Neurology APC has not been established
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