Fellow Section Research Articles

Neurology training and research in the COVID-19 pandemic: a survey of the Resident and Research Fellow Section of the European Academy of Neurology.

The COVID-19 (SARS-CoV-2) outbreak has disrupted residency programmes due to university and hospitals' priorities to face this emergency at all cost. Most research projects and clinical trials were temporarily stopped or postponed. The Resident and Research Fellow Section (RRFS) of the European Academy of Neurology (EAN) has decided to assess the impact of the COVID-19 pandemic on neurology training. All EAN RRFS members were invited to fill out an online questionnaire of 40 items concerning their clinical involvement during the COVID-19 emergency, and the impact of the pandemic on their training (Appendix S1). Of the 227 RRFS members who completed the questionnaire, 222 were from Europe, and of those 111 were from Portugal, Italy or France. Responders highlighted that severe restrictions have been imposed to face this pandemic, including reduction of inpatient beds, prohibition of in-person visits and limitation to hospital access for patients' relatives. This was accompanied by an increase in email correspondence and phone calls with 50% of countries allowing telemedicine to reach outpatients. Seventy-nine per cent of the respondents felt that the pandemic will probably have a serious impact on their training and career. The pandemic led to a disruption of neurology activities, including medical training and research. The long-run impact of these changes remains unknown, but it will probably change the way neurology practice and training will be organized for future generations.

An information marketing campaign promotes physician donation to a radiology political action committee: Campaign Promotes Donation to Radiology PAC

ObjectiveTo evaluate the impact of an informational marketing campaign on radiology political action committee (PAC) donations. MethodsThe Society of Interventional Radiology (SIR) Resident and Fellow Section (RFS) Advocacy Committee implemented an informational marketing campaign beginning with an email survey in January 2017. Society of Interventional Radiology Political Action Committee (SIRPAC) donors (n = 564) and donations were compared prior to and after the marketing campaign. ResultsComparisons from 2015-2016 (n = 353, 62.6%) to 2017-2018 (n = 432, 76.6%) showed a statistically significant increase (p < 0.001) in donors. Comparisons from 2015-2016 (M=$124.73, SD = 202.18) to 2017-2018 (M=$229.96, SD = 404.72) showed a statistically significant mean increase (p < 0.001) in donations. DiscussionRaising awareness of SIRPAC through a targeted informational marketing initiative had a positive impact on PAC donations. Although a causal relationship cannot be definitively determined, we believe that implementation of similar interventions can be useful in order to help raise funds for other medical specialty PACs.

Do you want to perform endovascular therapy? Perspectives from neurology trainees across Europe.

Endovascular therapy (EVT) has become standard care for acute ischaemic stroke caused by large-vessel occlusion in the anterior circulation. However, access to this treatment in Europe remains poor. The lack of operators is a contributing factor and there is on-going discussion as to whether other specialists, including neurologists, could contribute to the EVT workforce. The question remains whether the next generation of neurologists want to become 'interventional neurologists'. The aim of this study was to address this question. We conducted a short survey within the National Representatives Network (a division of the Resident and Research Fellow Section, European Academy of Neurology) in order to determine the interest of future neurologists in performing EVT. A total of 1218 responses from 27 European countries were received, with some variation in the number of respondents and results among individual countries. In total, 568 neurology trainees (47%) stated that they would want to be an 'interventional neurologist'. Our findings suggest that neurologists could make a significant contribution to the workforce performing EVT and have important implications for the development and uptake of training programmes in Europe.

ACMQ Student, Resident, and Fellow Section (SRF) COVID-19 Resident and Fellow Survey.

ACMQ Student, Resident, and Fellow Section (SRF) COVID-19 Resident and Fellow Survey.

Differences in neurology residency training programmes across Europe - a survey among the Residents and Research Fellow Section of the European Academy of Neurology national representatives.

Background and purposeNeurology is rapidly evolving as a result of continuous diagnostic and therapeutic progress, which influences the daily work of neurologists. Therefore, updating residency training programmes is crucial for the future of neurology. Several countries are currently discussing and/or modifying the structure of their neurology residency training programme. A detailed and up‐to‐date overview of the available European residency training programmes will aid this process.MethodsA questionnaire addressing numerous aspects of residency training programmes in neurology was distributed among 38 national representatives of the Resident and Research Fellow Section of the European Academy of Neurology.ResultsWe obtained data from 32 European countries (response rate 84%). The median (range) duration of the residency training programmes was 60 (12–72) months. In the majority of countries, rotations to other medical disciplines were mandatory, mostly psychiatry (69%), internal medicine (66%) and neurosurgery (59%). However, the choice of medical fields and the duration of rotations varied substantially between countries. In 50% of countries, there were formal regulations regarding training in evidence‐based medicine, teaching skills and/or leadership qualities. In many countries (75%), residents had to take an examination.ConclusionsWe found substantial variation among European countries in the duration of residency training programmes, and especially in the choice of obligatory rotations to external medical disciplines. Despite a presumably similar spectrum of patients, neurology residency training programmes across Europe are not harmonized. The structure of the programme should be determined by its relevance for neurologists today and in the future.

Early-Career Radiologists' Perceptions of National Corporations in Radiology.

Radiology, like many medical specialties, has experienced an increase in nationalized corporatization. The most vulnerable cohorts affected by this trend are early-career radiologists (ECRs), including trainees and recent graduates, particularly those entering or who have recently entered private practice. The aims of this study were to examine the awareness and perspectives of ECRs regarding this trend and to share salient examples of the impact of corporatization. From February 20, 2019, through May 28, 2019, an online survey of the members of the ACR's Resident and Fellow Section and Young and Early Career Professional Section was conducted. Respondents were queried about their awareness of corporatization, their opinions of how it affects radiology, their preferred practice type, whether they know other ECRs affected by corporatization, and whether they worry about their practices or future practices being acquired. A free-response opportunity was also provided for respondents to share their relevant personal experiences. A total of 602 ECRs returned completed surveys. Of this total, 85% of respondents were aware of national corporatization, 86% believe that corporate entities harm radiology as a specialty, 83% prefer to join independent private practices with 79% wanting to be involved in leadership or business, and 72% worry about their practices or future practices being acquired by national entities. Twenty-five percent of respondents submitted unique free responses regarding their experiences with corporatization. The majority of ECRs surveyed have negative perceptions of corporatization in radiology, prefer to join independent practices, and worry about their practices selling to national corporations.

3:18 PM Abstract No. 210 Mentoring in interventional radiology: opportunities to engage the next generation through research

The purpose of this study is to assess the experience of trainees in seeking mentorship in interventional radiology and to identify the gaps in engaging them to pursue research opportunities in the field. A 27-item survey was sent to all members of the Society of Interventional Radiology Resident, Fellow and Student (SIR-RFS) section and Medical Student Section (SIR-MSC) as part of an IRB-approved prospective study between July and September 2019. Items assessed included basic demographic information, whether or not the respondent has a mentor in IR, experience in seeking mentorship in IR and what guidance trainees are hoping to obtain from mentors in IR. Descriptive statistics were computed for all assessed categorical variables. Of the trainees surveyed, 102 respondents (∼20%) completed the questionnaire. Of those: 73% were male; 73% were medical students; 50% were white and 38.5% were Asian. Only 69% of respondents indicated that they had a mentor in IR while 31% indicated that they would like to find a mentor in the field. 73% of respondents agreed or strongly agreed that mentorship is essential to ensure success in IR. 80% of respondents with mentors stated that their mentors provide guidance in research, while only 64% said that they receive career guidance from their IR mentors. Unfortunately, 31% stated that they are not able to find a research mentor in IR at their institution. When it comes to research mentorship, 57.3% of respondents indicated that they are uncertain how to initiate a research project. 38.4% were uncertain how to navigate the ethical approval process at their institutions. 30.8% were looking for guidance in identifying research topics. The majority of respondents (62.7%) indicated that they meet with their mentors on a quarterly basis or less. While most respondents agreed that mentorship is essential to their success in IR, many trainees struggle with receiving career-related mentorship and may have difficulty identifying research mentors at their home institution. Greater efforts to develop IR mentorship programs for trainees is required.

Graduate Student/Postdoctoral Fellow Section of Child Maltreatment Editorial Board

Graduate Student/Postdoctoral Fellow Section of Child Maltreatment Editorial Board

Reader response: Mystery Case: Bilateral temporal crescent sparing after cardiac arrest.

I was surprised that the Mystery Case by Lindegger et al.1 was published in the Resident & Fellow Section. Although there is clear temporal crescent sparing, there are also smaller—but equally clear—residual nasal crescents in both the superior and inferior fields that cross the vertical meridian. The case seems to teach that the anterior most portion of the calcarine cortex has not only peripheral temporal fibers, but also fibers serving a peripheral nasal crescent.

Author response: Residency training: The review committee for neurology: Revisions to the common program requirements.

We thank Dr. Spector for the comment on our Resident & Fellow Section Residency Training article.1 We agree that work hour restrictions are only a piece of the complex environment affecting resident workload, and that work hours reduction is not the only way to address this challenge. The purpose of this article is to describe recent changes to Section VI of the Accreditation Council for Graduate Medical Education (ACGME) common program requirements, with a focus on work hour restrictions. Work hour restrictions are intended to create a ceiling under which specialties, programs, and departments have the flexibility to customize schedules. This is intended to ensure trainees have the experiences required for competence in their field, while maintaining a work–education and work–life balance. Under the newly titled “Well-Being” section of the ACGME common program requirements (VI.C.1.a and VI.C.1.b), other issues that contribute to workload are included as core requirements, such as minimization of nonphysician obligations, provision of administrative support, and attention to scheduling and work intensity.2 We hope that these issues, as well as other characteristics of the resident work environment that contribute to workload, continue to be addressed at the national, specialty, and program level.

Editors' note: Residency training: The review committee for neurology: Revisions to the common program requirements

In their Resident & Fellow Section Residency Training article, Nevel et al. described recent changes to Section VI of the Accreditation Council for Graduate Medical Education (ACGME) common program requirements, with a focus on work hour restrictions. Commenting on the article, Dr. Spector suggests that for work hour rules to function as intended, an emphasis on workload reduction, not just hours reduction, is required. He adds that departments should ensure adequate support from hospitalists, advanced practice providers, and administrators to allow residents to maximize learning during shorter shifts. Nevel et al. agree that work hour restrictions are only a piece of the complex environment affecting resident workload. They note that under the newly titled “Well-Being” section of the ACGME common program requirements, other issues that may affect workload include minimization of nonphysician obligations, provision of administrative support, and attention to scheduling and work intensity. In their Resident & Fellow Section Residency Training article, Nevel et al. described recent changes to Section VI of the Accreditation Council for Graduate Medical Education (ACGME) common program requirements, with a focus on work hour restrictions. Commenting on the article, Dr. Spector suggests that for work hour rules to function as intended, an emphasis on workload reduction, not just hours reduction, is required.

Reader response: Mystery Case: A case of fulminant encephalopathy in a 69-year-old woman.

I enjoyed reading the Resident & Fellow Section Mystery Case by Drs. Lamotte and Williams1 on fat embolic encephalopathy in a patient with sickle cell disease. However, there is a potentially confusing point that requires clarification by the authors.

Abstract No. 472 SIRPAC: characterizing donor behavior and crafting future fundraising strategies

This project aims to identify factors associated with Society of Interventional Radiology (SIR) member donations to the Society of Interventional Radiology Political Action Committee (SIRPAC); this will enable more targeted fundraising efforts that should lead to increased donations. A cross-sectional survey designed by the SIR Resident, Fellow and Student Section (RFS) Advocacy Committee was emailed to 4,474 SIR members including practicing interventional radiologists, residents, and fellows. Principal factors investigated include personal and professional demographics, donor history, and knowledge of the federal advocacy process as it pertains to IR. Basic summary statistics were compiled and logistic regression analysis was performed to determine factors influencing donor behavior. A total of 336 (7.5%) SIR members completed the survey. Overall, 119 (35.4%) members reported having donated to SIRPAC in the past year. Members whose annual income is more than $450,000 were 2.5 times more likely to donate relative to those who earn less than $450,000 (95% CI: 1.54-4.08; P<0.001). Stratifying by years of experience, those with ≥5 years in practice were 1.9 times more likely to donate compared to members with <5 years in practice (95% CI: 1.16-3.05; P = 0.010). Additionally, members with good knowledge of the federal advocacy process were 3.8 times more likely to donate to SIRPAC than those who have no knowledge (95% CI: 1.69 - 8.60; P = 0.001). The majority of respondents, 259 (77.1%) reported having limited or no knowledge of the federal advocacy process. However, 206 (61.3%) respondents indicated that they were more likely to donate after completing the survey. SIR members’ knowledge of the federal advocacy process, annual income, and years in practice were identified as key factors influencing donations. We plan to increase donations to SIRPAC by raising awareness of SIRPAC and the federal advocacy process, as well as by using targeted fundraising strategies aimed at higher earners.

Graduate Student/Postdoctoral Fellow Section of Child Maltreatment Editorial Board

Graduate Student/Postdoctoral Fellow Section of Child Maltreatment Editorial Board

AMA Calls on Licensing Boards to End Discrimination for MH Treatment

AMA Calls on Licensing Boards to End Discrimination for MH Treatment

Graduate Student/Postdoctoral Fellow Section of Child Maltreatment Editorial Board

Graduate Student/Postdoctoral Fellow Section of <i>Child Maltreatment</i> Editorial Board

Mystery Case: CSF-1R mutation is a cause of intracranial cerebral calcifications, cysts, and leukoencephalopathy.

The authors retract the article “Mystery Case: CSF-1R mutation is a cause of intracranial cerebral calcifications, cysts, and leukoencephalopathy” by X. Ayrignac et al., which appeared in the Resident & Fellow Section in volume 86, page e262, because 4 of the figures were previously published in another journal (European Neurology 2012;67:151–153).2 The earlier article was not cited and there were 3 common authors (Magnin, Berger, and Labauge) on the papers. In addition to the duplicate publication, 1 image attributed to the index case in this article was attributed to his mother in the earlier article and 3 images attributed to his mother in this article were attributed to the index case in the earlier article.

Message from the Editors to our Reviewers

From April 1, 2011, through September 30, 2011, Neurology ® received 2,167 new and 643 revised manuscripts. During this interval, 3,909 peer reviews were received (compared to 3,758 during the same period in 2010), with the average turnaround time after assignment being 8.5 days. Average time from submission to first decision for papers chosen for review remained at 33 days. Limitations in the number of pages we can publish allow us to accept only a minority of papers submitted. Your specific comments regarding the uniqueness of study populations, novel methods, studies that are especially educational, or new strategies for diagnosing and treating neurologic disease are appreciated; these comments help us immeasurably when we make final decisions regarding which articles we believe will most benefit our authors and readers, as well as improve patient care. Manuscripts for the Resident & Fellow Section of Neurology are often submitted by trainees who have less experience in preparing articles for publication, and it is the goal of the Section to help these junior authors improve their clinical and scientific writing abilities. We especially appreciate the constructive feedback provided by reviewers of these manuscripts. We recently posted an Information for Reviewers (IFR) link on www.neurology.org. Click on this link for information on expectations of reviewers regarding confidentiality, timeliness, and reviewer conflicts of interest. The IFR also provides instructions for formatting the comments to editors and authors in order to make communication with authors most effective. In appreciation of your dedication to Neurology , we offer an hour of CME credit, if requested, for each manuscript you review for the Journal (maximum of 15 credits per year as determined by ACCME). To receive credit, it should be evident that the reviewer has read and understood the content of the manuscript, accompanying figures and tables, supplementary …

Graduate Student/Postdoctoral Fellow Section of Child Maltreatment Editorial Board

Graduate Student/Postdoctoral Fellow Section of Child Maltreatment Editorial Board

Message from the Editors to our Reviewers

During the 6-month interval from October 1, 2014, through March 31, 2015, Neurology® received 2,476 new and 600 revised manuscripts (compared to 2,457 new and 594 revised manuscripts during this same period in 2013–2014). We received 4,264 peer reviews (compared to 4,282 during the same period in 2013–2014). We are only able to accept a minority of papers submitted as we are limited in the number of pages we can publish, and we must make difficult decisions regarding which articles we believe will most benefit readers and improve patient care. We encourage reviewers to make specific comments regarding uniqueness of study populations, novel methods, studies that are especially educational, or new strategies for diagnosing and treating neurologic disease. In addition, the constructive feedback for authors of manuscripts submitted to the Resident & Fellow Section of Neurology is immensely helpful to junior authors in improving their clinical and scientific writing abilities. Our gratitude for your dedication to reviewing for Neurology cannot be adequately conveyed.