Teaching neurology residents in the outpatient setting

D. J. Gelb
Department of Neurology, University of Michigan, Ann Arbor.

OBJECTIVE: To determine how residency programs are responding to the shift of neurological practice into the outpatient setting. DESIGN: A nine-item questionnaire was sent to the directors of all US neurology residency programs. Each item had two parts, the first describing the current program, and the second describing an "ideal" program designed to optimize resident education. The same questionnaire was also sent to all house officers and faculty associated with a single residency program to assess variability in perceptions. SETTING: United States neurology residency programs (mail survey). PARTICIPANTS: Directors of neurology residency programs and all house officers and faculty members at a single residency program. RESULTS: Eighty-one (70%) of the 116 questionnaires distributed were returned. There were four areas of general consensus among the program directors: (1) more time should be devoted to outpatient care during residency training; (2) more continuity at the resident level should be provided for patients seen in subspecialty clinics; (3) faculty should provide more supervision of residents when they see follow-up patients; and (4) conferences specifically directed at outpatient management issues should be developed. CONCLUSIONS: Neurology residency directors agree that current approaches to teaching in the outpatient setting fall short of an educationally ideal system. Four areas of perceived deficiency have been identified. Creative solutions will be necessary to correct these perceived deficiencies.