Education and training
Before starting specialist training in neurology, junior doctors must have completed their foundation training and core medical training and passed the MRCP. There is a national selection process for neurology posts at ST3.
Training in neurology can be via clinical or academic routes. The current curriculum defines the training, and all trainees must pass the neurology specialty certificate examination (SCE). All numbered trainees are enrolled in local training programs with regular training days (usually nine per year). Less than full-time training is possible.
The Academy of Medical Royal Colleges (AoMRC) has produced a cost of training document setting out the mandatory costs of training involved in college enrolment fees, examination costs and GMC fees. Published in October 2017, it has been compiled to help pre-specialty doctors make fully informed career selections, with a clear understanding of the mandatory costs of their future training pathway.
Neurology is a complex specialty, encompassing diverse areas such as:
- degenerative diseases (eg dementia and Parkinson’s disease)
- vascular disease (eg stroke in its numerous forms)
- genetic and inherited conditions (eg some epilepsies, movement disorders)
- inflammatory disease (eg multiple sclerosis)
- trauma (eg head injury)
- auto-immune disease (eg myasthenia gravis and encephalopathies)
- infectious diseases (eg meningoencephalitis)
- many idiopathic conditions (eg primary headache syndromes).
Additionally, many patients have symptoms not explained by disease (functional symptoms), and there is a strong overlap with psychiatry. Trainees must gain experience of treating patients with a broad range of these conditions in both acute and outpatient settings in order to progress to work effectively as independent consultants. Maintaining the high quality of training is crucial.
Continuing professional development
Full-time consultants should ideally have a minimum of two supporting professional activities (SPAs) to fulfil CPD requirements. Neurology is a rapidly expanding specialty with new treatments evolving (eg for multiple sclerosis, migraine and epilepsy), and major changes in our understanding of disease pathophysiology, especially with dramatic advances in genetics. It is vital that neurologists keep abreast of these changes and devote time and resources to maintain CPD.