Manganese Neurotoxicity and Familial Disorders of Manganese Transport.

The continued advancement of the field of child neurology—and the care of children with neurological disorders—depends on our ability to train child neurologists for the future. Although the field of child neurology began its infancy in the 1950s–1960s [], it was only in the 2016–2017 academic year when it was first recognized as an independent specialty as opposed to a subspecialty of neurology by the Accreditation Council of Graduate Medical Education (ACGME) []. In that respect, the field may still be emerging from its adolescent state, not completely independent from the parent fields of pediatrics and neurology. With another recent growth spurt, most notably the rapid developments in neurogenetics and precision medicine, along with certification of new child neurology–specific fellowships such as neonatal neurocritical care [], the practice of child neurology continues to diverge from pediatrics and adult neurology []. However, the standard child neurology training model is still largely based on the traditional pathway, which adopted heavily from the parent fields. The last major revision of ACGME requirements in 2014 did not change the overall framework of training [, ]. Modifications of training pathways should incorporate both the available evidence and the experience of those in the field. Recent papers on child neurology training, many published since 2014, include opinion pieces and surveys of child neurology educators and recent graduates [, , , , , , ]. These publications demonstrate mixed views on training models, including total training duration and the timing and duration of the three broad components of clinical training: general pediatrics, child neurology, and adult neurology. Currently, child neurology–specific training comprises only 40% of the total residency training []. Many favor reducing general pediatrics and adult neurology time in favor of more pediatric specialty training, such as in genetics and child development [, ], but support for this is not universal []. Debate also persists over maintaining a 5‐year total training model versus universal reduction to 4 years [, , ]. The ACGME and American Board of Psychiatry and Neurology (ABPN) have already acknowledged that 4 years of clinical training is adequate by approving a neuroscience research pathway that requires only 4 total years of clinical training, with only 1 year of general pediatrics [, ]. Notably, prior studies generally asked questions rooted in the current system [, , , ], limiting the range of responses and ability to conceptualize an entirely different model. Before the upcoming ACGME Shaping GME initiative [], during which child neurology program requirements may undergo substantial revisions, it is critical to obtain updated input from child neurology program directors (PDs), who are experts in child neurology training. We aimed to engage child neurology PDs using a more open‐ended and analytical method to develop a PD‐derived model of essential training components, with the ability to innovate beyond the current system.