Surveys shed light on state of neurology education
October 2, 2025
Periodic surveys from the AAN have been instrumental in identifying trends in US neurology training. The latest iterations of all three of these surveys—of neurology clerkship directors, program directors, and residents, all administered in 2022—have been published in various issues of Neurology® 好色先生 in the past year.
The results of the surveys have been essential in the AAN’s work to develop and support the neurology workforce. They’re also a valuable resource for neurology educators who want to identify trends in their field and better understand and support their students. Read on for perspectives from the authors of the three articles detailing the surveys’ results.
Neurology residents
The Neurology Residency Training survey was sent to AAN member neurology and child neurology/neurodevelopmental disabilities residents with training ending in 2022. Questions covered topics including fellowship and career trajectory choices, student loans, and business/practice management.
Nearly all of the respondents—98%—planned to pursue a fellowship. However, a large proportion of respondents intended to have a component of general neurology or neurohospitalist in their clinical practice. General neurology, stroke, and neurohospitalist were the most popular career trajectories, each significantly increasing from 2017. The proportion of graduates who intended to practice only general neurology remained stable.
Lead author Brian E. Emmert, MD, said this pattern is worth investigating: “Is it that people don’t feel ready to go into practice right out of residency and therefore feel they need extra training? Is it because they want to practice a mix of general neurology and something else, so they’re adding subspecialty training? Or is it just the culture of the way we train our residents?”
Emmert now tries to offset this potential issue by being conscious of how he approaches residents and asks about career trajectories while they make this important decision. Questions like “What fellowship are you going to apply for?” or “What subspecialty do you want to practice?” might imply to trainees that they need to pursue fellowship training, even if that’s not necessarily part of their actual practice goals.
Another interesting factor Emmert notes in the survey is that very few respondents felt prepared to tackle business and practice management tasks after training. He said schools of thought vary on how business readiness should be taught, and whether it should be covered in training or learned on the job.
“These results are something we can utilize as a jumping off point to say, OK, what exactly is out there and are there changes that we should make?” Emmert said. “The AAN has a great business and practice management webinar series, which residents may not even know exists based on the results of our survey.”
Neurology program directors
With its first iteration taking place in 1999, the program director survey is the longest running of the three. The 2022 survey of adult and child neurology program directors covered program makeup, curriculum content, and residency needs, as well as various trends like resident preparedness. Authors sought to build on and compare to past results.
“One of the things we wanted to pay attention to was breakdown across gender,” said lead author Jeffrey B. Ratliff, MD, FAAN. “We found a roughly 50/50 split across men and women in the role of program director. And while other data outside of program directors and neurology points to disparities in attaining academic rank between men and women, we didn’t find that in the program director cohort. We found that women neurology program directors seem to be attaining elevated academic ranks at roughly the same proportion as men.”
Another focus was protected time and administrative support for program directors. Ratliff said adult neurology program directors, on average, had around 45% of their time protected—about a 10% increase from when the last survey took place in 2017. Ratliff said a likely explanation for the shift is ACGME policy changes on the amount of protected time residency program directors should get based on program size. There was a corresponding shift in hours spent on the respondents’ programs.
“The total number of hours that they’re devoting to the residency program was a little bit higher, but now it lines up better with the amount of protected time they’re getting. So if they’re protected for 45% on average, they’re spending about that much of their week devoted to either resident teaching or administrative duties. A shift we saw, though, was that the number of hours devoted to teaching residents had gone down, and the number of hours devoted to administrative work went up.”
The survey also asked about program directors’ research activities. Ratliff said 45% conducted medical education research, and a large minority of 44% did not but wanted to. This was similar to 2017’s results, and something to track going forward as the AAN works to support program directors.
Neurology clerkships
The final survey sought data from US medical school neurology clerkship directors, covering trends like timing, duration, protected time, and burnout. Clerkships provide essential clinical training to medical students, and their importance to the neurology workforce can’t be understated.
“Neurology clerkships are vital for providing medical students with the skills to identify and manage neurological conditions and promoting the development of future neurologists, particularly amidst workforce shortages,” said author Stephen A. VanHaerents, MD, FAAN. “As a clerkship director, we are crucial in adapting our programs to advances in neurology and changes in medical education.”
VanHaerents said the 2022 survey confirmed several expectations for the authors. There was an increasing requirement for a four-week clinical experience rather than shorter experiences, and the data highlighted the resiliency clerkship programs showed during the COVID-19 pandemic. However, it also showed some areas for improvement.
“Maybe not surprisingly, we did learn that there is a need for more support for clerkship coordinators and protected time for clerkship directors,” VanHaerents said. “Also, despite high satisfaction levels, many respondents reported experiencing burnout due to lacking protected time and competing obligations. I believe this highlights the need for improvements in support systems and wellness initiatives within medical education.”
The clerkship director survey, along with the other two educational surveys, help provide a window into the state of neurology education—and give AAN leaders a roadmap to the types of resources, support, and advocacy educators need.
“What we try to do with these surveys is to showcase how much neurology clerkship directors are doing to help medical students, advance neurology education, and promote interest in neurology,” said fellow author Doris Kung, DO, FAAN. “It’s also showcasing how much more they need in terms of protected time or salary, and the resources they need to do what they love.”
The next set of surveys will take place in 2027.
Related AAN resources
Interested in connecting with your neurology education community? Check out the links below for online resources and opportunities, including virtual meetings for program and clerkship directors, topic-specific webinars for trainees, and ways to learn and connect for medical students.