10/22/2015 AMERICAN ACADEMY of NEUROLOGY 2015FELLOWSHIP SURVEY REPORT Executive Summary 2 Methods 3 Survey Demographics 5 Freq

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2015 Fellowship Survey Results: 10/22/2015 Response Rate: 31% (805/2,574)

10/22/2015

A MERICAN A CADEMY OF 2015 FELLOWSHIP SURVEY REPORT

NEUROLOGY

Executive Summary 2

Methods 3

Survey Demographics 5

Frequencies 6

Comments 12

Subspecialty Analysis 35 Child Neurology 35 EEG 39 EMG 44 Epilepsy 49

Movement Disorders 54

Multiple Sclerosis 58

Neurocritical Care 62

Neuromuscular 66 Neuro-oncology 70 Vascular and Stroke 74

2015 Fellowship Survey Results: 10/22/2015 Response Rate: 31% (805/2,574)

Executive Summary

Key Findings

There are a variety of factors that influence how members select neurology fellowships. Interest in the topic appears to be both the most common and the most important factor in choosing a fellowship. Clinical interest was the most frequently selected reason (81%), and was also the top-ranked reason. This was followed by personal interest (65%), which was ranked second. Research interest was a less common factor that influenced members’ decision (35%), but for those who considered it, it was an important factor, ranking third overall.

After interest, a role model/mentor is the next common factor that influenced respondents to select a fellowship (50%), and was ranked fourth. For those who listed a role model/mentor as influencing their fellowship decision, the top three subspecialty areas that respondents listed their role model/mentor working in were vascular neurology and stroke (17%), movement disorders (14%) and epilepsy (13%).

Although exposure to subspecialty during residency was not one of the top three most-important factors that influenced fellowship decision (46% selected it as a factor; it was ranked 5th), it stood out in the open- ended comments as one of the most important factors affecting how or why individuals select fellowships. Comments indicate that exposure during residency may spark clinical interest, and a lack of exposure may prevent members from selecting that fellowship.

Another reoccurring theme that appeared from the open-ended responses was that residents do not feel prepared to enter practice after completing a neurology residency. This was also apparent from almost a quarter of respondents (23%) selecting ‘I felt I needed more training’ as a reason to go into fellowship; prior research at AAN has observed this and a 2014 survey focused on which aspects of training residents feel most/least prepared1. Other fellowship deciding factors such as lifestyle, finances, and geographic location were considered ancillary for most respondents, but primary for some.

Conclusion

From the perspective of AAN members who have already selected or will be selecting a neurology fellowship, the primary influencing factor is interest in the area, whether it be clinical, personal, or research. As seen in past surveys, role models/mentors continue to play an important role in affecting fellowship decisions2, and exposure to the fellowship area also emerged as an important factor.

Recommendations

While AAN may not be able to directly influence a member’s interest in a fellowship area, the AAN should explore whether trainees are receiving adequate exposure to the various neurology subspecialties and fellowship areas during residency, since exposure appears to influence members’ interest in fellowship. Comments from this survey indicate there is a lack of exposure within the current neurology residency training system, and future AAN Resident Surveys should further examine this paucity.

In order to determine if there is a decline or increase in neurology residents selecting specific fellowships, part two of this project will survey program directors about whether they perceive such trends.

12014 AAN Resident Survey 22011 AAN Resident Survey

2015 Fellowship Survey Results: 10/22/2015 Response Rate: 31% (805/2,574)

Methods

Objective

The goal of the 2015 Fellowship Survey was to discover how members (specifically current residents, fellows, and those who recently completed fellowship) select fellowships. The results will be used by members of the AAN’s sections, Section Subcommittee, Graduate Education Subcommittee (GES), and staff, to determine what attracts members to fellowships. This survey also seeks to inform whether there are an adequate number of trainees in the neurology subspecialties, to best serve the needs of neurology patients in the United States.

Sample

Based on AAN’s membership database, current residents in Post Graduate Year (PGY) 3 or 4, current fellows (fellowship end date of 2016 or 2017), and those who recently finished a fellowship (fellowship end date of 2014 or 2015) were considered. The initial population consisted of 3,720 members; 428 were removed due to receiving an AAN survey within the past 6 months and 643 were removed because they reside outside of the United States. The eligible population was reduced to 2,649 members, which were all sent the invitation to participate; 75 were removed due to invalid email addresses, for a final population of 2,574 members. A detailed description of the final population’s demographic characteristics can be found on page 5.

Instrument

In early summer of 2015, the Education Committee of the MS Section proposed a survey to determine why residents are not entering MS Fellowships (a perceived trend). AAN staff and members of the MRS reviewed the concept and recommended two separate studies with aligning, yet distinct goals. The first proposed study turned into the 2015 Fellowship Survey and was developed based on questions from the MS Section Education Committee’s original research proposal to AAN. The instrument was revised by Carolyn Cahill (AAN Staff, Member Insights), and reviewed by other Insights staff, the Member Research Subcommittee, the GES Chair, the Executive Council on Sections and Subspecialties (ECOSS), and Chairs/Vice-Chairs of the AAN’s Sections. The instrument was finalized on September 24, 2015.

Data Collection

The 2015 Fellowship Survey was conducted solely online. An email was sent to the population on September 24, 2015. Reminder emails were sent to non-respondents on September 29 and October 2. Data collection was closed on October 9. Data from partial responses were recorded.

Response Rate

An overall response rate of 31.3% (805/2,574) was achieved for the 2015 Fellowship Survey. The sampling margin of error could not be calculated due to the fact that the entire population was used rather than a random sample.

Incentive

The AAN has previously used gift card incentives for surveys involving trainee members, to help increase response rates. Testing whether gift card incentives actually increases response rates in this population has not yet been performed; this survey sought to determine whether a gift card will increase response rates. The final population was randomly divided into three groups of 883; as stated above, 75 members

2015 Fellowship Survey Results: 10/22/2015 Response Rate: 31% (805/2,574)

were censored due to invalid email addresses, resulting in slightly different sizes of groups. One group did not receive an incentive (control), one group had the chance to be one of five winners of a $100 Amazon.com gift card (treatment 1), and one group had the chance to win a single $500 Amazon.com gift card (treatment 2). An odds ratio determined that there was not a significant difference in response rate between the control group and Treatment 1 (see Table 1). Treatment 2, however, had a significantly higher response rate than the control group (see Table 2); these results found that the larger value incentive provided a 4.9% boost in the response rate compared to no incentive, and indicate that an incentive with a higher value may prompt a greater response rate than either no incentive or a smaller incentive with increased odds of winning.

Table 1. Incentive response rate results: comparing control group to treatment 1 Odds Ratio Group Non- Respondents Respondents (95% CI) Control (no incentive) (n=850) 28.8% 71.2% 1.121 (0.91-1.38) Treatment 1 (five $100 winners) (n=855) 31.2% 68.8%

Table 2. Incentive response rate results: comparing control group to treatment 2 Odds Ratio Group Non- Respondents Respondents (95% CI) Control (no incentive) (n=850) 28.8% 71.2% 1.256 (1.02-1.54)* Treatment 2 (one $500 winner) (n=869) 33.7% 66.3% *Indicates significance

2015 Fellowship Survey Results: 10/22/2015 Response Rate: 31% (805/2,574)

Survey Respondents’ Demographic Characteristics

The following demographic information on survey respondents and non-respondents were analyzed from the AAN internal membership database. Significant differences between survey respondents and non- respondents were found in AAN membership type; Junior Fellows are over-represented, while Junior Residents are under-represented. A detailed comparison of all demographic variables can be found in Table 3.

Table 3. Demographic characteristics of survey respondents and non-respondents Survey Survey Significance Demographic characteristics respondents non-respondents testing (n = 805) (n = 1,769) 33.2 years 33.0 years Age1 (mean) p = .4013 (SD = 4.2) (SD = 4.5) Male 49.2 53.3 Gender2 (%) p = .0574 Female 50.8 46.7 Active 10.2 10.6 AAN membership Associate 1.1 1.4 p = .0344 type (%) Junior Fellow 26.7* 21.5 Junior Resident 62.0* 66.6 1Data missing for 3% of respondents and 6% of non-respondents 2Data missing for 3% of respondents and 3% of non-respondents 3t-test 4Pearson Chi-Square *Significant at the p<.05 level

2015 Fellowship Survey Results: 10/22/2015 Response Rate: 31% (805/2,574)

Survey Frequencies

1. Are you currently in a fellowship? (n=804)

24.4% Yes1 25.9% No, but I recently completed one1 43.9% No, but I plan to go into one 1 3.5% No, and I am unsure whether I will go into one1 2.4% No, and I do not plan to go into one 1Respondents were skipped to question 2.

1b. Please indicate the reasons are you not planning to go into a fellowship. 2 Mark all that apply. 3 (n=16)

50.0% Prefer to enter general neurology 37.5% Did not see the need 37.5% Felt prepared to enter workforce 37.5% Financial (student loan obligations, family to support, etc.) 37.5% Tired of training 25.0% Other (please specify):4 25.0% Received job offer 18.8% Cannot commit to one area of sub-specialization 12.5% Fellowship not offered in area of geographic preference 6.3% Applied but was not accepted 6.3% Going into research 0.0% Do not meet fellowship requirements 0.0% Limitation of being in the military 2Response options were randomly presented. 3Total may exceed 100%. 4Comments are on page 13.

1c. Please describe your next career move:5

Comments are on page 9 5Respondents were skipped to the end of the survey.

2. Which type of fellowship are you planning/hoping to enter or did you enter? (n=780)

62.3% Clinical 31.5% Mixture of clinical and research (basic science or clinical) 3.1% Clinical research 1.5% Mixture of basic science research and clinical research 0.6% Basic science research 0.5% Unsure 0.4% Other (please specify):6 6Comments are on page 13.

2015 Fellowship Survey Results: 10/22/2015 Response Rate: 31% (805/2,574)

3. Please indicate all of the neurology fellowship areas you are considering (or did consider, prior to fellowship). Mark all that apply.7 (n=776)

28.2% EEG – Clinical neurophysiology 3.2% Sports neurology 23.3% Epilepsy 2.8% Pain medicine 22.3% Vascular neurology and stroke 2.8% Neuroinfectious disease 18.2% EMG – Clinical neurophysiology 2.6% Clinical research 18.0% Movement disorders 2.4% Neural repair and rehabilitation 17.5% Neurocritical care 2.3% Neuro-ophthalmology 12.5% Neuromuscular medicine 1.9% Other (please specify):8 Neuroimmunology and multiple 1.8% Autonomic disorders 9.5% sclerosis 1.3% Neurogenetics Behavioral neurology and 0.9% Unsure 7.5% neuropsychiatry 0.5% Neuro-otology 6.6% Sleep medicine 0.5% Palliative medicine 6.6% Headache medicine 0.4% Balance disorders 6.1% Child neurology 0.4% Geriatric neurology 6.1% Intervention neuroradiology 0.3% Neuropharmacology 5.9% Cognitive disorders 0.1% Complementary medicine 5.4% Neurohospitalist 0.1% Neuroendocrinology 5.3% Neuro-oncology 7Total may exceed 100%. 8 3.6% Neuroimaging Comments are on page 13.

4. Please select the first fellowship that you are planning/hoping to go into, are currently in, or most recently finished. (n=776)

14.0% Vascular neurology and stroke 0.8% Cognitive disorders 11.9% EEG – Clinical neurophysiology 0.8% Neuro-ophthalmology 11.3% Movement disorders 0.8% Neurohospitalist 9.9% Neurocritical care 0.5% Neural repair and rehabilitation 9.7% Epilepsy 0.5% Neurogenetics 7.7% Neuromuscular medicine 0.5% Unsure 5.8% EMG – Clinical neurophysiology 0.3% Clinical research Neuroimmunology and multiple 0.3% Sports neurology 5.4% sclerosis 0.1% Autonomic disorders 3.9% Child neurology 0.1% Neuro-otology 3.5% Neuro-oncology 0.0% Balance disorders 2.8% Headache medicine 0.0% Complementary medicine Behavioral neurology and 0.0% Geriatric neurology 2.7% neuropsychiatry 0.0% Neuroendocrinology 1.8% Sleep medicine 0.0% Neuroimaging 1.7% Other (please specify):9 0.0% Neuropharmacology 1.2% Intervention neuroradiology 0.0% Palliative medicine 1.2% Pain medicine 9Comments are on page 14. 0.9% Neuroinfectious disease

2015 Fellowship Survey Results: 10/22/2015 Response Rate: 31% (805/2,574)

5. How long is/was the [insert q4 choice] fellowship? (n=772)

65.9% 1 year, or 1 year with an option for one or more additional years 28.1% 2 years, or 2 years with an option for one or more additional years 4.8% 3 years 1.2% Unsure

6. What factors influenced your decision to select the [insert q4 choice] fellowship?10 Mark all that apply.11 (n=769)

81.0% Clinical interest 65.4% Personal interest 49.5% Influenced by a role model or mentor during residency or other training 45.8% Exposure to subspecialty during residency 35.2% Scientific or research interest 26.3% Perceptions of post-fellowship opportunities in selected subspecialty area Better lifestyle opportunities within the subspecialty area (presence of nights on call during 26.1% fellowship and beyond) 23.0% Ability to incorporate fellowship training into a general neurology practice 22.9% I felt I needed more training 18.1% Greater financial opportunities within the subspecialty area (ease of generating revenue) 17.0% Fellowship availability at residency institution 12.6% ACGME or UCNS certification at the end of fellowship 12.1% I would not be able to get a job in my desired area without first completing a fellowship Complex clinic interactions (expensive medication with authorization process, 11.6% multidisciplinary aspect of care) 10.1% Local or regional availability of fellowships 7.8% Family or friend affected by disease 3.4% Ease of available funds and grants for fellowships 3.4% National availability of fellowships 1.6% Other (please specify):12 1.3% Deadlines for applications 1.0% National Residency Match Program (NRMP) Specialties Matching Service for fellowships 10Response options were randomly presented 11Total may exceed 100%. 12Comments are on page 14.

2015 Fellowship Survey Results: 10/22/2015 Response Rate: 31% (805/2,574)

6b. Of the factors that influenced your decision to select the [insert q4 choice] fellowship, please rank up to three of the most important factors (1=most important, 2=second-most important, 3=third-most important).13

Rank Sum14 Rank Factor that Influenced Fellowship Decision 1,352 1 Clinical interest (n=452) 789 2 Personal interest (n=336) 426 3 Scientific or research interest (n=209) 360 4 Influenced by a role model or mentor during residency or other training (n=214) 237 5 Exposure to subspecialty during residency (n=140) 197 6 Ability to incorporate fellowship training into a general neurology practice (n=98) Better lifestyle opportunities within the subspecialty area (presence of nights on call 188 7 during fellowship and beyond) (n=107) 145 8 I felt I needed more training (n=80) 127 9 Perceptions of post-fellowship opportunities in selected subspecialty area (n=80) Greater financial opportunities within the subspecialty area (ease of generating 102 10 revenue) (n=61) 76 11 Fellowship availability at residency institution (n=41) I would not be able to get a job in my desired area without first completing a 75 12 fellowship (n=39) Complex clinic interactions (expensive medication with authorization process, 46 13 multidisciplinary aspect of care) (n=27) 42 14 ACGME or UCNS certification at the end of fellowship (n=28) 38 15 Local or regional availability of fellowships (n=24) 35 16 Family or friend affected by disease (n=17) 19 17 Other (please specify):15 (n=9) 11 18 Ease of available funds and grants for fellowships (n=8) 5 19 Deadlines for applications (n=3) 3 20 National availability of fellowships (n=2) National Residency Match Program (NRMP) Specialties Matching Service for 3 20 fellowships (n=1) 13Only responses selected in question 6 were displayed. 14Value for rank: 1=3, 2=2, 3=1. 15Comments are on page 15.

2015 Fellowship Survey Results: 10/22/2015 Response Rate: 31% (805/2,574)

6c. You indicated that a role model or mentor influenced your decision to select the [insert q4 choice] fellowship. What primary subspecialty area did your role model or mentor work in? (n=374)

17.1% Vascular neurology and stroke 0.8% Neurohospitalist 13.6% Movement disorders 0.8% Unsure 13.4% Epilepsy Endovascular and interventional 0.5% 10.4% Neuromuscular medicine neurology 10.2% Neurocritical care 0.5% Neural repair and rehabilitation 5.1% Child neurology 0.5% Neurophysiology Neuroimmunology and multiple 0.5% Pain medicine 4.5% sclerosis 0.3% Autonomic disorders Behavioral neurology and 0.3% Geriatric neurology 3.7% neuropsychiatry 0.3% Neuro-otology 3.7% Neuro-oncology 0.3% Neurogenetics 2.7% Headache medicine 0.0% Neuroepidemiology 3.5% Clinical neurophysiology 0.0% Neuroimaging 2.1% General neurology 0.0% Neuromuscular pathology 1.9% Sleep medicine 0.0% Palliative neurology 1.6% Other (please specify):14 0.0% Sports neurology 0.8% Infectious diseases and neurovirology 0.0% Traumatic brain injury 0.8% Neuro-ophthalmology 14Comments are on page 15.

7. Please indicate any fellowship options about which you feel you do not (or felt you did not) have enough knowledge to consider it as a career path prior to fellowship. Mark all that apply.15 (n=671)

50.8% Autonomic disorders 14.2% Neuroinfectious disease 46.2% Neuroendocrinology 13.9% Clinical research 46.1% Complementary medicine 12.4% Cognitive disorders 45.0% Neural repair and rehabilitation 9.7% Movement disorders 42.6% Neuro-otology 8.9% EMG – Clinical neurophysiology 41.7% Neurogenetics 8.8% Neuroimaging 39.8% Sports neurology 6.4% Neuromuscular medicine 39.6% Balance disorders 6.3% EEG – Clinical neurophysiology 27.1% Neuropharmacology 5.7% Neurocritical care 24.9% Geriatric neurology Neuroimmunology and multiple 5.5% 24.6% Neuro-oncology sclerosis 21.5% Neuro-ophthalmology 5.1% Headache medicine Behavioral neurology and 3.6% Epilepsy 20.0% neuropsychiatry 3.4% Neurohospitalist 18.8% Intervention neuroradiology 2.1% Vascular neurology and stroke 16.1% Child neurology 0.6% Other (please specify):16 15.2% Pain medicine 0.0% Unsure 15.2% Palliative medicine 15Total may exceed 100%. 16 14.9% Sleep medicine Comments are on page 15.

2015 Fellowship Survey Results: 10/22/2015 Response Rate: 31% (805/2,574)

8. Did you attend or are you planning to attend a second fellowship? (n=753)

17.4% Yes 66.3% No17 16.3% Unsure18 17Skipped to question 9. 18Skipped to question 8c.

8b. Of [INSERT SELECTED FELLOWSHIPS IN Q3], please select the second fellowship you went into or are planning to go into. (n=131)

26.0% Other (please specify): 19 0.8% Cognitive disorders 13.0% EEG – Clinical neurophysiology 0.8% Headache medicine 9.9% Epilepsy 0.8% Neural repair and rehabilitation 6.9% Intervention neuroradiology 0.8% Neuro-oncology 4.6% EMG – Clinical neurophysiology 0.8% Neuro-ophthalmology Behavioral neurology and 0.8% Neuroendocrinology 3.8% neuropsychiatry 0.8% Neuroinfectious disease 3.8% Movement disorders 0.0% Balance disorders 3.8% Neurocritical care 0.0% Child neurology 3.8% Neuromuscular medicine 0.0% Complementary medicine 3.8% Vascular neurology and stroke 0.0% Geriatric neurology Neuroimmunology and multiple 0.0% Neuro-otology 3.1% sclerosis 0.0% Neurogenetics 3.1% Sleep medicine 0.0% Neurohospitalist 3.1% Sports neurology 0.0% Neuropharmacology 1.5% Autonomic disorders 0.0% Pain medicine 1.5% Clinical research 0.0% Palliative medicine 1.5% Neuroimaging 19Comments are on page 15. 1.5% Unsure

8c. Why did you decide to enter or are considering a second fellowship?

Comments are on page 16.

9. If respondents selected Clinical Neurophysiology, Epilepsy, Neural Repair and Rehabilitation, Neurogenetics or Sleep Medicine as their primary subspecialty in question 4, a subspecialty- specific set of questions was displayed to them at this point.

Please see Appendices for subspecialty-specific questions and additional analyses

10. Please provide any other feedback that you believe will help inform the AAN about how or why individuals select certain fellowships:

Comments are on page 24

2015 Fellowship Survey Results: 10/22/2015 Response Rate: 31% (805/2,574)

Survey Comments

1b. Please indicate the reasons are you not planning to go into a fellowship2. Other (please specify):

 Already doing pediatric neurology and decided 5 years was enough  I have a contract for student loan forgiveness that obligates me to enter practice within 9 months of graduation, thereby not allowing for fellowship  No financial incentive  Pediatric neurology

1c. Please describe your next career move:

 General pediatric neurology (2)  Academic practice, child neurology  After residency I will be starting a hospital employed position, mixed inpatient/outpatient.  Applying for jobs in pediatric neurology in California  Basic neuroscience research with academic clinical responsibilities  Child neurology private practice  Employment as Clinical Assistant Professor at an academic institution.  General neurology  General neurology, academic  I plan to practice general child neurology in an academic hospital-based practice.  I would like to remain where I am, in an academic position  Neurohospitalist  Planning to work as general child neurologist in outpatient setting.  Private practice  Private practice outpatient neurology

2. Which type of fellowship are you planning/hoping to enter or did you enter? Other (please specify):

 Health services research  Mixture of Clinical Training and Basic Science  Movement disorder

3. Please indicate all of the neurology fellowship areas you are considering (or did consider, prior to fellowship). Other (please specify):

 Autism and neurodevelopmental disorders  Basic science research  Clinical informatics  Combination of sports neurology and acquired brain injury/polytrauma  EEG/EMG Clinical neurophysiology 75/25  Health services research  Intra operative neurophysiology monitoring  Intraoperative monitoring 12

2015 Fellowship Survey Results: 10/22/2015 Response Rate: 31% (805/2,574)

 Intraoperative Neuromonitoring  Muscular Dystrophy  Neonatal Neurology  Neuroimmunology  Neurointerventional  Neuropathology  Pulmonary/critical care

4. Please select the first fellowship that you are planning/hoping to go into, are currently in, or most recently finished. Other (please specify):

 Autism and neurodevelopmental disorders  Clinical informatics  Combination of sports neurology and acquired brain injury/polytrauma  EEG/EMG Clinical neurophysiology 75/25  Health services research  Intra operative neurophysiology monitoring  Intraoperative monitoring  Intraoperative Neuromonitoring  Muscular Dystrophy  Neonatal Neurology  Neuroimmunology  Neurointerventional  Pulm/critical care

6. What factors influenced your decision to select the [insert q4 choice] fellowship? Other (please specify):

 Ability to learn billable procedures for future practice (ie Botox injections, DBS programming)  Ability to see children and adults  I enjoyed it the most and had an amazing mentor. It was an area where I felt I could practice medicine and treat the whole patient rather than a disease state.  I initially did not want to apply to fellowship in 3rd year, but I changed my mind. At that point, it was too late to apply to anything that required a match.  Like to do procedures and interventions  Need in resource-limited settings  Neurology residency training was dissatisfying  None  Procedural-based  Proximity to husband’s job  Service requirement  To apply skills into another subspecialty area after training.

2015 Fellowship Survey Results: 10/22/2015 Response Rate: 31% (805/2,574)

Rank Other (please specify):  Like to do procedures and interventions  Need in resource-limited settings  Neurology residency training was dissatisfying  Ability to learn billable procedures for future practice (ie Botox injections, DBS programming)  Ability to see children and adults  Proximity to husband’s job  To apply skills into another subspecialty area after training.  I enjoyed it the most and had an amazing mentor. It was an area where I felt I could practice medicine and treat the whole patient rather than a disease state.  I initially did not want to apply to fellowship in 3rd year, but I changed my mind. At that point, it was too late to apply to anything that required a match.

6c. You indicated that a role model or mentor influenced your decision to select the [insert q4 choice] fellowship. What primary subspecialty area did your role model or mentor work in? Other (please specify):

 Oncology (2)  Cognitive Disorders  He is a last year resident  Intraoperative monitoring  Neonatal Neurology

7. Please indicate any fellowship options about which you feel you do not (or felt you did not) have enough knowledge to consider it as a career path prior to fellowship. Other (please specify):

 I just wasn't interested in anything else  None

8b. Of [INSERT SELECTED FELLOWSHIPS IN Q3], please select the second fellowship you went into or are planning to go into. Other (please specify):

 Vascular neurology (5)  IOM (2)  Palliative care (2)  Stroke (2)  Advanced general neurology  Critical care  Critical care EEG  EEG

2015 Fellowship Survey Results: 10/22/2015 Response Rate: 31% (805/2,574)

 Endovascular  Intervention  Interventional  Interventional neuroradiology  IR  Neonatal Neurology  Neuro interventional  Neurocritical care  Neuroimaging  Neuro-immunology  Neurointesive or neuromuscular  Neuromuscular with a focus on spine disorders  Neuro-ophthalmology  Neurophysiology  Research - Neuromodulation  Research Basic Science  Sleep  Undecided

For the last two questions, comments were grouped by theme (bolded titles), and italicized if they belong to more than one theme. Comments under multiple theses were underlined and italicized to easily indicate which part of the comment was related to that particular theme. A comment with a number after it (#) indicates number of times the comment was repeated. Comments descend by alphabetical order within each theme.

8c. Why did you decide to enter or are considering a second fellowship?

Additional Training/Gain Expertise

 More training (7)  Additional training (2)  Additional expertise in epilepsy  Additional training as preparation for an academic career  Additional training in another area  Additional training in area of interest.  Additional training, research if interested in pursuing an academic position in the future  Based on deficits in current knowledge  Because I think I need more exposure.  Better training  Broaden subspecialty expertise or bridge two areas together to create a niche area of expertise.  Clinical interest. Desire for more knowledge and training  Completion of advanced vascular training.  Depending on interests and job opportunities may want additional training.  Depends on whether or not I feel that I need more training. My residency is very inpatient focused (neurocritical care and vascular/stroke) but I am more interested in outpatient clinical care, so feel that I am underprepared for some outpatient specialties and expertise.  Diversify knowledge base and connections in areas of interest  For further exposure and for more experience 15

2015 Fellowship Survey Results: 10/22/2015 Response Rate: 31% (805/2,574)

 Further knowledge necessary for independent clinical practice  Further research training.  Further specialization into Child Neurology. Want to learn EMG. Want to do clinical and pre- clinical research  Further subspecialty  Further training in an area of personal interest  Further training, career opportunities, financial incentive  Gain more expertise; more marketable for academic practice.  I completed neuro-ophthalmology before starting my neurology residency. I feel that I need more training in clinical neuro-physiology area which might make me equipped to deal with most of the outpatients.  I didn't do EMG in the first peripheral nerve fellowship  I felt like I need to learn more and neuroimmunology is my favorite subject as well  I had a clinical interest in this area and it was a good continuation of my neuromuscular expertise  I want to have more knowledge and expertise in other fields as well  I was misguided on reading of EEG's. I was told by multiple physicians that I could be certified to read EEG's before leaving my Child Neurology fellowship, so I could read them in practice, but I recently found out that this is institutional and every location I go to would have to double read my EEG's for 100-300 readings and then certify me to read on my own and if I change locations, I would have to re-certify. This was never conveyed to me, as I was told I could read when I left, so now I am considering adding additional year(s) for neurophysiology, so I can read EEG's without re-certifying at every location I work for the rest of my career.  In depth experience  Increasing subspecialty knowledge, allowing for a broad practice such as neuro-hospitalist  Insufficient exposure during residency  Insufficient training to perform neuropathology clinical research  More expertise for research interests  More opportunities for learning about areas of interest in detail.  More specialized training  More training and expertise  More training, clinical interest, better opportunities.  Need for broad knowledge  Need for more training  Need training for better patient care  Personal interest, and to get more education in specific field  Possibly require more training  Potential career opportunities by learning more skills  Special skill set  Specialty training  To add on practice based experience  To be more knowledgeable/marketable in neurology and because of my personal interest  To enhance my clinical skills and make me more competitive  To enhance my critical decision making by means of interpreting this frequently used tool in the assessment of critical care patients. In addition, having a leader in this field [Name Withheld] who designed this fellowship in my current institution made this decision a no-brainer.

2015 Fellowship Survey Results: 10/22/2015 Response Rate: 31% (805/2,574)

 To expand on the knowledge base and cement concepts from the first year. Gain more surgical case exposure, attend more courses for professional development (review courses, stats classes, leadership courses)  To gain more exposure in my second interest

Career Opportunities

 1) Clinical/research interests beyond the fellowship I have taken 2) Multiple faculty members at my institution have multiple board certifications. After discussing the pros/cons with these faculty it seems like a personally and professionally fulfilling situation that is worth considering.  Additional job opportunities, need within neurology, personal interest  Additional training as preparation for an academic career  Additional training, research if interested in pursuing an academic position in the future  Advanced career opportunities  As I like more than one subspecialty, and if in the future I do not like one, I can practice the other  Both fellowships complement and supplement each other knowledge bases. I thought it would work well with my career goals.  Career opportunities  Clinical and Research Interest, and it integrates well career-wise with MS  Clinical and research interest; job market  Clinical interest and desire to work in this field  Clinical interest, additional research exposure required for clinician scientist position  Depending on interests and job opportunities may want additional training.  Fields are related. Having both certifications increases job options and opportunities.  For the job market  Further advancement of ultimate career goals  Further training, career opportunities, financial incentive  Gain more expertise; more marketable for academic practice.  I can integrate both fellowships in my future practice  I was misguided on reading of EEG's. I was told by multiple physicians that I could be certified to read EEG's before leaving my Child Neurology fellowship, so I could read them in practice, but I recently found out that this is institutional and every location I go to would have to double read my EEG's for 100-300 readings and then certify me to read on my own and if I change locations, I would have to re-certify. This was never conveyed to me, as I was told I could read when I left, so now I am considering adding additional year(s) for neurophysiology, so I can read EEG's without re-certifying at every location I work for the rest of my career.  I would like to focus on an area that interests me, and will help better my career  Job opportunities, complement each other, I am interested both CNS and PNS  Long-term career goal  More career opportunities  More job opportunities  More training, clinical interest, better opportunities.  Personal interest, job opportunities.  Potential career opportunities by learning more skills  Professional interests  Requirement to fulfill my clinical interest in pursuing a career in NCC and INR  The first fellowship (MvD) was based on my top clinical interest. The second fellowship (autonomic) was based on clinical interest and job opportunities at my residency institution. 17

2015 Fellowship Survey Results: 10/22/2015 Response Rate: 31% (805/2,574)

 To be more knowledgeable/marketable in neurology and because of my personal interest  To enhance my clinical skills and make me more competitive  To increase my option for practice  To open up job opportunities in an academic department.  To suit my academic practice, was given the option  Ultimate career goal is to be an academic neurointensivist with a specialization in EEG/neuromonitoring. Felt this combination of specialties provided the most logical path.

Complementary/Multidisciplinary/Related

 To complement my clinical interests (2)  Because I want to merge both areas by cEEG in the ICU setting in order to improve care in my patients. I am also interested in doing research in EEG waves pattern changes before complications in different diseases, as well as the research of prognosis by EEG patterns in patients not on only in Neuro ICU but also in MICU and CCU  Because my clinical work and research complement each other  Because neurodegenerative disorders present movement and cognitive features. I considered combining both would make me a better clinician and researcher  Believe it would mesh well with my first fellowship  Both fellowships complement and supplement each other knowledge bases. I thought it would work well with my career goals.  Broaden subspecialty expertise or bridge two areas together to create a niche area of expertise.  Diversify knowledge base and connections in areas of interest  Epilepsy covers a broad spectrum of etiologies including genetics, metabolics, and neuroimmunology, each with a variety of neurological manifestations.  Fields are related. Having both certifications increases job options and opportunities.  For movement disorders to better manage and see more movement patients in conjunction with my bigger goal of healthcare redesign after health services research.  Good combination of knowledge, disorders commonly occur together  I wanted to complete dual training in clinical neurophysiology and autonomic disorders as the two subspecialties are complementary.  Initial plan to combine subspecialties; main academic focus rests within second fellowship.  Interventional neuroradiology / neurology is ultimately my dream, what I would love to do the rest of my life. So I see myself combining the practice of both fellowships, neuroIR doing procedures and vascular neurology, helping and seeing patients in the outpatient and inpatient setting.  It seems it would be more beneficial to have a second fellowship to pair with a neuroimaging fellowship for example. At least that is my current perception.  Job opportunities, complement each other, I am interested both CNS and PNS  Multidisciplinary patient care and research  Multidisciplinary training  Potentially stroke given that it complements Neurocritical care  Previous interest in this subspecialty since college. Also works well with the current fellowship I am completing for both research and clinical work.  Research interests involve the overlap of these two subspecialties, being cognitive impairment in Parkinson's disease.  The Neuro-critical Care is what I chose as career. I picked my first fellowship in Neurophysiology - EEG because it supplements well the Neuro-critical care fellowship. 18

2015 Fellowship Survey Results: 10/22/2015 Response Rate: 31% (805/2,574)

 Ultimate career goal is to be an academic neurointensivist with a specialization in EEG/neuromonitoring. Felt this combination of specialties provided the most logical path.

Subspecialty-Specific

 Did this first, epilepsy second  EEG  EMG  Epilepsy  Evolving field of neurointerventional  Finished vascular neurology, and currently in neuroendovascular surgery.  I just entered Pediatric Epilepsy fellowship this week  I wanted a combined fellowship in neuroinfectious disease and neuro-immunology, but such a thing does not exist as of now  I wanted to complete dual training in clinical neurophysiology and autonomic disorders as the two subspecialties are complementary.  I wanted to do more clinical neurophysiology  I'd like to get a broader training related to cognitive disorders and I'm especially interested in behavioral problems and neuropsychiatry.  Interest in critical care patients.  Interventional neuroradiology / neurology is ultimately my dream, what I would love to do the rest of my life. So I see myself combining the practice of both fellowships, neuroIR doing procedures and vascular neurology, helping and seeing patients in the outpatient and inpatient setting.  It is actually part of my clinical neurophysiology 1 year training. 50% EEG and 50% EMG  It is required as a part of my first (epilepsy) fellowship at the particular institution where I am doing my fellowship.  I've been wanting to go into Neurointervention since I was in medical school.  Might decide to do more basic research. May decide to do more pediatric neuro  MS  Multiple sclerosis  My first fellowship was neuromuscular medicine, second fellowship is now neuroimmunology. I am interested in immunology of both the CNS and PNS.  Neuroimaging or cognitive neurology  Pain  Peripheral immunology  Potentially stroke given that it complements Neurocritical care  Prerequisite for epilepsy  Still completing rotation in epilepsy, so still undecided  Stroke  Surgical capability like epilepsy surgery, surgical implantation of DBS  To do intervention  To focus in epilepsy  To further specialize in epilepsy  To pursue my clinic interest I may in the future pursue a second fellowship in Neuro-oncology at a different institute.  Ultimate career goal is to be an academic neurointensivist with a specialization in EEG/neuromonitoring. Felt this combination of specialties provided the most logical path. 19

2015 Fellowship Survey Results: 10/22/2015 Response Rate: 31% (805/2,574)

 Want to learn about pituitary and hypothalamic lesions and see this patient population  Wanted more training in sports neurology after my neuromuscular fellowship  You need stroke to go into interventional

Clinical Interest

 Clinical interest (13)  Interest in Sleep Medicine (2)  To complement my clinical interests (2)  1) Clinical/research interests beyond the fellowship I have taken 2) Multiple faculty members at my institution have multiple board certifications. After discussing the pros/cons with these faculty it seems like a personally and professionally fulfilling situation that is worth considering.  Clinical and research interest  Clinical and Research interest, and it integrates well career-wise with MS  Clinical and research interest; job market  Clinical interest and desire to work in this field  Clinical interest, additional research exposure required for clinician scientist position  Clinical and scientific interest  Clinical interest. Desire for more knowledge and training  Clinical interests  I had a clinical interest in this area and it was a good continuation of my neuromuscular expertise  I like vascular neurology, as well as hands on approach and the ability to provide immediate relief  Interest clinically, financial opportunities  Interest for procedures and subject  More training, clinical interest, better opportunities.  Personal and clinical interest, research  Personal, clinical and research interest  Requirement to fulfill my clinical interest in pursuing a career in NCC and INR  The first fellowship (MvD) was based on my top clinical interest. The second fellowship (autonomic) was based on clinical interest and job opportunities at my residency institution.  This was my main clinical interest  To pursue my clinic interest I may in the future pursue a second fellowship in Neuro-oncology at a different institute.

Personal or General Interest

 Personal interest (5)  Interest (2)  1. Personal interest 2. Role model in the same field  Additional job opportunities, need within neurology, personal interest  Depending on interests and job opportunities may want additional training.  Further training in an area of personal interest  I enjoyed the pathophysiology of critical care and all that it encompasses. I may decide to pursue a sports neurology fellowship at some point.  I enjoyed the pathophysiology of critical care and all that it encompasses. I may decide to pursue a sports neurology fellowship at some point.  I felt like I need to learn more and neuroimmunology is my favorite subject as well 20

2015 Fellowship Survey Results: 10/22/2015 Response Rate: 31% (805/2,574)

 I like procedural field and I am amazed with fast pace of changes in interventional neurology.  I would like to focus on an area that interests me, and will help better my career  Interested  Job opportunities, complement each other, I am interested both CNS and PNS  Like the field since it makes a difference in taking care of patients  Personal and clinical interest, research  Personal interest, and to get more education in specific field  Personal interest, job opportunities.  Personal satisfaction within this area.  Personal, clinical and research interest  Previous interest in this subspecialty since college. Also works well with the current fellowship I am completing for both research and clinical work.  To be more knowledgeable/marketable in neurology and because of my personal interest

Research Interest

 Because I want to merge both areas by cEEG in the ICU setting in order to improve care in my patients. I am also interested in doing research in EEG waves pattern changes before complications in different diseases, as well as the research of prognosis by EEG patterns in patients not on only in Neuro ICU but also in MICU and CCU  Clinical and research interest  Clinical and Research Interest, and it integrates well career-wise with MS  Clinical and research interest; job market  Clinical and scientific interest  Due to scientific/research interest.  Further specialization into Child Neurology. Want to learn EMG. Want to do clinical and pre- clinical research  I wanted to get more research experience (my first movement fellowship was mainly clinical)  Insufficient training to perform neuropathology clinical research  Might want to get more research experience  More expertise for research interests  Personal and clinical interest, research  Personal, clinical and research interest  Research Interest  Research interests involve the overlap of these two subspecialties, being cognitive impairment in Parkinson's disease.

Lifestyle/Balance

 As critical care attending to be, it is hard to maintain its stressful lifestyle all throughout my career. Downtime in less stressful yet proactive field is needed thus going for stroke  Balance of work and lifestyle  Continue j1 visa in overlapping clinical field with good lifestyle future  I prefer to stay in my current city for personal/family reasons and am not sure I can get into my first choice fellowship there in the year I graduate.  My first fellowship is purely clinical, and I plan to pursue a clinical research fellowship following that. I have unique family circumstances that influenced this decision to do separate fellowships.

2015 Fellowship Survey Results: 10/22/2015 Response Rate: 31% (805/2,574)

Perceived Expectations

 Expectation of the field  For being able to establish myself in the clinical research field of neurodegenerative disorders.  I would not have been able to get the job that I wanted unless I had completed that fellowship.  Make myself more marketable  Seems to be a trend in pediatric neurology to further subspecialize. Especially at the large institution I train at  There are more jobs available for that particular specialty  You need stroke to go into interventional

Financial

 Extra revenue  Further training, career opportunities, financial incentive  Interest clinically, financial opportunities  Money

Role Model

 1. Personal interest 2. Role model in the same field  To enhance my critical decision making by means of interpreting this frequently used tool in the assessment of critical care patients. In addition, having a leader in this field [Name Withheld] who designed this fellowship in my current institution made this decision a no-brainer.

Unsure

 Unsure (5)  I am not sure about a second fellowship  Not sure  Not sure if I will  Not sure if I would consider a second fellowship.  Not sure yet  Still completing rotation in epilepsy, so still undecided

Other

 Complicated  Continue j1 visa in overlapping clinical field with good lifestyle future  I love to learn  If I do not like the first one I will think about a 2nd..  Last year  Only if it would broaden procedures  PGY3  Residency

2015 Fellowship Survey Results: 10/22/2015 Response Rate: 31% (805/2,574)

10. Please provide any other feedback that you believe will help inform the AAN about how or why individuals select certain fellowships:

Exposure

 A wide exposure to various subspecialties will help  Attendance at conferences at a national or local level helps residents interact with faculty across different specialties and can help in generating interest in a particular subspecialty  Based on what they are exposed to in residency and feel more comfortable with  Career and quality of life after fellowship. Previous exposure to research before residency.  Exposure and mentors are the most important factors, unless one is already pre-decided coming into residency. But one still needs to be exposed to ensure they want to pursue that path.  Exposure and personal interest were the most important aspects that help determine fellowship choice  Exposure during residency and having good mentors can move an individual to select certain fellowships over others.  Exposure during residency is key as well as good role models.  Exposure in medical school  Exposure in residency at parent institution  Exposure in residency is a big driving factor.  Exposure is key  Exposure is needed first, then a person can choose based on their clinical, research and personal interests.  Exposure to fellowships is a big factor  Exposure to patients  Exposure to specific areas in residency plays a big role in influencing the decision.  Exposure to the subspecialty fields is critical, thus allowing residents opportunities to spend time doing away rotations/electives at institutions which offer such subspecialties if their home institution does not is an important factor to consider in developing interest in uncommon subspecialty practices.  Highly depends on exposure of the residents in their respective programs, I believe. For example, if a field is not offered at the program they can never like it if they never have exposure to it and thus won’t apply for it. If a program is very strong in a certain field, very likely they will be influenced to go into that specific field  I believe the selection of fellowships is highly influenced by the mentors and training that you get in residency. In my training program, we were heavily exposed to ICU and stroke rotations, and naturally more residents choose those fields because of their broader knowledge base and experience.  I believe there is a strong correlation between which fellowships residents choose and the exposure during residency. For example, none of the residents pursued headache fellowships historically at my residency until a headache specialist was hired. In the immediate years after this, a high percentage of residents chose headache fellowship.  I feel that exposure to subspecialties during residency and the provision of time to work in the subspecialties (as many neurology programs are inpatient heavy and we do not get enough time to do electives) influences us. I pretty much used my post call and vacation time to work in electives and gather experience as my program was heavy on inpatient service and call.  I needed more info about daily routine and the nature of daily work of each fellowship to help me decide.

2015 Fellowship Survey Results: 10/22/2015 Response Rate: 31% (805/2,574)

 I think a lot depends on exposure during residency.  I think a lot of it has to do with opportunities available in your vicinity and what fields excel in the program you're already in.  I think exposure during residency is one of the most important factors in deciding which fellowship to go into as well as lifestyle desires as vascular neurology will be more inpatient acute things vs. something like dementia. Also the desire to do procedures and how comfortable people are with them is important.  I think exposure is an important factor. That being said I was exposed to neurocritical care in medical school but not in residency to the degree that one would require in order to have a full grasp/understanding of what the field is truly like. For me, my medical school exposure was enough.  I think it differs on career goals. Academic vs private practice. In practice it is more useful to do a fellowship in which residency training program is lacking or not adequate exposure.  In discussions with other residents, I have noticed that oftentimes fellowships are chosen secondary to comfort level due to exposure and education during residency training.  It is easier to choose a fellowship and commit to the extended period of training if you have had exposure to the field during residency so you know what you are committing to.  It is important for neurology residents to have exposure to variety of sub-specialties in their program (or as elective in other programs) to be able to recognize the most attractive subspecialty that they enjoy to take as their future career. It's all about passion and inspiration.  Most important is mentors and clinical experience in deciding which fellowship to choose.  My choice primarily related to lifestyle, clinical interest, and perceived opportunities to advance field of HA medicine. Several mentors at my residency and fellowship institution provided a lot of guidance, and insight into my decision. Ability to explore away rotation while a resident at the institution helped greatly as headache medicine was not particularly developed within my residency program.  My fellowship decision was made primarily through my experiences during residency and discovering the areas in which I excelled/enjoyed the most. My ultimate selection was much different than what I anticipated prior to starting fellowship.  Residency training is woefully inadequate to produce a “general neurologist” by both the overly intensive training like a neurohospitalist and the lack of experience with the variety of procedural modalities that 1) need to be interpreted for proper clinical care (part of which is through understanding how they are done) and 2) provide essential financial support to the average clinical practice (not to mention, they are often a required skill to join many practices). This educational pathology turns a 4-year residency in neurology into a prolonged neurohospitalist fellowship, after which most residents must pursue fellowship to gain essential neurological skills for their actual future job (i.e. most neurology residents don't know that they're signing up for a 5+ year residency program), which is primarily outpatient-based. It is no wonder most medical students who come into medicine interested in the neurosciences, end up disinterested after their (often not mandatory) neurology clerkships show them what they're in for: they don't practice the inspirational, longitudinal neurology that is seen in the clinic; and if they do try to get the breadth of exposure, the depth is so minimal as to be unsatisfying.  The only exposure to subspecialties that each resident has at our institution is stroke and EMG. Residents must use VERY limited elective time on what they are already interested in, resulting in very limited choices in fellowship. Exposure to areas of neurology beyond stroke and EMG should be encouraged, not seen as a distraction  There are many subspecialties that some programs do not have. When we do not have exposure to those, we are not sure if we can pursue a fellowship and make a practice of the fellowship

2015 Fellowship Survey Results: 10/22/2015 Response Rate: 31% (805/2,574)

 There are different reasons why people choose individual fellowships. For me, it was the experience I had prior to starting residency as a research assistant in a comprehensive epilepsy center, which taught me how to see and approach complicated/interesting cases of epilepsy.  Usually based on exposure during residency

Interest (Clinical, Personal and Research)

 Based on interest, research, lifestyle factors.  Based on personal interests and financial  Clinical interest and life style  Clinical interest, practicality of fellowship  Clinical interest, having role model in neuromuscular from current program, lifestyle  Exposure and personal interest were the most important aspects that help determine fellowship choice  Exposure is needed first, then a person can choose based on their clinical, research and personal interests.  Follow your interest  For me the only factors were my personal interest in cognition and the faculty mentors I had available in cognitive and behavioral neurology.  For me... Interest and role models during residency  I am considering fellowships based on my clinical interests primarily.  I based my selection purely on clinic interest and the acuity of stroke care.  I believe there are 3 general motivations that guide neurologists to fellowship. I look at it in 2 parts. The 1st part and motivation is a sincere clinical interest in a certain discipline. For me, that is neurocritical care. For others, epilepsy, headache, pain, movement or what have you. Part 2 has 2 factors. Lifestyle and financial aspects. I know for a fact that fellowship training does not always translate into more money. I have friends that specialize in movement disorders and earn about the same as a generalist. I think this is explained by the 1st motivation. I know many academic neurocritical care doctors who make less money than me and have a much better call schedule. This falls under lifestyle. It all depends what the graduating neurologist wants.  I chose what was most interesting to me  I had already done a PhD in this area, so by the time I entered residency, my plan was to pursue a fellowship in this area so that my clinical and research interests would match.  I needed to learn a billable procedure, and EMG/EEG procedures did not interest me personally. That factor, along with my personal interest in the field, as well as my desire to practice primarily outpatient neurology, are the reasons I decided to pursue a movement disorders fellowship. I am now practicing general neurology with a movement disorders subspecialty focus.  I think most do fellowships because they are interested in that area.  I think people prioritize picking a subspecialty that excites them. But if they are picking between two things, other factors come into play like ease in getting that fellowship in a desired location, lifestyle factors, etc.  I think personal interest is the main reason, but lifestyle and financial reasons contribute as well.  I think selection of fellowship is based on clinical interest, good institution and future prospects.  I think the main factor is interest, institution reputation, and future career options.  Interest. Financial  Interest, financial viability  It's about personal interest and lifestyle.  Location, lifestyle, preference/interest, job prospects, research opportunities 25

2015 Fellowship Survey Results: 10/22/2015 Response Rate: 31% (805/2,574)

 Main thing about fellowship for a resident is his/her personal interest which is highly or can be detoured by the financial aid for the fellowship funding. I chose to go epilepsy first because of available funding. I will try neuroimmunology next and hopefully I can find some funded fellowship.  Mentors, personal/clinical interest  Most important reason I think is clinical interest. Then availability of resources (mentors and electives in those areas) really help consolidate the decision.  My choice primarily related to lifestyle, clinical interest, and perceived opportunities to advance field of HA medicine. Several mentors at my residency and fellowship institution provided a lot of guidance, and insight into my decision. Ability to explore away rotation while a resident at the institution helped greatly as headache medicine was not particularly developed within my residency program.  Personal clinical interest. People will do better in things they like, and so do physicians.  Personal interest  Personal interest and availability  Should select completely based on their interest and passion  The funding of the department and the vision of clinical vs research is very important to the balance of patient loads and pursuit of interest in selected aims, in terms of clinical vs research, always ask this up front.  The neurologists are attracted by good mentors, great infrastructure facilities for high level research in basic, translational and clinical science.  Very happy I choose subspecialty that is so rewarding and in high demand  You have to consider the best fit for your family and career goals. Mentorship versus just training is very critical. Clinical & research opportunity

Subspecialty-Specific

 80% of child neurology is epilepsy. This is the most sensible fellowship even for general pediatric neurologist  Ability to take Child Neurology applicants, or a Child Neurology specific fellowship being available.  Because interventional is one of the most exciting things going on in neurology right now  Following child neurology, many of the fellowships are “unofficial”- I'd like to do MS, but it would be relatively informal.  For me the only factors were my personal interest in cognition and the faculty mentors I had available in cognitive and behavioral neurology.  I based my selection purely on clinic interest and the acuity of stroke care.  I chose Clinical Neurophysiology because of my career goals - general outpatient neurology.  I enjoyed training in sleep medicine, and believe I have made the right decision.  I hope that there is a table that compares fellowships in every subspecialties, I did one for neuromuscular and happy to share. [Name withheld]  I picked clinical neurophysiology because I felt I did not receive enough training in EEG and EMG in residency in order to perform it in practice. Additionally, I wanted more training in neuromuscular and epilepsy.  I selected a second fellowship in NCC as I wanted more clinical experience in acute management and procedural skills  I think mentors play a very big role by showing you what the specialty adds to their knowledge base as a neurologist in general and how sane they are when they are living and practicing their

2015 Fellowship Survey Results: 10/22/2015 Response Rate: 31% (805/2,574)

specialty...my mentor was my Program Director [Name Withheld]...need I say more. The man's a legend. Neuromuscular was an obvious choice for me.  I think more residents would be interested in going into stroke and interventional because of the recent acute stroke clinical trials  I think the way the pediatric neurology match is structured does make it difficult for people who are not 4th year medical students apply for and match into training programs. There also is very limited exposure to most child neurology programs in medical school.  I was limited to a fellowship in my city. The only options were vascular and clinical neurophysiology. I chose CNP because I felt that I had adequate exposure to vascular neurology and a neurophysiology fellowship will help me incorporate EEG reading/EMG studies into my future general practice.  Interventional Neuroradiology provides a practice of significant reach and intervention in Neurologic disease process. You can provide a service and produce a dramatic change in neurological clinical outcome.  Just to clarify, I'm in child a Neuro residency program, planning on doing child epilepsy fellowship  My fellowship is a combination of neuroID and neuroimmunology/MS.  Neuro-infections are an important aspect of neurology, typically poorly managed and not taught in residencies, so people typically have very little appreciation for CNS infections, little interest and thus do not consider the fellowship. I suggest that the academy try to involve more residents into the Neuro-ID group.  Of many epilepsy fellowship offers, I decided between them based almost entirely on how the programs treat their fellows (i.e. how much they seem to emphasize education over simple work- horse)  Pain is neurology phenomena, and I could see the advantage of my neurology training background over my other co-fellows who came from different residency training  Perhaps the AAN should promote the field of Neurointervention within Neurology more; make it more salient as a field that can be developed within the field of Neurology by itself.  Personally, I liked DBS and the effectiveness of DBS in helping individuals with Parkinson's and I didn't get enough exposure during training, therefore wanted to go for extra to learn about DBS. I also thought doing [botox] will help revenue stream.  There are no pediatric neurocritical care fellowships that lead to board certification/ability to practice as an intensivist at the end. To get specialized neurocritical care training as a child neurologist and have the ability to practice as an intensivist (even if it is in an adult unit), this has to be pursued through adult fellowship programs.  There are different reasons why people choose individual fellowships. For me, it was the experience I had prior to starting residency as a research assistant in a comprehensive epilepsy center, which taught me how to see and approach complicated/interesting cases of epilepsy.  UCNS website listing behavioral neurology fellowships, limited access to these fellowships for international residents

Career Opportunities

 Career and quality of life after fellowship. Previous exposure to research before residency.  For additional credentials. For income opportunity.  I chose Clinical Neurophysiology because of my career goals - general outpatient neurology.  I think it differs on career goals. Academic vs private practice. In practice it is more useful to do a fellowship in which residency training program is lacking or not adequate exposure.

2015 Fellowship Survey Results: 10/22/2015 Response Rate: 31% (805/2,574)

 I think mentors play a great role in how individuals select a certain fellowship and second is the job market. In academics, for example, most places require a two year fellowship.  I think selection of fellowship is based on clinical interest, good institution and future prospects.  I think the main factor is interest, institution reputation, and future career options.  I was told to choose a fellowship to enhance marketability and improve my own quality of life as an expert in a field (less undesirable consults). This compared to not doing any fellowship.  Job availability and reimbursements are huge factors as well. I can do DBS and Botox injections  Job opportunities, income, life style  Job security/flexibility, duration of fellowship  Knowledge of future opportunities within subspecialty  Lifestyle and perceived job opportunities are very important to trainees in my opinion  Look for job placement after fellowship  My choice primarily related to lifestyle, clinical interest, and perceived opportunities to advance field of HA medicine. Several mentors at my residency and fellowship institution provided a lot of guidance, and insight into my decision. Ability to explore away rotation while a resident at the institution helped greatly as headache medicine was not particularly developed within my residency program.  People choose fellowship based on benefit vs. time evaluation. I decided to pursue fellowship training because I want to obtain a leadership position in research and clinical practice of vascular neurology.  The perception I was given was that it would be difficult to get a good job without a fellowship and therefore it wasn't if you were doing a fellowship but which one to do.  There is a perception that only individuals with fellowship training can get a job in academic center  Unfortunately, I have found that although there are numerous fellowship training options available to residents there is an incongruence between these training opportunities and the dearth of employment opportunities post-fellowship in certain subspecialties (i.e Neurorehabilitation and Neural repair). Most job postings appear to be looking for fellows with training in Stroke/NCC, Movement, Epilepsy, Neuromuscular, MS, Neuro-oncology behavioral Neurology and Sleep...  Very happy I choose subspecialty that is so rewarding and in high demand  You have to consider the best fit for your family and career goals. Mentorship versus just training is very critical. Clinical & research opportunity

Lifestyle

 Based on interest, research, lifestyle factors.  Career and quality of life after fellowship. Previous exposure to research before residency.  Clinical interest and lifestyle  Clinical interest, having role model in neuromuscular from current program, lifestyle  I believe there are 3 general motivations that guide neurologists to fellowship. I look at it in 2 parts. The 1st part and motivation is a sincere clinical interest in a certain discipline. For me, that is neurocritical care. For others, epilepsy, headache, pain, movement or what have you. Part 2 has 2 factors. Lifestyle and financial aspects. I know for a fact that fellowship training does not always translate into more money. I have friends that specialize in movement disorders and earn about the same as a generalist. I think this is explained by the 1st motivation. I know many academic neurocritical care doctors who make less money than me and have a much better call schedule. This falls under lifestyle. It all depends what the graduating neurologist wants.  I think personal interest is the main reason, but lifestyle and financial reasons contribute as well.

2015 Fellowship Survey Results: 10/22/2015 Response Rate: 31% (805/2,574)

 I was told to choose a fellowship to enhance marketability and improve my own quality of life as an expert in a field (less undesirable consults). This compared to not doing any fellowship.  Information about lifestyle and income would be very helpful  It's about personal interest and lifestyle.  Job opportunities, income, life style  Lifestyle and perceived job opportunities are very important to trainees in my opinion  Lifestyle and salary are unfortunately the two most important factors. Several of my co-residents went into certain fellowships so that they could do procedures or have skills that would be compatible with a lucrative neurology practice, even though they were not interested in the subspecialty.  Location, lifestyle, preference/interest, job prospects, research opportunities  Mentor inspiration. Work schedule. Financial incentives  My choice primarily related to lifestyle, clinical interest, and perceived opportunities to advance field of HA medicine. Several mentors at my residency and fellowship institution provided a lot of guidance, and insight into my decision. Ability to explore away rotation while a resident at the institution helped greatly as headache medicine was not particularly developed within my residency program.  Salary and quality of life  You have to consider the best fit for your family and career goals. Mentorship versus just training is very critical. Clinical & research opportunity

Suggestions

 AAN can offer more info of the fellowship programs on its website and AAN annual conference, e.g. A fellowship room during the conference, like ASCO does.  AAN should make the process centralized  All fellowship should be through ECFMG match or none of them should be  Although the fellowship should always be based on a personal interest, sometimes it helps to eliminate few sub specialties (eliminate the sub specialties you do not like at all) completely to help narrow down the choices.  Ask program directors to summarize their trainee's choices to get an idea of how different programs tend to approach this.  Encourage and assist in fellowship accreditation.  I hope that there is a table that compares fellowships in every subspecialties, I did one for neuromuscular and happy to share. [Name withheld]  Let fellows know how many average EEG people read, average EMGs done in fellowship, number of EMU months allowed  More information about individual programs and availability should be centralized, as well as a streamlined process for application  One should consider that IMGs frequently have problems in selecting non-ACGME fellowships due to the misunderstanding that ECFMG would not sponsor the VISA, which is not a correct statement.  Participation or not in the fellowship match is important and not consistent among institutions or among different fellowships at the same institution.  Perhaps the AAN should promote the field of Neurointervention within Neurology more; make it more salient as a field that can be developed within the field of Neurology by itself.  Personal factors are often found to be highly related to residency site selection, consider expanding upon this for future surveys.

2015 Fellowship Survey Results: 10/22/2015 Response Rate: 31% (805/2,574)

 The funding of the department and the vision of clinical vs research is very important to the balance of patient loads and pursuit of interest in selected aims, in terms of clinical vs research, always ask this up front.  The only exposure to subspecialties that each resident has at our institution is stroke and EMG. Residents must use VERY limited elective time on what they are already interested in, resulting in very limited choices in fellowship. Exposure to areas of neurology beyond stroke and EMG should be encouraged, not seen as a distraction

Role Model/Mentor

 Clinical interest, having role model in neuromuscular from current program, lifestyle  Emphasis or focus of the residency training program. In my case, I believe the selection of my fellowships was not only influenced by my mentor but also how the residency program was designed.  Exposure and mentors are the most important factors, unless one is already pre-decided coming into residency. But one still needs to be exposed to ensure they want to pursue that path.  Exposure during residency and having good mentors can move an individual to select certain fellowships over others.  Exposure during residency is key as well as good role models.  For me the only factors were my personal interest in cognition and the faculty mentors I had available in cognitive and behavioral neurology.  For me... Interest and role models during residency  Good to have mentors  I believe the selection of fellowships is highly influenced by the mentors and training that you get in residency. In my training program, we were heavily exposed to ICU and stroke rotations, and naturally more residents choose those fields because of their broader knowledge base and experience.  I think mentors play a great role in how individuals select a certain fellowship and second is the job market. In academics, for example, most places require a two year fellowship.  I think mentors play a very big role by showing you what the specialty adds to their knowledge base as a neurologist in general and how sane they are when they are living and practicing their specialty...my mentor was my Program Director [Name Withheld]...need I say more. The man's a legend. Neuromuscular was an obvious choice for me.  In my case, it was all about the research opportunities and the available mentorship in basic science at the institution  Location, size of program, mentors, who you can see yourself working with and learning from  Mentor inspiration. Work schedule. Financial incentives  Mentors  Mentors, personal/clinical interest  Most important is mentors and clinical experience in deciding which fellowship to choose.  Most important reason I think is clinical interest. Then availability of resources (mentors and electives in those areas) really help consolidate the decision.  The neurologists are attracted by good mentors, great infrastructure facilities for high level research in basic, translational and clinical science.  You have to consider the best fit for your family and career goals. Mentorship versus just training is very critical. Clinical & research opportunity

2015 Fellowship Survey Results: 10/22/2015 Response Rate: 31% (805/2,574)

Financial

 Any fellowship that increases the pay is the one to go for.  Financial support, geographic availability, competitiveness are other factors  For additional credentials. For income opportunity.  I believe there are 3 general motivations that guide neurologists to fellowship. I look at it in 2 parts. The 1st part and motivation is a sincere clinical interest in a certain discipline. For me, that is neurocritical care. For others, epilepsy, headache, pain, movement or what have you. Part 2 has 2 factors. Lifestyle and financial aspects. I know for a fact that fellowship training does not always translate into more money. I have friends that specialize in movement disorders and earn about the same as a generalist. I think this is explained by the 1st motivation. I know many academic neurocritical care doctors who make less money than me and have a much better call schedule. This falls under lifestyle. It all depends what the graduating neurologist wants.  I needed to learn a billable procedure, and EMG/EEG procedures did not interest me personally. That factor, along with my personal interest in the field, as well as my desire to practice primarily outpatient neurology, are the reasons I decided to pursue a movement disorders fellowship. I am now practicing general neurology with a movement disorders subspecialty focus.  I think an important factor is the financial/economic benefits of some subspecialties  I think personal interest is the main reason, but lifestyle and financial reasons contribute as well.  I was not financially able to do a fellowship that did not at least pay a PGY - 4 salary.  Information about lifestyle and income would be very helpful  Interest. Financial  Interest, financial viability  Job opportunities, income, life style  Lifestyle and salary are unfortunately the two most important factors. Several of my co-residents went into certain fellowships so that they could do procedures or have skills that would be compatible with a lucrative neurology practice, even though they were not interested in the subspecialty.  Main thing about fellowship for a resident is his/her personal interest which is highly or can be detoured by the financial aid for the fellowship funding. I chose to go epilepsy first because of available funding. I will try neuroimmunology next and hopefully I can find some funded fellowship.  Mentor inspiration. Work schedule. Financial incentives  Money  Salary and quality of life  The funding of the department and the vision of clinical vs research is very important to the balance of patient loads and pursuit of interest in selected aims, in terms of clinical vs research, always ask this up front.

Training Process

 Ease of the fellowship process.  Emphasis or focus of the residency training program. In my case, I believe the selection of my fellowships was not only influenced by my mentor but also how the residency program was designed.  I feel that exposure to subspecialties during residency and the provision of time to work in the subspecialties (as many neurology programs are inpatient heavy and we do not get enough time to do electives) influences us. I pretty much used my post call and vacation time to work in electives and gather experience as my program was heavy on inpatient service and call. 31

2015 Fellowship Survey Results: 10/22/2015 Response Rate: 31% (805/2,574)

 I think the way the pediatric neurology match is structured does make it difficult for people who are not 4th year medical students apply for and match into training programs. There also is very limited exposure to most child neurology programs in medical school.  Job security/flexibility, duration of fellowship  Locating fellowships within neurology that are not part of a match system is a difficult and tedious process.  Residency training is woefully inadequate to produce a “general neurologist” by both the overly intensive training like a neurohospitalist and the lack of experience with the variety of procedural modalities that 1) need to be interpreted for proper clinical care (part of which is through understanding how they are done) and 2) provide essential financial support to the average clinical practice (not to mention, they are often a required skill to join many practices). This educational pathology turns a 4-year residency in neurology into a prolonged neurohospitalist fellowship, after which most residents must pursue fellowship to gain essential neurological skills for their actual future job (i.e. most neurology residents don't know that they're signing up for a 5+ year residency program), which is primarily outpatient-based. It is no wonder most medical students who come into medicine interested in the neurosciences, end up disinterested after their (often not mandatory) neurology clerkships show them what they're in for: they don't practice the inspirational, longitudinal neurology that is seen in the clinic; and if they do try to get the breadth of exposure, the depth is so minimal as to be unsatisfying.  The only exposure to subspecialties that each resident has at our institution is stroke and EMG. Residents must use VERY limited elective time on what they are already interested in, resulting in very limited choices in fellowship. Exposure to areas of neurology beyond stroke and EMG should be encouraged, not seen as a distraction  There should be uniformity in training hours in different domains within fellowships among various institutes.

Geographic Location

 Financial support, geographic availability, competitiveness are other factors  I believe most residents start families during residency, after which it becomes very difficult to move. Especially if the spouse has a job, kids are in school, own a home, etc., thus local options are best options for the majority.  I personally look for places where I can move with my family. So location is important  I think a lot of it has to do with opportunities available in your vicinity and what fields excel in the program you're already in.  I think people prioritize picking a subspecialty that excites them. But if they are picking between two things, other factors come into play like ease in getting that fellowship in a desired location, lifestyle factors, etc.  I was limited to a fellowship in my city. The only options were vascular and clinical neurophysiology. I chose CNP because I felt that I had adequate exposure to vascular neurology and a neurophysiology fellowship will help me incorporate EEG reading/EMG studies into my future general practice.  Location is another big factor.  Location very important  Location, lifestyle, preference/interest, job prospects, research opportunities  Location, prestige, ease of schedule

2015 Fellowship Survey Results: 10/22/2015 Response Rate: 31% (805/2,574)

Gain Additional Experience or Expertise

 Fellowships are helpful to select the patient population that trainees prefer to see. Remaining a generalist leaves openings to see pathology that you might not enjoy - it also enables you to become an expert, stay in academia and participate in research, if you want to.  Getting additional training through fellowship always helps  I do think many of my peers do not feel ready after residency and just need an extra year of something.  I think myself and others in my residency class felt unprepared for clinical practice after residency alone and therefore further training was needed.  It makes them more prepared and acquire more experience in certain area  The neurology field is growing at such a rapid rate that having a subspecialty interest at least allows you to keep abreast of new research in one area.

Patients

 Consider the spectrum of patients in the options  Exposure to patients  Fellowships are helpful to select the patient population that trainees prefer to see. Remaining a generalist leaves openings to see pathology that you might not enjoy - it also enables you to become an expert, stay in academia and participate in research, if you want to.  I was told to choose a fellowship to enhance marketability and improve my own quality of life as an expert in a field (less undesirable consults). This compared to not doing any fellowship.  The funding of the department and the vision of clinical vs research is very important to the balance of patient loads and pursuit of interest in selected aims, in terms of clinical vs research, always ask this up front.

Deadlines/Timing

 Application deadlines. Most fellowships now require application 2 years ahead of graduation, and some people cannot decide within that time.  Aside from my chosen reasons (Ranked 1-3) Definitely #4 would have been deadlines. There is not much room for personal growth or chance to assimilate what subspecialties in neurology would have to offer or would be like in actual practice in the first 1-2 years of Residency, including internship, to have a solid plan for a fellowship application prior to PGY3 or during early PGY3. My experiences as a PGY3 were much more helpful in shaping my perception of most of our experience as neurologist, and spending time mostly in neurology office, not just in hospital wards (which most programs front load into PGY2). By the time I felt comfortable planning a future in subspecialty neurology, many deadlines for other types of fellowships had already been missed.  Timing: Some programs have interviewed and accepted fellows before other programs have even confirmed receipt of the application.

Program/Institution-Specific

 If the institution is participating in a match and if the fellowship is clinical versus research, paid vs unpaid and ACGME vs non-standard.  In my case, it was all about the research opportunities and the available mentorship in basic science at the institution 33

2015 Fellowship Survey Results: 10/22/2015 Response Rate: 31% (805/2,574)

 Location, size of program, mentors, who you can see yourself working with and learning from

Competitiveness

 Financial support, geographic availability, competitiveness are other factors  Perceived competitiveness may be a factor. This was not necessarily an issue for me, but some of my colleagues are interested in neurocritical care and are concerned about their chances of matching due to perceived competitiveness.  Sometimes it is influenced by your co-residents. If there are already few residents doing that fellowship, you may think “should I do something else?”.

Other

 N/A (8)  None (5)  Clinical interest, practicality of fellowship  Don't have any  From what I have seen, some people keep doing fellowships in order to remain 5 years in the U.S. and then apply for citizenship, instead of doing a fellowship because of your professional interest.  It is important for neurology residents to have exposure to variety of sub-specialties in their program (or as elective in other programs) to be able to recognize the most attractive subspecialty that they enjoy to take as their future career. It's all about passion and inspiration.  It’s complex personal life factors that have probably influenced me as much as anything  Location, prestige, ease of schedule  No  No additional comments  No further feedback.  Ok  People choose fellowship based on benefit vs. time evaluation. I decided to pursue fellowship training because I want to obtain a leadership position in research and clinical practice of vascular neurology.  People select them by advertisement, recommendation, geography, and (often assumed) prestige. None of these factors are directly related to individual probability of good program fit.  Personal interest and availability  Pioneers in each field should be acquainted to the residents through website.  Thanks  This survey appears to be a good way of selecting or reflecting on the decision process.  Unsure  Visa issues waiver jobs

2015 Fellowship Survey Results: 7/21/2016 Child Neurology response: 3.9% (30/776)

7/21/16

A MERICAN

A CADEMY OF CHILD NEUROLOGY FELLOWSHIP FREQUENCIES N EUROLOGY

2015 Fellowship Survey Results: 7/21/2016 Child Neurology response: 3.9% (30/776)

Survey Frequencies by Child Neurology Fellowship ***Filtered by those who selected Child Neurology as their fellowship choice.

Please indicate all of the neurology fellowship areas you are considering (or did consider, prior to fellowship). Mark all that apply.1 (n=30)

100.0% Child neurology 0.0% Balance disorders 36.7% EEG – Clinical neurophysiology 0.0% Cognitive disorders 30.0% Epilepsy 0.0% Complementary medicine 13.3% EMG – Clinical neurophysiology 0.0% Geriatric neurology 10.0% Movement disorders 0.0% Headache medicine Behavioral neurology & 0.0% Intervention neuroradiology 6.7% neuropsychiatry 0.0% Neural repair & rehabilitation 6.7% Neurogenetics 0.0% Neuro-ophtalmology 3.3% Clinical research 0.0% Neuro-otology 3.3% Neuro-oncology 0.0% Neuroendocrinology 3.3% Neurocritical care 0.0% Neuroimaging 3.3% Neurohospitalist 0.0% Neuropharmacology Neuroimmunology & multiple 0.0% Pain medicine 3.3% sclerosis 0.0% Palliative medicine 3.3% Neuroinfectious disease 0.0% Sports neurology 3.3% Neuromuscular medicine 0.0% Other (please specify): 3.3% Sleep medicine 0.0% Unsure 1 3.3% Vascular neurology & stroke Total may exceed 100%. 0.0% Autonomic disorders

What factors influenced your decision to select the Child Neurology fellowship?2 Mark all that apply.3 (n=29)

86.2% Clinical interest 79.3% Personal interest 62.1% Influenced by a role model or mentor during residency or other training Better lifestyle opportunities within the subspecialty area (presence of nights on call during 17.2% fellowship and beyond) 17.2% Exposure to subspecialty during residency 17.2% Scientific or research interest 10.3% Family or friend affected by disease 10.3% Fellowship availability at residency institution 10.3% Local or regional availability of fellowships 10.3% Perceptions of post-fellowship opportunities in selected subspecialty area Complex clinic interactions (expensive medication with authorization process, 6.9% multidisciplinary aspect of care) 6.9% Greater financial opportunities within the subspecialty area (ease of generating revenue) 6.9% I felt I needed more training 3.4% Ability to incorporate fellowship training into a general neurology practice 3.4% I would not be able to get a job in my desired area without first completing a fellowship 3.4% National availability of fellowships 0.0% ACGME or UCNS certification at the end of fellowship 0.0% Deadlines for applications 2

2015 Fellowship Survey Results: 7/21/2016 Child Neurology response: 3.9% (30/776)

0.0% Ease of available funds and grants for fellowships 0.0% National Residency Match Program (NRMP) Specialties Matching Service for fellowships 0.0% Other (please specify): 2Response options were randomly presented 3Total may exceed 100%.

Of the factors that influenced your decision to select the Child Neurology fellowship, please rank up to three of the most important factors (1=most important, 2=second-most important, 3=third-most important).4

Rank Sum5 Rank Factor that Influenced Fellowship Decision 62 1 Clinical interest (n=24) 39 2 Personal interest (n=21) 25 3 Influenced by a role model or mentor during residency or other training (n=12) 10 4 Scientific or research interest (n=5) 5 5 Exposure to subspecialty during residency (n=3) Better lifestyle opportunities within the subspecialty area (presence of nights on call 5 5 during fellowship and beyond) (n=2) 4 7 Fellowship availability at residency institution (n=2) I would not be able to get a job in my desired area without first completing a 2 8 fellowship (n=1) 1 9 Ability to incorporate fellowship training into a general neurology practice (n=1) 1 9 Family or friend affected by disease (n=1) 1 9 Perceptions of post-fellowship opportunities in selected subspecialty area (n=1) 0 - Local or regional availability of fellowships (n=0) Complex clinic interactions (expensive medication with authorization process, 0 - multidisciplinary aspect of care) (n=0) Greater financial opportunities within the subspecialty area (ease of generating 0 - revenue) (n=0) 0 - I felt I needed more training (n=0) 0 - National availability of fellowships (n=0) 0 - ACGME or UCNS certification at the end of fellowship (n=0) 0 - Deadlines for applications (n=0) 0 - Ease of available funds and grants for fellowships National Residency Match Program (NRMP) Specialties Matching Service for 0 - fellowships (n=0) 0 - Other (please specify): (n=0) 4Only responses selected in question 6 were displayed. 5Value for rank: 1=3, 2=2, 3=1.

2015 Fellowship Survey Results: 7/21/2016 Child Neurology response: 3.9% (30/776)

You indicated that a role model or mentor influenced your decision to select the Child Neurology fellowship. What primary subspecialty area did your role model or mentor work in? (n=18)

83.3% Child neurology 0.0% Neuro-otology 11.1% Neuromuscular medicine 0.0% Neurocritical care 5.6% General neurology 0.0% Neuroepidemiology 0.0% Autonomic disorders 0.0% Neurogenetics Behavioral neurology and 0.0% Neurohospitalist 0.0% neuropsychiatry 0.0% Neuroimaging 0.0% Clinical neurophysiology Neuroimmunology and multiple 0.0% Endovascular and interventional sclerosis 0.0% neurology 0.0% Neuromuscular pathology 0.0% Epilepsy 0.0% Neurophysiology 0.0% Geriatric neurology 0.0% Pain medicine 0.0% Headache medicine 0.0% Palliative neurology Infectious diseases and 0.0% Sleep medicine 0.0% neurovirology 0.0% Sports neurology 0.0% Movement disorders 0.0% Traumatic brain injury 0.0% Neural repair and rehabilitation 0.0% Unsure 0.0% Neuro-oncology 0.0% Vascular neurology and stroke 0.0% Neuro-ophthalmology 0.0% Other (please specify):

2015 Fellowship Survey Results: 7/21/2016 EEG response: 13.9% (108/776)

7/21/16

A MERICAN EEG – CLINICAL NEUROPHYSIOLOGY FELLOWSHIP ACADEMY OF FREQUENCIES N EUROLOGY

2015 Fellowship Survey Results: 7/21/2016 EEG response: 13.9% (108/776)

Frequencies – Clinical Neurophysiology Subspecialty Questions ***Displayed to those who selected either EEG – Clinical Neurophysiology or EMG – Clinical Neurophysiology as their first fellowship choice.

What are/were the most important features in selecting your Clinical Neurophysiology fellowship site? Please rank the top 5 reasons, with 1=most important to 5=least important.

Rank Sum1 Rank Factor that Influenced Clinical Neurophysiology fellowship site 282 1 Geographic location (n=79) 249 2 Diversity of Clinical Neurophysiology training (EEG/EMG/IOM/Sleep) (n=71) 232 3 Prestige of the program (n=67) 215 4 Future career opportunity (n=74) 200 5 Nationally recognized faculty (n=63) 194 6 Completed residency there (n=49) 109 7 Limited call time (n=41) 89 8 Size of the fellowship (n=31) 70 9 Mentor suggestion (n=28) 62 10 Mix of adult and pediatric cases (n=23) 62 10 Research opportunities (n=21) 40 12 Financial incentive (n=15) 35 13 Other (please specify):6 (n=10) 1 Value for rank: 1=5, 2=4, 3=3, 4=2, 5=1. 2Comments are below

What are/were the most important features in selecting your Clinical Neurophysiology fellowship site? Other (please specify):  Adequacy of teaching/education  Clinical expertise and case mix  Family  I looked for a program that had large amount of patients and that have a diversity of ethnic and cultural background  Near to family  No research requirement  Perceived strength of training  Regional career opportunities for spouse  Volume of cases

2015 Fellowship Survey Results: 7/21/2016 EEG response: 13.9% (108/776)

Survey Frequencies by EEG Fellowship ***Filtered by those who selected EEG as their fellowship choice.

Please indicate all of the neurology fellowship areas you are considering (or did consider, prior to fellowship). Mark all that apply.3 (n=108)

100.0% EEG – Clinical neurophysiology 1.9% Neuro-ophtalmology 50.9% Epilepsy 1.9% Sports neurology 28.7% EMG – Clinical neurophysiology 0.9% Clinical research 11.1% Neurocritical care 0.9% Neural repair & rehabilitation 10.2% Movement disorders 0.9% Neurogenetics 9.3% Child neurology 0.9% Neuromuscular medicine 8.3% Sleep medicine 0.9% Pain medicine 6.5% Vascular neurology & stroke 0.0% Balance disorders Behavioral neurology & 0.0% Complementary medicine 5.6% neuropsychiatry 0.0% Geriatric neurology Neuroimmunology & multiple 0.0% Neuroinfectious disease 5.6% sclerosis 0.0% Neuro-otology 3.7% Cognitive disorders 0.0% Neuroendocrinology 3.7% Headache medicine 0.0% Neuropharmacology 3.7% Neuroimaging 0.0% Palliative medicine 2.8% Neurohospitalist 0.0% Other (please specify): 1.9% Autonomic disorders 0.0% Unsure 3 1.9% Intervention neuroradiology Total may exceed 100%. 1.9% Neuro-oncology

What factors influenced your decision to select the EEG fellowship?4 Mark all that apply.5 (n=108)

75.0% Clinical interest 60.2% Personal interest 40.7% Exposure to subspecialty during residency 35.2% Influenced by a role model or mentor during residency or other training 32.4% I felt I needed more training 28.7% Perceptions of post-fellowship opportunities in selected subspecialty area 27.8% Ability to incorporate fellowship training into a general neurology practice 24.1% Scientific or research interest 21.3% Greater financial opportunities within the subspecialty area (ease of generating revenue) Better lifestyle opportunities within the subspecialty area (presence of nights on call during 20.4% fellowship and beyond) 15.7% Fellowship availability at residency institution 14.8% ACGME or UCNS certification at the end of fellowship 11.1% Local or regional availability of fellowships 10.2% I would not be able to get a job in my desired area without first completing a fellowship Complex clinic interactions (expensive medication with authorization process, 8.3% multidisciplinary aspect of care) 7.4% National availability of fellowships 2.8% Family or friend affected by disease 0.9% Ease of available funds and grants for fellowships 0.9% Deadlines for applications 3

2015 Fellowship Survey Results: 7/21/2016 EEG response: 13.9% (108/776)

0.9% Other (please specify): 0.0% National Residency Match Program (NRMP) Specialties Matching Service for fellowships 4Response options were randomly presented 5Total may exceed 100%.

Of the factors that influenced your decision to select the EEG fellowship, please rank up to three of the most important factors (1=most important, 2=second-most important, 3=third-most important).6

Rank Sum7 Rank Factor that Influenced Fellowship Decision 175 1 Clinical interest (n=71) 107 2 Personal interest (n=46) 47 3 Ability to incorporate fellowship training into a general neurology practice (n=23) 46 4 Scientific or research interest (n=22) 37 5 I felt I needed more training (n=18) 27 6 Influenced by a role model or mentor during residency or other training (n=16) 26 7 Perceptions of post-fellowship opportunities in selected subspecialty area (n=15) Better lifestyle opportunities within the subspecialty area (presence of nights on call 26 7 during fellowship and beyond) (n=13) 25 9 Exposure to subspecialty during residency (n=15) Greater financial opportunities within the subspecialty area (ease of generating 21 10 revenue) (n=12) 15 11 Fellowship availability at residency institution (n=8) 11 12 ACGME or UCNS certification at the end of fellowship (n=7) I would not be able to get a job in my desired area without first completing a 10 13 fellowship (n=6) 9 14 Local or regional availability of fellowships (n=6) 3 15 Family or friend affected by disease (n=1) Complex clinic interactions (expensive medication with authorization process, 2 17 multidisciplinary aspect of care) (n=1) 2 17 Other (please specify): (n=1) 0 - National availability of fellowships 0 - Ease of available funds and grants for fellowships 0 - Deadlines for applications National Residency Match Program (NRMP) Specialties Matching Service for 0 - fellowships 6Only responses selected in question 6 were displayed. 7Value for rank: 1=3, 2=2, 3=1.

2015 Fellowship Survey Results: 7/21/2016 EEG response: 13.9% (108/776)

You indicated that a role model or mentor influenced your decision to select the EEG fellowship. What primary subspecialty area did your role model or mentor work in? (n=37)

62.2% Epilepsy 0.0% Neural repair and rehabilitation 16.2% Clinical neurophysiology 0.0% Neuro-oncology 5.6% Child neurology 0.0% Neuro-ophthalmology 2.7% Neurocritical care 0.0% Neuro-otology 2.7% Neuromuscular medicine 0.0% Neuroepidemiology 2.7% Sleep medicine 0.0% Neurogenetics 2.7% Unsure 0.0% Neurohospitalist 0.0% Autonomic disorders 0.0% Neuroimaging Behavioral neurology and Neuroimmunology and multiple 0.0% 0.0% neuropsychiatry sclerosis Endovascular and interventional 0.0% Neuromuscular pathology 0.0% neurology 0.0% Neurophysiology 0.0% General neurology 0.0% Pain medicine 0.0% Geriatric neurology 0.0% Palliative neurology 0.0% Headache medicine 0.0% Sports neurology Infectious diseases and 0.0% Traumatic brain injury 0.0% neurovirology 0.0% Vascular neurology and stroke 0.0% Movement disorders 0.0% Other (please specify):

2015 Fellowship Survey Results: 7/21/2016 EMG response: 6.6% (51/776)

7/21/16

A MERICAN EMG – CLINICAL NEUROPHYSIOLOGY FELLOWSHIP ACADEMY OF FREQUENCIES N EUROLOGY

2015 Fellowship Survey Results: 7/21/2016 EMG response: 6.6% (51/776)

What are/were the most important features in selecting your Clinical Neurophysiology fellowship site? Please rank the top 5 reasons, with 1=most important to 5=least important.

2015 Fellowship Survey Results: 7/21/2016 EMG response: 6.6% (51/776)

Survey Frequencies by EMG Fellowship ***Filtered by those who selected EMG – Clinical Neurophysiology as their fellowship choice.

Please indicate all of the neurology fellowship areas you are considering (or did consider, prior to fellowship). Mark all that apply.1 (n=51)

100.0% EMG – Clinical neurophysiology Behavioral neurology & 0.0% 41.2% EEG – Clinical neurophysiology neuropsychiatry 37.3% Neuromuscular medicine 0.0% Complementary medicine 13.7% Movement disorders 0.0% Geriatric neurology 11.8% Epilepsy 0.0% Headache medicine 5.9% Sleep medicine 0.0% Intervention neuroradiology 5.9% Vascular neurology & stroke 0.0% Neural repair & rehabilitation 3.9% Clinical research 0.0% Neuro-oncology 3.9% Neurocritical care 0.0% Neuro-otology 3.9% Neuroimaging 0.0% Neuroendocrinology 3.9% Pain medicine 0.0% Neurogenetics 2.0% Autonomic disorders 0.0% Neurohospitalist 2.0% Child neurology 0.0% Neuroimaging 2.0% Cognitive disorders 0.0% Neuroinfectious disease 2.0% Neuro-ophtalmology 0.0% Neuropharmacology Neuroimmunology & multiple 0.0% Pain medicine 2.0% sclerosis 0.0% Other (please specify): 2.0% Sports neurology 0.0% Unsure 0.0% Balance disorders 1Total may exceed 100%.

What factors influenced your decision to select the EMG fellowship?2 Mark all that apply.3 (n=51)

74.5% Clinical interest 58.8% Personal interest 52.9% Ability to incorporate fellowship training into a general neurology practice 39.2% Influenced by a role model or mentor during residency or other training Better lifestyle opportunities within the subspecialty area (presence of nights on call during 39.2% fellowship and beyond) 39.2% I felt I needed more training 31.4% Exposure to subspecialty during residency 25.5% Greater financial opportunities within the subspecialty area (ease of generating revenue) 23.5% Fellowship availability at residency institution 17.6% ACGME or UCNS certification at the end of fellowship 15.7% Perceptions of post-fellowship opportunities in selected subspecialty area 13.7% Local or regional availability of fellowships 11.8% I would not be able to get a job in my desired area without first completing a fellowship 5.9% Scientific or research interest 3.9% Deadlines for applications Complex clinic interactions (expensive medication with authorization process, 2.0% multidisciplinary aspect of care) 2.0% National availability of fellowships 0.0% Ease of available funds and grants for fellowships 3

2015 Fellowship Survey Results: 7/21/2016 EMG response: 6.6% (51/776)

0.0% Family or friend affected by disease 0.0% National Residency Match Program (NRMP) Specialties Matching Service for fellowships 0.0% Other (please specify): 2Response options were randomly presented 3Total may exceed 100%.

Of the factors that influenced your decision to select the EMG fellowship, please rank up to three of the most important factors (1=most important, 2=second-most important, 3=third-most important).4

Rank Sum5 Rank Factor that Influenced Fellowship Decision 84 1 Clinical interest (n=34) 47 2 Ability to incorporate fellowship training into a general neurology practice (n=21) 44 3 Personal interest (n=19) 29 4 I felt I needed more training (n=14) 16 5 Influenced by a role model or mentor during residency or other training (n=9) 13 6 Exposure to subspecialty during residency (n=6) Better lifestyle opportunities within the subspecialty area (presence of nights on call 12 7 during fellowship and beyond) (n=9) Greater financial opportunities within the subspecialty area (ease of generating 12 7 revenue) (n=8) 10 9 Fellowship availability at residency institution (n=5) 6 10 ACGME or UCNS certification at the end of fellowship (n=4) 4 11 Scientific or research interest (n=3) 4 11 Local or regional availability of fellowships (n=3) 2 13 Deadlines for applications (n=1) I would not be able to get a job in my desired area without first completing a 2 13 fellowship (n=1) 1 15 Perceptions of post-fellowship opportunities in selected subspecialty area (n=1) 0 - National availability of fellowships (n=0) Complex clinic interactions (expensive medication with authorization process, 0 - multidisciplinary aspect of care) (n=0) 0 - Family or friend affected by disease (n=0) 0 - Ease of available funds and grants for fellowships (n=0) National Residency Match Program (NRMP) Specialties Matching Service for 0 - fellowships (n=0) 0 - Other (please specify): (n=0) 4Only responses selected in question 6 were displayed. 5Value for rank: 1=3, 2=2, 3=1.

2015 Fellowship Survey Results: 7/21/2016 EMG response: 6.6% (51/776)

You indicated that a role model or mentor influenced your decision to select the EMG fellowship. What primary subspecialty area did your role model or mentor work in? (n=20)

55.0% Neuromuscular medicine 0.0% Neurogenetics 30.0% Clinical neurophysiology 0.0% Neurohospitalist 5.0% General neurology 0.0% Neuroimaging 5.0% Movement disorders Neuroimmunology and multiple 0.0% 5.0% Neurophysiology sclerosis 0.0% Autonomic disorders 0.0% Neuromuscular medicine Behavioral neurology and 0.0% Neuromuscular pathology 0.0% neuropsychiatry 0.0% Neuro-oncology 0.0% Child neurology 0.0% Neuro-ophthalmology Endovascular and interventional 0.0% Neuro-otology 0.0% neurology 0.0% Pain medicine 0.0% Epilepsy 0.0% Palliative neurology 0.0% Geriatric neurology 0.0% Sleep medicine 0.0% Headache medicine 0.0% Sports neurology Infectious diseases and 0.0% Traumatic brain injury 0.0% neurovirology 0.0% Unsure 0.0% Neural repair and rehabilitation 0.0% Vascular neurology and stroke 0.0% Neurocritical care 0.0% Other (please specify): 0.0% Neuroepidemiology

2015 Fellowship Survey – Epilepsy Subspecialty Analysis Results: 2/9/2016 Epilepsy response: 11% (87/776)

2/9/16

A MERICAN EPILEPSY SUBSPECIALTY ANALYSIS FROM THE 2015 ACADEMY OF FELLOWSHIP SURVEY N EUROLOGY

2015 Fellowship Survey – Epilepsy Subspecialty Analysis Results: 2/9/2016 Epilepsy response: 11% (87/776)

Frequencies – Epilepsy Subspecialty Questions ***Displayed to those who selected Epilepsy as their first fellowship choice.

In your residency program, have you had teaching devoted to functional neurologic disorders such as psychogenic nonepileptic spells/seizures? Mark all that apply.1 (n=72)

65.3% Yes, as part of a didactic lecture that addressed differential diagnosis from neurologic disease such as epilepsy 36.1% Yes, there was at least one dedicated lecture on the topic 72.2% Yes, as part of clinical supervision in the Epilepsy Monitoring Unit 43.1% Yes, as part of clinical supervision in the outpatient setting 5.6% Yes, as part of a medical simulation teaching exercise 26.4% Yes, using a video library of different seizure types including both epileptic and nonepileptic seizures to learn differential diagnosis or an equivalent for other functional neurological syndromes 4.2% Yes, as part of a formal journal club 4.2% Yes, but only after requesting the topic 5.6% No, I have not yet had teaching specifically about this topic2 1Total may exceed 100%. 2Exclusive response option.

In your residency training program, what were you taught about conversion disorder (also known as functional neurologic symptom disorder)? Mark all that apply.3 (n=72)

88.9% How to distinguish neurological disease from functional disorder 81.9% How to communicate the diagnosis to patients and/or their families 45.8% How to collaborate with psychiatry to create comprehensive explanatory models 33.3% How to treat conversion disorder 4.2% There was no teaching in my residency about conversion disorder4 3Total may exceed 100%. 4Exclusive response option.

How comfortable are you in knowing how to communicate a diagnosis of psychogenic nonepileptic seizure or other functional neurologic disorder to a patient who has been definitively diagnosed? (n=71)

26.8% Extremely comfortable 59.2% Comfortable 11.3% Neither comfortable, nor uncomfortable 1.4% Uncomfortable 1.4% Extremely uncomfortable

2015 Fellowship Survey – Epilepsy Subspecialty Analysis Results: 2/9/2016 Epilepsy response: 11% (87/776)

Survey Frequencies by Epilepsy Fellowship

Please indicate all of the neurology fellowship areas you are considering (or did consider, prior to fellowship). Mark all that apply.5 (n=87) ***Filtered by those who selected Epilepsy as their fellowship choice.

100.0% Epilepsy 2.3% Intervention neuroradiology 60.9% EEG – Clinical neurophysiology 2.3% Neurogenetics 11.5% Sleep medicine 2.3% Neuromuscular medicine 10.3% EMG – Clinical neurophysiology 2.3% Neuro-oncology 6.9% Child neurology 2.3% Neuro-ophtalmology 5.7% Movement disorders 2.3% Neuro-otology 5.7% Neurocritical care 1.1% Autonomic disorders 4.6% Neuroimmunology and multiple 1.1% Neuropharmacology sclerosis 1.1% Other (please specify): 4.6% Vascular neurology and stroke 1.1% Pain medicine 3.4% Clinical research 0% Balance disorders 3.4% Cognitive disorders 0% Complementary medicine 3.4% Headache medicine 0% Geriatric neurology 3.4% Neurohospitalist 0% Neural repair and rehabilitation 3.4% Neuroimaging 0% Neuroimaging 3.4% Neuroinfectious disease 0% Neuropharmacology 3.4% Sports neurology 0% Palliative medicine 2.3% Behavioral neurology and 0% Unsure neuropsychiatry 5Total may exceed 100%.

What factors influenced your decision to select the Epilepsy fellowship?6 Mark all that apply.7 (n=86)

81.4% Clinical interest 51.2% Exposure to subspecialty during residency 45.3% Personal interest 41.9% Influenced by a role model or mentor during residency or other training 38.4% Scientific or research interest 29.1% Ability to incorporate fellowship training into a general neurology practice 27.9% Better lifestyle opportunities within the subspecialty area (presence of nights on call during fellowship and beyond) 26.7% I felt I needed more training 22.1% Perceptions of post-fellowship opportunities in selected subspecialty area 16.3% ACGME or UCNS certification at the end of fellowship 15.1% I would not be able to get a job in my desired area without first completing a fellowship 12.8% Greater financial opportunities within the subspecialty area (ease of generating revenue) 10.5% Complex clinic interactions (expensive medication with authorization process, multidisciplinary aspect of care) 9.3% Fellowship availability at residency institution 9.3% Local or regional availability of fellowships 5.8% Family or friend affected by disease 5.8% National availability of fellowships 4.7% Ease of available funds and grants for fellowships 3

2015 Fellowship Survey – Epilepsy Subspecialty Analysis Results: 2/9/2016 Epilepsy response: 11% (87/776)

2.3% Other (please specify): 1.2% Deadlines for applications 0.0% National Residency Match Program (NRMP) Specialties Matching Service for fellowships 6Response options were randomly presented 7Total may exceed 100%.

Of the factors that influenced your decision to select the Epilepsy fellowship, please rank up to three of the most important factors (1=most important, 2=second-most important, 3=third- most important).8

Rank Sum9 Rank Factor that Influenced Fellowship Decision 161 1 Clinical interest (n=63) 73 2 Personal interest (n=30) 50 3 Scientific or research interest (n=26) 41 4 Exposure to subspecialty during residency (n=21) 33 5 Influenced by a role model or mentor during residency or other training (n=20) 32 6 Ability to incorporate fellowship training into a general neurology practice (n=16) Better lifestyle opportunities within the subspecialty area (presence of nights on call 20 7 during fellowship and beyond) (n=9) 17 8 I felt I needed more training (n=9) I would not be able to get a job in my desired area without first completing a 12 9 fellowship (n=8) 11 10 Perceptions of post-fellowship opportunities in selected subspecialty area (n=9) Greater financial opportunities within the subspecialty area (ease of generating 7 11 revenue) (n=5) 5 12 Local or regional availability of fellowships (n=3) 4 13 ACGME or UCNS certification at the end of fellowship (n=4) 4 13 Other (please specify): (n=2) 3 15 Ease of available funds and grants for fellowships (n=3) Complex clinic interactions (expensive medication with authorization process, 3 15 multidisciplinary aspect of care) (n=2) 1 17 National availability of fellowships (n=1) 0 - Deadlines for applications 0 - Family or friend affected by disease 0 - Fellowship availability at residency institution National Residency Match Program (NRMP) Specialties Matching Service for 0 - fellowships 8Only responses selected in question 6 were displayed. 9Value for rank: 1=3, 2=2, 3=1.

2015 Fellowship Survey – Epilepsy Subspecialty Analysis Results: 2/9/2016 Epilepsy response: 11% (87/776)

You indicated that a role model or mentor influenced your decision to select the Epilepsy fellowship. What primary subspecialty area did your role model or mentor work in? (n=36)

83.3% Epilepsy 0.0% Neuroimaging 8.3% General neurology 0.0% Neuroimmunology and multiple 5.6% Child neurology sclerosis 2.8% Sleep medicine 0.0% Neuromuscular medicine 0.0% Autonomic disorders 0.0% Neuromuscular pathology 0.0% Behavioral neurology and 0.0% Neuro-oncology neuropsychiatry 0.0% Neuro-ophthalmology 0.0% Clinical neurophysiology 0.0% Neuro-otology 0.0% Endovascular and interventional 0.0% Neurophysiology neurology 0.0% Neural repair and rehabilitation 0.0% Geriatric neurology 0.0% Pain medicine 0.0% Headache medicine 0.0% Palliative neurology 0.0% Infectious diseases and 0.0% Sports neurology neurovirology 0.0% Traumatic brain injury 0.0% Movement disorders 0.0% Unsure 0.0% Neurocritical care 0.0% Vascular neurology and stroke 0.0% Neuroepidemiology 0.0% Other (please specify): 0.0% Neurogenetics 0.0% Neurohospitalist

2015 Fellowship Survey Results: 7/21/2016 Movement Disorders response: 11.9% (92/776)

7/21/16

A MERICAN

A CADEMY OF MOVEMENT DISORDERS FELLOWSHIP FREQUENCIES N EUROLOGY

2015 Fellowship Survey Results: 7/21/2016 Movement Disorders response: 11.9% (92/776)

Survey Frequencies by Movement Disorders Fellowship ***Filtered by those who selected Movement Disorders as their fellowship choice.

Please indicate all of the neurology fellowship areas you are considering (or did consider, prior to fellowship). Mark all that apply.1 (n=92)

100.0% Movement disorders 2.2% Neural repair & rehabilitation 12.0% Cognitive disorders 2.2% Neuro-ophtalmology Behavioral neurology and 2.2% Sports neurology 8.7% neuropsychiatry 1.1% Neurohospitalist 8.7% EEG – Clinical neurophysiology Neuroimmunology & multiple 1.1% 8.7% EMG – Clinical neurophysiology sclerosis 7.6% Epilepsy 1.1% Neuroinfectious disease 5.4% Neuromuscular medicine 1.1% Pain medicine 4.3% Sleep medicine 1.1% Other (please specify): 4.3% Neurocritical care 0.0% Complementary medicine 3.3% Autonomic disorders 0.0% Neuro-oncology 3.3% Clinical research 0.0% Neuro-otology 3.3% Headache medicine 0.0% Neuroendocrinology 3.3% Neuroimaging 0.0% Neurogenetics 3.3% Vascular neurology & stroke 0.0% Neuroinfectious disease 2.2% Balance disorders 0.0% Neuropharmacology 2.2% Child neurology 0.0% Palliative medicine 1 2.2% Geriatric neurology Total may exceed 100%. 2.2% Intervention neuroradiology

What factors influenced your decision to select the Movement Disorders fellowship?2 Mark all that apply.3 (n=91)

86.8% Clinical interest 70.3% Personal interest 62.6% Influenced by a role model or mentor during residency or other training 49.5% Scientific or research interest 42.9% Exposure to subspecialty during residency Better lifestyle opportunities within the subspecialty area (presence of nights on call during 36.3% fellowship and beyond) 28.6% I felt I needed more training 19.8% Fellowship availability at residency institution 19.8% Perceptions of post-fellowship opportunities in selected subspecialty area 18.7% Ability to incorporate fellowship training into a general neurology practice Complex clinic interactions (expensive medication with authorization process, 15.4% multidisciplinary aspect of care) 13.2% Greater financial opportunities within the subspecialty area (ease of generating revenue) 13.2% I would not be able to get a job in my desired area without first completing a fellowship 12.1% Family or friend affected by disease 11.0% Local or regional availability of fellowships 7.7% Ease of available funds and grants for fellowships 3.3% National availability of fellowships 3.3% Other (please specify): 2

2015 Fellowship Survey Results: 7/21/2016 Movement Disorders response: 11.9% (92/776)

1.1% ACGME or UCNS certification at the end of fellowship 1.1% Deadlines for applications 1.1% National Residency Match Program (NRMP) Specialties Matching Service for fellowships 2Response options were randomly presented 3Total may exceed 100%.

Of the factors that influenced your decision to select the Movement Disorders fellowship, please rank up to three of the most important factors (1=most important, 2=second-most important, 3=third-most important).4

Rank Sum5 Rank Factor that Influenced Fellowship Decision 167 1 Clinical interest (n=67) 78 2 Personal interest (n=34) 66 3 Scientific or research interest (n=34) 61 4 Influenced by a role model or mentor during residency or other training (n=33) Better lifestyle opportunities within the subspecialty area (presence of nights on call 31 5 during fellowship and beyond) (n=21) 21 6 Exposure to subspecialty during residency (n=13) 17 7 Ability to incorporate fellowship training into a general neurology practice (n=7) 15 8 I felt I needed more training (n=10) I would not be able to get a job in my desired area without first completing a 12 9 fellowship (n=5) 11 10 Perceptions of post-fellowship opportunities in selected subspecialty area (n=7) 11 10 Fellowship availability at residency institution (n=6) 4 12 Family or friend affected by disease (n=2) 4 12 Other (please specify): (n=2) Complex clinic interactions (expensive medication with authorization process, 3 14 multidisciplinary aspect of care) (n=2) Greater financial opportunities within the subspecialty area (ease of generating 3 14 revenue) (n=2) 2 16 Local or regional availability of fellowships (n=2) 1 18 Ease of available funds and grants for fellowships (n=1) 0 - National availability of fellowships (n=0) 0 - ACGME or UCNS certification at the end of fellowship (n=0) 0 - Deadlines for applications (n=0) National Residency Match Program (NRMP) Specialties Matching Service for 0 - fellowships (n=0) 4Only responses selected in question 6 were displayed. 5Value for rank: 1=3, 2=2, 3=1.

2015 Fellowship Survey Results: 7/21/2016 Movement Disorders response: 11.9% (92/776)

You indicated that a role model or mentor influenced your decision to select the Movement Disorders fellowship. What primary subspecialty area did your role model or mentor work in? (n=53)

92.5% Movement disorders 0.0% Neuro-oncology 1.9% Autonomic disorders 0.0% Neuro-ophthalmology 1.9% Neuromuscular medicine 0.0% Neuro-otology 1.9% Vascular neurology and stroke 0.0% Neurocritical care 1.9% Unsure 0.0% Neuroepidemiology Behavioral neurology and 0.0% Neurogenetics 0.0% neuropsychiatry 0.0% Neurohospitalist 0.0% Child neurology 0.0% Neuroimaging 0.0% Clinical neurophysiology Neuroimmunology and multiple 0.0% Endovascular and interventional sclerosis 0.0% neurology 0.0% Neuromuscular pathology 0.0% Epilepsy 0.0% Neurophysiology 0.0% General neurology 0.0% Pain medicine 0.0% Geriatric neurology 0.0% Palliative neurology 0.0% Headache medicine 0.0% Sleep medicine Infectious diseases and 0.0% Sports neurology 0.0% neurovirology 0.0% Traumatic brain injury 0.0% Neural repair and rehabilitation 0.0% Other (please specify):

2015 Fellowship Survey Results: 7/21/2016 MS response: 6% (45/776)

7/21/16

A MERICAN

A CADEMY OF MS FELLOWSHIP FREQUENCIES N EUROLOGY

2015 Fellowship Survey Results: 7/21/2016 MS response: 6% (45/776)

Survey Frequencies by MS Fellowship ***Filtered by those who selected Neuroimmunology and multiple sclerosis as their fellowship choice.

Please indicate all of the neurology fellowship areas you are considering (or did consider, prior to fellowship). Mark all that apply.1 (n=45)

Neuroimmunology and multiple 2.2% Neurocritical care 100.0% sclerosis 2.2% Neuropharmacology 20.0% Neuroinfectious disease 2.2% Pain medicine 8.9% Neural repair and rehabilitation 2.2% Sleep medicine 8.9% Neuromuscular medicine 2.2% Sports neurology 8.9% Vascular neurology and stroke 0.0% Balance disorders 6.7% Clinical research 0.0% Complementary medicine 6.7% Cognitive disorders 0.0% Geriatric neurology 6.7% Epilepsy 0.0% Intervention neuroradiology 6.7% Neuro-ophtalmology 0.0% Neurogenetics 6.7% Neuroimaging 0.0% Neurohospitalist 4.4% Autonomic disorders 0.0% Neuroimaging Behavioral neurology and 0.0% Neuro-otology 4.4% neuropsychiatry 0.0% Neuro-oncology 4.4% EMG – Clinical neurophysiology 0.0% Neuropharmacology 4.4% Headache medicine 0.0% Other (please specify): 4.4% Movement disorders 0.0% Palliative medicine 2.2% Child neurology 0.0% Unsure 2.2% EEG – Clinical neurophysiology 1Total may exceed 100%.

What factors influenced your decision to select the MS fellowship?2 Mark all that apply.3 (n=45)

75.6% Clinical interest 60.0% Personal interest 57.8% Scientific or research interest 40.0% Influenced by a role model or mentor during residency or other training 40.0% Exposure to subspecialty during residency 24.4% I felt I needed more training 22.2% Ability to incorporate fellowship training into a general neurology practice Complex clinic interactions (expensive medication with authorization process, 20.0% multidisciplinary aspect of care) Better lifestyle opportunities within the subspecialty area (presence of nights on call during 17.8% fellowship and beyond) 13.3% Fellowship availability at residency institution 11.1% Perceptions of post-fellowship opportunities in selected subspecialty area 8.9% Ease of available funds and grants for fellowships 6.7% Local or regional availability of fellowships 6.7% Family or friend affected by disease 4.4% Greater financial opportunities within the subspecialty area (ease of generating revenue) 4.4% I would not be able to get a job in my desired area without first completing a fellowship 2.2% Deadlines for applications 0.0% ACGME or UCNS certification at the end of fellowship 2

2015 Fellowship Survey Results: 7/21/2016 MS response: 6% (45/776)

0.0% National availability of fellowships 0.0% National Residency Match Program (NRMP) Specialties Matching Service for fellowships 0.0% Other (please specify): 2Response options were randomly presented 3Total may exceed 100%.

Of the factors that influenced your decision to select the MS fellowship, please rank up to three of the most important factors (1=most important, 2=second-most important, 3=third-most important).4

Rank Sum5 Rank Factor that Influenced Fellowship Decision 84 1 Clinical interest (n=32) 54 2 Scientific or research interest (n=22) 33 3 Personal interest (n=15) 21 4 Influenced by a role model or mentor during residency or other training (n=11) 11 5 Ability to incorporate fellowship training into a general neurology practice (n=7) 10 6 Exposure to subspecialty during residency (n=7) Better lifestyle opportunities within the subspecialty area (presence of nights on call 9 7 during fellowship and beyond) (n=5) Complex clinic interactions (expensive medication with authorization process, 6 10 multidisciplinary aspect of care) (n=5) 6 10 I felt I needed more training (n=4) 6 10 Fellowship availability at residency institution (n=4) 3 12 Perceptions of post-fellowship opportunities in selected subspecialty area (n=2) 3 12 Family or friend affected by disease (n=2) 2 13 Ease of available funds and grants for fellowships (n=2) I would not be able to get a job in my desired area without first completing a 1 15 fellowship (n=1) 1 15 Deadlines for applications (n=1) 0 - ACGME or UCNS certification at the end of fellowship (n=0) Greater financial opportunities within the subspecialty area (ease of generating 0 - revenue) (n=0) 0 - Local or regional availability of fellowships (n=0) 0 - National availability of fellowships (n=0) National Residency Match Program (NRMP) Specialties Matching Service for 0 - fellowships (n=0) 0 - Other (please specify): (n=0) 4Only responses selected in question 6 were displayed. 5Value for rank: 1=3, 2=2, 3=1.

2015 Fellowship Survey Results: 7/21/2016 MS response: 6% (45/776)

You indicated that a role model or mentor influenced your decision to select the MS fellowship. What primary subspecialty area did your role model or mentor work in? (n=18)

Neuroimmunology and multiple 0.0% Neuroepidemiology 88.9% sclerosis 0.0% Neurogenetics 5.6% Neuro-oncology 0.0% Neurohospitalist 5.6% Neurohospitalist 0.0% Neuroimaging 0.0% Autonomic disorders 0.0% Neuromuscular medicine Behavioral neurology and 0.0% Neuromuscular pathology 0.0% neuropsychiatry 0.0% Neuro-oncology 0.0% Child neurology 0.0% Neuro-ophthalmology 0.0% Clinical neurophysiology 0.0% Neuro-otology Endovascular and interventional 0.0% Neurophysiology 0.0% neurology 0.0% Neural repair and rehabilitation 0.0% Epilepsy 0.0% Pain medicine 0.0% Geriatric neurology 0.0% Palliative neurology 0.0% General neurology 0.0% Sleep medicine 0.0% Headache medicine 0.0% Sports neurology Infectious diseases and 0.0% Traumatic brain injury 0.0% neurovirology 0.0% Unsure 0.0% Movement disorders 0.0% Vascular neurology and stroke 0.0% Neurocritical care 0.0% Other (please specify):

2015 Fellowship Survey Results: 7/21/2016 Neurocritical Care response: 10.6% (82/776)

7/21/16

A MERICAN

A CADEMY OF NEUROCRITICAL CARE FELLOWSHIP FREQUENCIES N EUROLOGY

2015 Fellowship Survey Results: 7/21/2016 Neurocritical Care response: 10.6% (82/776)

Survey Frequencies by Neurocritical Care Fellowship ***Filtered by those who selected Neurocritical Care as their fellowship choice.

Please indicate all of the neurology fellowship areas you are considering (or did consider, prior to fellowship). Mark all that apply.1 (n=82)

100.0% Neurocritical care 1.2% Palliative medicine 23.2% Vascular neurology & stroke 0.0% Balance disorders 18.3% EEG – Clinical neurophysiology 0.0% Clinical research 14.6% Epilepsy 0.0% Complementary medicine 9.8% Neurohospitalist 0.0% Headache medicine 8.5% Intervention neuroradiology 0.0% Neuro-ophtalmology 4.9% Neuro-oncology 0.0% Neuro-otology Behavioral neurology & 0.0% Neuroendocrinology 3.7% neuropsychiatry 0.0% Neurogenetics 3.7% Neuroimaging Neuroimmunology & multiple 0.0% 2.4% Cognitive disorders sclerosis 2.4% Neural repair & rehabilitation 0.0% Neuroinfectious disease 2.4% Sports neurology 0.0% Neuropharmacology 1.2% Autonomic disorders 0.0% Pain medicine 1.2% EMG – Clinical neurophysiology 0.0% Sleep medicine 1.2% Geriatric neurology 0.0% Other (please specify): 1.2% Movement disorders 0.0% Unsure 1.2% Neuromuscular medicine 1Total may exceed 100%.

What factors influenced your decision to select the Neurocritical Care fellowship?2 Mark all that apply.3 (n=82)

92.7% Clinical interest 74.4% Personal interest 58.5% Exposure to subspecialty during residency 58.5% Influenced by a role model or mentor during residency or other training 43.9% Scientific or research interest 39.0% Perceptions of post-fellowship opportunities in selected subspecialty area 36.6% Greater financial opportunities within the subspecialty area (ease of generating revenue) Complex clinic interactions (expensive medication with authorization process, 20.7% multidisciplinary aspect of care) 20.7% I would not be able to get a job in my desired area without first completing a fellowship 18.3% ACGME or UCNS certification at the end of fellowship Better lifestyle opportunities within the subspecialty area (presence of nights on call during 13.4% fellowship and beyond) 13.4% I felt I needed more training 12.2% Fellowship availability at residency institution 7.3% Local or regional availability of fellowships 6.1% Ability to incorporate fellowship training into a general neurology practice 3.7% Family or friend affected by disease 2.4% National availability of fellowships 2.4% Ease of available funds and grants for fellowships 2

2015 Fellowship Survey Results: 7/21/2016 Neurocritical Care response: 10.6% (82/776)

1.2% National Residency Match Program (NRMP) Specialties Matching Service for fellowships 1.2% Other (please specify): 0.0% Deadlines for applications 2Response options were randomly presented 3Total may exceed 100%.

Of the factors that influenced your decision to select the Neurocritical Care fellowship, please rank up to three of the most important factors (1=most important, 2=second-most important, 3=third-most important).4

Rank Sum5 Rank Factor that Influenced Fellowship Decision 175 1 Clinical interest (n=68) 92 2 Personal interest (n=39) 53 3 Scientific or research interest (n=30) 40 4 Influenced by a role model or mentor during residency or other training (n=29) 27 5 Exposure to subspecialty during residency (n=17) Greater financial opportunities within the subspecialty area (ease of generating 15 6 revenue) (n=9) 12 7 Perceptions of post-fellowship opportunities in selected subspecialty area (n=7) Complex clinic interactions (expensive medication with authorization process, 12 7 multidisciplinary aspect of care) (n=6) I would not be able to get a job in my desired area without first completing a 7 9 fellowship (n=5) 7 9 ACGME or UCNS certification at the end of fellowship (n=4) Better lifestyle opportunities within the subspecialty area (presence of nights on call 6 11 during fellowship and beyond) (n=3) 3 12 Local or regional availability of fellowships (n=2) 3 12 I felt I needed more training (n=2) 2 14 Ability to incorporate fellowship training into a general neurology practice (n=1) 2 14 Other (please specify): (n=1) 1 16 Fellowship availability at residency institution (n=1) 0 - National availability of fellowships (n=0) 0 - Family or friend affected by disease (n=0) 0 - Ease of available funds and grants for fellowships (n=0) 0 - Deadlines for applications (n=0) National Residency Match Program (NRMP) Specialties Matching Service for 0 - fellowships (n=0) 4Only responses selected in question 6 were displayed. 5Value for rank: 1=3, 2=2, 3=1.

2015 Fellowship Survey Results: 7/21/2016 Neurocritical Care response: 10.6% (82/776)

You indicated that a role model or mentor influenced your decision to select the Neurocritical Care fellowship. What primary subspecialty area did your role model or mentor work in? (n=46)

80.4% Neurocritical care 0.0% Neurogenetics 10.9% Vascular neurology and stroke 0.0% Neurohospitalist 4.3% Epilepsy 0.0% Neuroimaging Behavioral neurology and Neuroimmunology and multiple 2.2% 0.0% neuropsychiatry sclerosis 2.2% Unsure 0.0% Neuromuscular medicine 0.0% Autonomic disorders 0.0% Neuromuscular pathology 0.0% Child neurology 0.0% Neuro-oncology 0.0% Clinical neurophysiology 0.0% Neuro-ophthalmology Endovascular and interventional 0.0% Neuro-otology 0.0% neurology 0.0% Neurophysiology 0.0% Geriatric neurology 0.0% Neural repair and rehabilitation 0.0% General neurology 0.0% Pain medicine 0.0% Headache medicine 0.0% Palliative neurology Infectious diseases and 0.0% Sleep medicine 0.0% neurovirology 0.0% Sports neurology 0.0% Movement disorders 0.0% Traumatic brain injury 0.0% Neuroepidemiology 0.0% Other (please specify):

2015 Fellowship Survey Results: 7/21/2016 Neuromuscular response: 8.4% (65/776)

7/21/16

A MERICAN

A CADEMY OF NEUROMUSCULAR FELLOWSHIP FREQUENCIES N EUROLOGY

2015 Fellowship Survey Results: 7/21/2016 Neuromuscular response: 8.4% (65/776)

Survey Frequencies by Neuromuscular Fellowship ***Filtered by those who selected Neuromuscular as their fellowship choice.

Please indicate all of the neurology fellowship areas you are considering (or did consider, prior to fellowship). Mark all that apply.1 (n=65)

100.0% Neuromuscular medicine 1.5% Neurogenetics 49.2% EMG – Clinical neurophysiology 1.5% Neuroimaging Neuroimmunology & multiple 1.5% Pain medicine 12.3% sclerosis 1.5% Palliative medicine 9.2% Movement disorders 0.0% Balance disorders 9.2% Neurocritical care Behavioral neurology & 0.0% 7.7% Sports neurology neuropsychiatry 7.7% Vascular neurology & stroke 0.0% Clinical research 6.2% Epilepsy 0.0% Complementary medicine 6.2% Sleep medicine 0.0% EEG – Clinical neurophysiology 4.6% Child neurology 0.0% Geriatric neurology 3.1% Autonomic disorders 0.0% Headache medicine 3.1% Intervention neuroradiology 0.0% Neuro-otology 3.1% Neurohospitalist 0.0% Neuroendocrinology 3.1% Neuroinfectious disease 0.0% Neuropharmacology 1.5% Cognitive disorders 0.0% Other (please specify): 1.5% Neural repair & rehabilitation 0.0% Unsure 1 1.5% Neuro-oncology Total may exceed 100%. 1.5% Neuro-ophtalmology

What factors influenced your decision to select the Neuromuscular fellowship?2 Mark all that apply.3 (n=65)

84.6% Clinical interest 72.3% Personal interest 50.8% Influenced by a role model or mentor during residency or other training 49.2% Exposure to subspecialty during residency Better lifestyle opportunities within the subspecialty area (presence of nights on call during 38.5% fellowship and beyond) 38.5% I felt I needed more training 29.2% Perceptions of post-fellowship opportunities in selected subspecialty area 29.2% Ability to incorporate fellowship training into a general neurology practice 29.2% Fellowship availability at residency institution 21.5% Scientific or research interest 13.8% Greater financial opportunities within the subspecialty area (ease of generating revenue) 13.8% ACGME or UCNS certification at the end of fellowship 9.2% I would not be able to get a job in my desired area without first completing a fellowship 9.2% Local or regional availability of fellowships Complex clinic interactions (expensive medication with authorization process, 7.7% multidisciplinary aspect of care) 3.1% Family or friend affected by disease 1.5% National availability of fellowships 1.5% Ease of available funds and grants for fellowships 2

2015 Fellowship Survey Results: 7/21/2016 Neuromuscular response: 8.4% (65/776)

0.0% Deadlines for applications 0.0% National Residency Match Program (NRMP) Specialties Matching Service for fellowships 0.0% Other (please specify): 2Response options were randomly presented 3Total may exceed 100%.

Of the factors that influenced your decision to select the Neuromuscular fellowship, please rank up to three of the most important factors (1=most important, 2=second-most important, 3=third-most important).4

Rank Sum5 Rank Factor that Influenced Fellowship Decision 119 1 Clinical interest (n=47) 67 2 Personal interest (n=30) 32 3 Influenced by a role model or mentor during residency or other training (n=18) 32 3 I felt I needed more training (n=16) 23 5 Ability to incorporate fellowship training into a general neurology practice (n=11) Better lifestyle opportunities within the subspecialty area (presence of nights on call 22 6 during fellowship and beyond) (n=12) 20 7 Exposure to subspecialty during residency (n=11) 18 8 Scientific or research interest (n=10) 10 9 Perceptions of post-fellowship opportunities in selected subspecialty area (n=7) 9 10 Fellowship availability at residency institution (n=6) I would not be able to get a job in my desired area without first completing a 6 11 fellowship (n=3) Greater financial opportunities within the subspecialty area (ease of generating 5 12 revenue) (n=4) 3 13 ACGME or UCNS certification at the end of fellowship (n=3) 2 14 Local or regional availability of fellowships (n=1) Complex clinic interactions (expensive medication with authorization process, 2 14 multidisciplinary aspect of care) (n=1) 0 - National availability of fellowships 0 - Ease of available funds and grants for fellowships 0 - Deadlines for applications National Residency Match Program (NRMP) Specialties Matching Service for 0 - fellowships 0 - Family or friend affected by disease 0 - Other (please specify): 4Only responses selected in question 6 were displayed. 5Value for rank: 1=3, 2=2, 3=1.

2015 Fellowship Survey Results: 7/21/2016 Neuromuscular response: 8.4% (65/776)

You indicated that a role model or mentor influenced your decision to select the Neuromuscular fellowship. What primary subspecialty area did your role model or mentor work in? (n=33)

81.8% Neuromuscular medicine 0.0% Neurocritical care 3.0% Child neurology 0.0% Neuroepidemiology 3.0% Clinical neurophysiology 0.0% Neurogenetics Infectious diseases and 0.0% Neurohospitalist 3.0% neurovirology 0.0% Neuroimaging 3.0% Movement disorders 0.0% Neuromuscular pathology Neuroimmunology and multiple 0.0% Neuro-oncology 3.0% sclerosis 0.0% Neuro-ophthalmology 3.0% Neurophysiology 0.0% Neuro-otology 0.0% Autonomic disorders 0.0% Neural repair and rehabilitation Behavioral neurology and 0.0% Pain medicine 0.0% neuropsychiatry 0.0% Palliative neurology Endovascular and interventional 0.0% Sleep medicine 0.0% neurology 0.0% Sports neurology 0.0% Epilepsy 0.0% Traumatic brain injury 0.0% Geriatric neurology 0.0% Unsure 0.0% General neurology 0.0% Vascular neurology and stroke 0.0% Headache medicine 0.0% Other (please specify):14

2015 Fellowship Survey Results: 7/21/2016 Neuro-oncology response: 3.5% (27/776)

7/21/16

A MERICAN

A CADEMY OF NEURO-ONCOLOGY FELLOWSHIP FREQUENCIES N EUROLOGY

2015 Fellowship Survey Results: 7/21/2016 Neuro-oncology response: 3.5% (27/776)

Survey Frequencies by Neuro-oncology Fellowship ***Filtered by those who selected Neuro-oncology as their fellowship choice.

Please indicate all of the neurology fellowship areas you are considering (or did consider, prior to fellowship). Mark all that apply.1 (n=27)

100.0% Neuro-oncology 0.0% Autonomic disorders 14.8% Vascular neurology and stroke 0.0% Balance disorders 11.1% Epilepsy 0.0% Complementary medicine 11.1% Neurocritical care 0.0% Geriatric neurology 7.4% EEG – Clinical neurophysiology 0.0% Neuro-ophtalmology 7.4% Headache medicine 0.0% Neuro-otology 7.4% Movement disorders 0.0% Neurogenetics Behavioral neurology & 0.0% Neurohospitalist 3.7% neuropsychiatry 0.0% Neuroimaging 3.7% Child neurology Neuroimmunology & multiple 0.0% 3.7% Clinical research sclerosis 3.7% Cognitive disorders 0.0% Neuroinfectious disease 3.7% EMG – Clinical neurophysiology 0.0% Neuromuscular medicine 3.7% Intervention neuroradiology 0.0% Neuropharmacology 3.7% Neural repair & rehabilitation 0.0% Pain medicine 3.7% Neuroendocrinology 0.0% Palliative medicine 3.7% Neuroimaging 0.0% Unsure 3.7% Neuropharmacology 0.0% Other (please specify): 3.7% Sports neurology 1Total may exceed 100%.

What factors influenced your decision to select the Neuro-oncology fellowship?2 Mark all that apply.3 (n=27)

88.9% Clinical interest 77.8% Scientific or research interest 70.4% Personal interest 63.0% Influenced by a role model or mentor during residency or other training Better lifestyle opportunities within the subspecialty area (presence of nights on call during 40.7% fellowship and beyond) 40.7% Exposure to subspecialty during residency 29.6% ACGME or UCNS certification at the end of fellowship Complex clinic interactions (expensive medication with authorization process, 25.9% multidisciplinary aspect of care) 22.2% Perceptions of post-fellowship opportunities in selected subspecialty area 18.5% I would not be able to get a job in my desired area without first completing a fellowship 11.1% Ability to incorporate fellowship training into a general neurology practice 11.1% I felt I needed more training 7.4% Family or friend affected by disease 7.4% Fellowship availability at residency institution 7.4% Ease of available funds and grants for fellowships 3.7% Greater financial opportunities within the subspecialty area (ease of generating revenue) 3.7% Other (please specify): 2

2015 Fellowship Survey Results: 7/21/2016 Neuro-oncology response: 3.5% (27/776)

0.0% Deadlines for applications 0.0% National availability of fellowships 0.0% National Residency Match Program (NRMP) Specialties Matching Service for fellowships 0.0% Other (please specify): 2Response options were randomly presented 3Total may exceed 100%.

Of the factors that influenced your decision to select the Neuro-oncology fellowship, please rank up to three of the most important factors (1=most important, 2=second-most important, 3=third-most important).4

Rank Sum5 Rank Factor that Influenced Fellowship Decision 56 1 Clinical interest (n=22) 31 2 Scientific or research interest (n=16) 22 3 Personal interest (n=10) 13 4 Exposure to subspecialty during residency (n=6) 12 5 Influenced by a role model or mentor during residency or other training (n=8) Better lifestyle opportunities within the subspecialty area (presence of nights on call 5 6 during fellowship and beyond) (n=5) Complex clinic interactions (expensive medication with authorization process, 4 7 multidisciplinary aspect of care) (n=2) 3 8 Fellowship availability at residency institution (n=2) 3 8 Family or friend affected by disease (n=1) I would not be able to get a job in my desired area without first completing a 3 8 fellowship (n=1) 2 11 Perceptions of post-fellowship opportunities in selected subspecialty area (n=2) 2 11 ACGME or UCNS certification at the end of fellowship (n=1) 2 11 Ease of available funds and grants for fellowships (n=1) 1 14 I felt I needed more training (n=1) 0 - National availability of fellowships (n=0) 0 - Local or regional availability of fellowships (n=0) 0 - Ability to incorporate fellowship training into a general neurology practice (n=0) Greater financial opportunities within the subspecialty area (ease of generating 0 - revenue) (n=0) 0 - Deadlines for applications (n=0) National Residency Match Program (NRMP) Specialties Matching Service for 0 - fellowships (n=0) 0 - Other (please specify): (n=0) 4Only responses selected in question 6 were displayed. 5Value for rank: 1=3, 2=2, 3=1.

2015 Fellowship Survey Results: 7/21/2016 Neuro-oncology response: 3.5% (27/776)

You indicated that a role model or mentor influenced your decision to select the Neuro-oncology fellowship. What primary subspecialty area did your role model or mentor work in? (n=17)

76.5% Neuro-oncology 0.0% Neuro-otology 11.8% Other (please specify): 0.0% Neurocritical care 5.9% General neurology 0.0% Neuroepidemiology 5.9% Vascular neurology and stroke 0.0% Neurogenetics 0.0% Autonomic disorders 0.0% Neurohospitalist Behavioral neurology and 0.0% Neuroimaging 0.0% neuropsychiatry Neuroimmunology and multiple 0.0% 0.0% Child neurology sclerosis 0.0% Clinical neurophysiology 0.0% Neuromuscular medicine Endovascular and interventional 0.0% Neuromuscular pathology 0.0% neurology 0.0% Neurophysiology 0.0% Geriatric neurology 0.0% Pain medicine 0.0% Headache medicine 0.0% Palliative neurology Infectious diseases and 0.0% Sleep medicine 0.0% neurovirology 0.0% Sports neurology 0.0% Movement disorders 0.0% Traumatic brain injury 0.0% Neural repair and rehabilitation 0.0% Vascular neurology and stroke 0.0% Neuro-oncology 0.0% Unsure 0.0% Neuro-ophthalmology 0.0% Other (please specify):

2015 Fellowship Survey Results: 7/21/2016 Vascular Neurology & Stroke response: 14.4% (112/776)

7/21/16

A MERICAN VASCULAR NEUROLOGY & STROKE FELLOWSHIP ACADEMY OF FREQUENCIES N EUROLOGY

2015 Fellowship Survey Results: 7/21/2016 Vascular Neurology & Stroke response: 14.4% (112/776)

Survey Frequencies by Vascular Neurology & Stroke Fellowship ***Filtered by those who selected Vascular Neurology & Stroke as their fellowship choice.

Please indicate all of the neurology fellowship areas you are considering (or did consider, prior to fellowship). Mark all that apply.1 (n=112)

100.0% Vascular neurology and stroke 0.9% Sports neurology 19.6% Neurocritical care 0.0% Autonomic disorders 15.2% Intervention neuroradiology 0.0% Balance disorders 9.8% Neurohospitalist 0.0% Child neurology 8.0% EEG – Clinical neurophysiology 0.0% Clinical research 7.1% Epilepsy 0.0% Complementary medicine 6.3% Movement disorders 0.0% Geriatric neurology 6.3% Neuroimaging 0.0% Neuro-ophtalmology 4.5% Neuro-oncology 0.0% Neuro-otology 3.6% Headache medicine 0.0% Neuroendocrinology Behavioral neurology & 0.0% Neurogenetics 2.7% neuropsychiatry Neuroimmunology & multiple 0.0% 2.7% Cognitive disorders sclerosis 2.7% EMG – Clinical neurophysiology 0.0% Neuropharmacology 1.8% Neural repair & rehabilitation 0.0% Palliative medicine 1.8% Neuroinfectious disease 0.0% Other (please specify): 1.8% Pain medicine 0.0% Unsure 1 0.9% Neuromuscular medicine Total may exceed 100%. 0.9% Sleep medicine

What factors influenced your decision to select the Vascular Neurology & Stroke fellowship?2 Mark all that apply.3 (n=110)

79.1% Clinical research 65.5% Personal interest 60.9% Exposure to subspecialty during residency 58.2% Influenced by a role model or mentor during residency or other training 34.5% Perceptions of post-fellowship opportunities in selected subspecialty area 24.5% Scientific or research interest 22.7% Greater financial opportunities within the subspecialty area (ease of generating revenue) 19.1% Ability to incorporate fellowship training into a general neurology practice 18.2% Fellowship availability at residency institution 14.5% Family or friend affected by disease 12.7% ACGME or UCNS certification at the end of fellowship 12.7% I would not be able to get a job in my desired area without first completing a fellowship 9.1% I felt I needed more training 9.1% Local or regional availability of fellowships Complex clinic interactions (expensive medication with authorization process, 8.2% multidisciplinary aspect of care) 6.4% National availability of fellowships Better lifestyle opportunities within the subspecialty area (presence of nights on call during 2.7% fellowship and beyond) 2.7% Deadlines for applications 2

2015 Fellowship Survey Results: 7/21/2016 Vascular Neurology & Stroke response: 14.4% (112/776)

2.7% National Residency Match Program (NRMP) Specialties Matching Service for fellowships 0.9% Other (please specify): 0.0% Ease of available funds and grants for fellowships 2Response options were randomly presented 3Total may exceed 100%.

Of the factors that influenced your decision to select the Vascular Neurology & Stroke fellowship, please rank up to three of the most important factors (1=most important, 2=second-most important, 3=third-most important).4

Rank Sum5 Rank Factor that Influenced Fellowship Decision 194 1 Clinical interest (n=75) 127 2 Personal interest (n=52) 78 3 Influenced by a role model or mentor during residency or other training (n=44) 47 4 Exposure to subspecialty during residency (n=32) 36 5 Perceptions of post-fellowship opportunities in selected subspecialty area (n=21) 30 6 Scientific or research interest (n=16) Greater financial opportunities within the subspecialty area (ease of generating 20 7 revenue) (n=12) I would not be able to get a job in my desired area without first completing a 14 8 fellowship (n=6) 12 9 Family or friend affected by disease (n=6) 11 10 Ability to incorporate fellowship training into a general neurology practice (n=6) 10 11 Local or regional availability of fellowships (n=5) 10 11 Fellowship availability at residency institution (n=4) Complex clinic interactions (expensive medication with authorization process, 6 13 multidisciplinary aspect of care) (n=5) 6 13 ACGME or UCNS certification at the end of fellowship (n=4) 4 15 I felt I needed more training (n=4) National Residency Match Program (NRMP) Specialties Matching Service for 3 16 fellowships (n=1) 2 17 National availability of fellowships (n=1) 2 17 Deadlines for applications (n=1) Better lifestyle opportunities within the subspecialty area (presence of nights on call 1 19 during fellowship and beyond) (n=1) 0 - Ease of available funds and grants for fellowships (n=0) 0 - Other (please specify): (n=0) 4Only responses selected in question 6 were displayed. 5Value for rank: 1=3, 2=2, 3=1.

2015 Fellowship Survey Results: 7/21/2016 Vascular Neurology & Stroke response: 14.4% (112/776)

You indicated that a role model or mentor influenced your decision to select the Vascular Neurology & Stroke fellowship. What primary subspecialty area did your role model or mentor work in? (n=64)

89.1% Vascular neurology and stroke 0.0% Neuro-oncology Behavioral neurology and 0.0% Neuro-ophthalmology 4.7% neuropsychiatry 0.0% Neuro-otology 1.6% Child neurology 0.0% Neuroepidemiology Endovascular and interventional 0.0% Neurogenetics 1.6% neurology 0.0% Neuroimaging 1.6% Neurocritical care Neuroimmunology and multiple 0.0% 1.6% Neurohospitalist sclerosis 0.0% Autonomic disorders 0.0% Neuromuscular medicine 0.0% Clinical neurophysiology 0.0% Neuromuscular pathology 0.0% Epilepsy 0.0% Neurophysiology 0.0% General neurology 0.0% Pain medicine 0.0% Geriatric neurology 0.0% Palliative neurology 0.0% Headache medicine 0.0% Sleep medicine Infectious diseases and 0.0% Sports neurology 0.0% neurovirology 0.0% Traumatic brain injury 0.0% Movement disorders 0.0% Unsure 0.0% Neural repair and rehabilitation 0.0% Other (please specify):