The Neurodevelopmental Disabilities (NDD) Residency Program, under the direction of Patricia Evans, M.D., Ph.D., is an independent 4-year, ACGME-accredited program. The NDD resident follows a similar curriculum as core pediatric neurology but focuses on the evaluation, diagnosis, and ongoing pharmacotherapeutic and supportive therapies of children with a wide range of cognitive, motor, and emotional issues. These issues include, but are not limited to, cerebral palsy, epilepsy, chromosomal disorders, metabolic disorders, movement disorders, and learning disabilities such as ADHD and autism.

NDD is a discipline particularly focused on multidisciplinary team approaches, and as such, seeks to train NDD residents to not only be astute clinical scholars, but also advocates and thought leaders in the field of neurodevelopment.

Our exceptional neurology faculty includes specialists in neurodevelopmental disabilities, neurometabolism, neurogenetics, pediatric stroke, neuromuscular disorders, and pediatric epilepsy. Additionally, the NDD faculty works closely with the outstanding UTSW faculty in psychiatry, psychology, and physical medicine and rehabilitation. The NDD faculty also enjoys close working relationships with local public school districts as well as special needs private schools.

The Neurodevelopmental Disabilities resident enters the four-year NDD Residency Program at UT Southwestern after two years of pediatric residency training at an accredited program. While there can be variation in the exact schedule for a pediatric neurology trainee, the following represents an average four-year program.

Year 1

• 8 months of adult neurology at our affiliated adult neurology institutions.
• 3 months of pediatric neurology services at Children’s Medical Center.
• 1 month basic science

Year 1 is primarily devoted to obtaining competence in adult neurology while still becoming acquainted with the NDD team. Typically, three blocks are spent on a child neurology rotation and one block on a basic science selective rotation. The remaining nine blocks are divided into four-week blocks with rotations involving adult neurology wards, consults, and emergency room at any of the adult facilities (Parkland Memorial Hospital, Dallas Veterans Affairs Medical Center, and Zale Lipshy Pavilion—William P. Clements Jr. University Hospital). Two of these blocks are on Adult Epilepsy with coverage of the adult in-patient epilepsy monitoring unit. The exact schedule for the adult neurology rotations is determined by the Adult Neurology Residency Director and the Adult Chief Neurology Resident.

Additionally, the NDD resident will start a weekly, four-hour continuity care clinic with NDD faculty that will continue throughout the four years of training.

Year 2

The second and third years of the Residency Program comprise 12-15 months of pediatric neurology service, three months of subspecialty rotations with adult neurology faculty, and the remainder of the time in approved neurology electives. These electives provide sufficient flexibility as to be tailored to each resident’s particular interests, including clinical or basic neuroscience research.

Year 2 begins the pediatric neurology experience more fully. Four blocks of adult neurology occur sometime during this year. This experience could be as senior consult resident at Parkland Memorial Hospital depending on the needs of the Adult Neurology program as determined by the Adult Residency Director. There are six blocks of direct patient care experiences at either Children's Medical Center or Scottish Rite for Children. There is one block of basic science elective. Electives make up the remaining two blocks.

Additionally, NDD residents will participate in 2-3 didactic classes through the UTSW Master of Science in Clinical Science Program, which will be tailored to the NDD resident’s interest. Historically, residents have chosen courses on critical reading as well as effective research design. The goal will be to train the NDD resident to create a research project, chose a mentor from the neurology faculty, and work on this project for the remainder of the Residency Program. The goal will be to have the NDD resident present original research either as a poster, paper, or other creative product by the end of the four years of residency training.

Year 3

Year 3 completes the core pediatric neurology training, and starts neurodevelopmental training in earnest. The resident will spend 9 blocks at either Children's Medical Center or Scottish Rite for Children and one block of child psychiatry. The remaining three blocks are for electives in neurologic-related fields. The NDD resident will be expected to begin leading multidisciplinary teams in clinical and educational settings.

Year 4

The NDD resident will spend most of the last year in nearly all neurodevelopmentally related electives and research. The resident will participate in electives, specifically neuro-ophthalmology, neurogenetics/metabolic disease, neuromuscular disorders, neuro-oncology, and neurologic rehabilitation. Additionally, the resident will be encouraged to complete the research project that was started at the beginning of the four-year program.

Summary

The curriculum for the entire four-year, NDD program is in accordance with ACGME requirements. The curriculum represents a broad exposure to neurological disorders in adult neurology (1 year), pediatric neurology (1.5 years), and neurodevelopmental disabilities (1.5 years). At the end of training, the NDD graduate resident is then eligible to sit for boards in pediatrics per the American Board of Pediatrics (ABP):

• Adult neurology with special certification in pediatric neurology (ABPN)
• Neurodevelopmental disabilities (also through the ABPN)

Additionally, the NDD residency graduate will have produced original research as a result of close mentoring and excellent didactic teaching on creating effective research. Also, the NDD graduate will have a solid understanding of how to correctly assess cognitive, motor, and emotional states of children with a broad set of illnesses using a range of neurocognitive instruments.

Finally, the graduate will have skills to lead multidisciplinary teams on behalf of patients in clinical and educational settings. It is with this broad and important skill set that the NDD graduate resident will have options to pursue academic careers, private practice, or a combination of the two.

Table 1. NDD Program Requirements by Residencies

Table 2. NDD Program Requirements of Child Neurology and Neurodevelopmental Rotations.

*Does not include NDD continuity care clinics weekly for four years

Table 3. Clinical and Basic Sciences Portion of NDD Training of 18 Months over Four Years of NDD Residency

*RCC mandated
** UTSW NDD Program mandated

Table 4. Summary of All NDD Residency Requirements by Months/Year of Training