Education Research: Neurologic Education in Physician Assistant Programs

A growing number of advanced practice providers (APPs) are entering neurologic practice, and educational initiatives focused on postgraduate training in neurology for these providers are growing in turn. Neurologic education in APP degree programs is not well defined, which limits the ability to tailor these initiatives to the specific needs of APPs. We aim to describe neurologic education in physician assistant (PA) degree programs to better inform these efforts.

The 2018 American Academy of Neurology clerkship director survey was adapted for directors of PA programs via an iterative approach. The survey was distributed to program directors (PDs) of accredited programs in Fall 2021 and again in Spring 2022 for nonresponders. Simultaneously, websites of accredited programs were systematically reviewed for content related to neurologic education.

Sixty of 255 contacted PDs completed the survey (23.5%). All PDs reported education in selected neuroscience topics. Neuroradiology instruction was included less frequently (66.7%) than neuroanatomy (91.7%) or neurologic examination techniques (95.0%). Twenty-six PDs (43.3%) reported a dedicated neuroscience course; 53 of 260 websites reviewed identified dedicated neuroscience courses (20.8%, k = 0.41). Directors of 10 (38.5%) reported neuroscience courses were neuroscience trained. Only 1 program required a neurology clinical rotation in both the website review (0.4%) and the PD survey (1.7%, k = 1.00). Elective neurology rotations were offered by 51 programs (85.0%) and used by less than 20% of students in 46 programs (92.0%). More programs with dedicated neuroscience didactics (80.0% vs 74.2%) and offerings in clinical neurology (78.7% vs 66.7%) reported graduates pursuing careers in neurology, but these differences were not statistically significant.

Survey respondents reported the inclusion of most of the queried preclinical neuroscience topics, typically distributed throughout the curriculum. Dedicated neuroscience courses were less common and most commonly not taught by a neurologist or neurology APP. Clinical neurology rotations are almost never required, but most programs offer an elective. These results suggest opportunities for augmenting neurologic education in APP degree programs, including encouraging students to take clinical neurology rotations and increasing exposure to APPs practicing neurology. These findings additionally inform key targets for postgraduate educational initiatives.