Assessing the landscape and charting paths: UK neurology trainees' opinions on neuroinflammation subspecialty

Therapeutics of neuroinflammatory disorders including multiple sclerosis is one of the fastest growing areas in neurology. However, pressures on higher specialty training in neurology together with an expanding curriculum have led to challenges in adequately preparing trainees for a subspecialist career. In this study we set out to understand current perceptions and barriers to training in neuroinflammatory disorders among neurology trainees in the UK. A structured questionnaire was used to assess trainees' perspectives on training opportunities and career aspirations. Findings reveal significant gaps in training, including insufficient training opportunities, lack of mentorship, and concerns about managing complex treatment regimes. We used these findings to develop structured action points with aim of improving training and retention in this subspecialty. These include early exposure to subspecialty experiences, enhanced mentorship, and equal access to training opportunities regardless of geographical location. Our findings underscore the need for further curriculum development in neurology training, potentially combining early support with dedicated fellowships later in training, in order to ensure sustainability of neuroinflammation as a subspecialty and to meet the growing demand for expertise in MS and related conditions.