Jeanne Feuerstein was getting ready for a class skit and practicing dance moves that she and her fellow medical students, now in the final stretch of their four years together, would be performing. It is a long tradition on Match Day at the University of Arizona College of Medicine, a way to deflect the nervous energy that comes with finally finding out where they will spend the next four years of their lives. During the skit, a Gilligan's Island-themed treasure hunt searching for the box that holds the match letters, teams of people ready for a pediatrics residency ran up to the captain. Then, it was the internal medicine folks. Then, Jeanne Feurerstein jogged up alone. She was the only one of her 110 classmates who matched for neurology.
On Match Day 2014, more than 16,000 US medical school seniors matched into first-year residency positions. Nearly all of the 380 positions at the 80 neurology residency programs throughout the country were filled. Feuerstein was among 192 US seniors who matched into one of these programs. Come July, she will be spending the next four years at the University of Colorado School of Medicine.
The number of neurology positions offered in matching programs is up from last year — from 339 to 380. In 2010, there were 228 positions, and 403 US medical school seniors applied for a neurology residency, according to the National Resident Matching Program. Physicians who want neurology still represent a small sliver — 1.2 percent — of people applying to all medical specialties, and half of all applicants match from foreign medical school graduates.
Clearly, some schools are inspiring a bigger piece of the residency pie. At Indiana University, 17 of their 340 medical students matched for neurology. University of Rochester School of Medicine and Dentistry had 10 percent of its students match to neurology. And University of Iowa had seven students match to neurology, four of whom will stay in Iowa.
“We had a bumper crop year,” said George B. Richerson, MD, PhD, chair of neurology at University of Iowa. Dr. Richerson, who moved from Yale University School of Medicine three years ago, said that a strong faculty is key to any successful residency program. He has hired 14 scientists and clinicians, and the school offers six residency positions a year. Iowa has a strong research track.
Neurology Today reached out to neurology chairs, residency program directors, and a half-dozen almost newly-minted doctors who will go on to become the next generation of neurologists. They were asked a simple question: Why neurology? In a series of articles in Neurology Today, we'll share their answers. In this first article in our series, we feature Jeanne Feuerstein, who matched to the University of Colorado residency program.
COMING TO THE UNIVERSITY OF COLORADO
Both of Jeanne Feuerstein's parents are physicians, and the last thing any of the three Feuerstein children wanted was a career in medicine. Jeanne Feuerstein's two older brothers are lawyers, and she set out as a creative writing and English major in college. Then, she read a short story by neurologist Oliver Sacks and began her obsession with all things brain. After a short stint working at a law firm (she ended up interviewing families with a long list of asbestos-related medical problems), she signed on to Bennington College's post-baccalaureate program.
During medical school, Feuerstein conducted research on frontotemporal dementia patients at the University of California, San Francisco, and decided that she wanted to become a behavioral neurologist. She applied to 15 residency programs and ranked for 10 of them. She counted five behavioral neurologists at the University of Colorado, which is where she matched. It was at the top of her list. She hopes to do research and take care of dementia patients.
That combination of interests will be highly valued in the current health care setting, said University of Colorado's neurology residency program director Augusto Miravalle, MD, who arrived at the academic medical center in 2009. He noted that residency training programs now have to incorporate activities that focus on workforce development, quality improvement, and leadership skills. This year, he said, the University of Colorado established the Leaders in Education, Administration and Research working group to develop that training program further.
The current health care climate has led to some changes in the teaching strategies, he said. “This is an opportunity for neurologists to re-visit our current methodology for the promotion and integration of patient care into system-based practice. A changing health care environment will result in the immediate need for more physicians trained in providing care to heterogeneous population of patients with a focus on systems care and quality improvement.”
Who comprises the next generation of neurologists? In this and consecutive issues of Neurology Today, we'll feature the newest graduating class of medical school students who matched to neurology residency training programs this past March.