Pediatric Neurology Training During Neurology Residency: Perceptions and Experiences of Residents in Portugal

Abstract

Introduction: Pediatric Neurology training is mandatory during Neurology residency in Portugal, yet national data on its quality remain scarce. To address this gap, the Neurology Residents and Early-Career Neurologists Committee (CIREN) of the Portuguese Neurology Society, in collaboration with the Portuguese Society of Pediatric Neurology, developed this study.

Methods: An anonymous 33-item online questionnaire was administered to Neurology residents in Portugal to assess perceptions regarding confidence in managing pediatric patients with neurological disorders, knowledge acquired, and training quality across different institutional contexts. The survey was disseminated through CIREN’s official channels and was available between December 2024 and June 2025. Descriptive analysis was performed, and group comparisons.

Results: The survey was answered by 56 residents, with mean age of 29.6 (±2.6) years; most participants were women (54.5%, n=30), and the majority were in advanced years of residency (≥3rd year; 85.5%). Geographic distribution was balanced, except for the autonomous regions. In 41.1% of cases, there was no Pediatric Neurology unit in the training hospital. Among the 28 residents who completed the rotation, all did so in a central hospital, with a mean of 5.3 (±2.4) pediatric neurologists per institution. Skill acquisition was perceived as most effective in outpatient clinics and inpatient wards, compared to emergency settings. However, the presence of an emergency department with direct patient evaluation was associated with greater competency acquisition (p<0.001). After the rotation, only 14.3% felt prepared to interpret specific laboratory tests and 21.4% to manage neurometabolic diseases. Most residents agreed with the rotation duration (75.0%) and its mandatory nature within Neurology residency (82.1%); 17.8% expressed interest in subspecialization.

Conclusions: The findings support the relevance of the Pediatric Neurology rotation and emphasize the need to strengthen and standardize training within Neurology residency, particularly given the heterogeneity of emergency care exposure.