October 2017: Growing Our Workforce to Meet the Rising Demands for Neurological Care
One in six people have some neurological condition, and as our population ages the number of people who need neurological care is rising. There are too few neurologists to meet these growing demands. For a number of years, and through several AAN presidencies, the Academy has been confronting the growing deficit of neurologists in the workforce with direct action. The AAN's Workforce Task Force found that the United States is currently experiencing an 11-percent shortfall in the number of neurologists needed for patient care that will grow to 19 percent by 2025. We need to act quickly to fill this gap and ensure that our populations have access to high-quality patient-centered neurological care. I would like to take a moment to update you on two major initiatives to help strengthen and grow our profession.
We need to more effectively engage advanced practice providers (APPs) as essential members of our neurology workforce and fully embrace the concept of the interdisciplinary patient care team. Whether in academic departments, subspecialty clinics, or in community practice, APPs are greatly helping to provide neurological care. The growing employment of APPs collaborating with neurologists and helping to alleviate workload prompted the AAN to establish two APP membership categories. In just four years, I'm happy to report that we have crossed the 1,000-member threshold and APPs are the fastest growing segment of our organization. A high priority for the Academy is to do everything we can to increase APP participation both within the organization and in the field of neurology generally.
Collaborating across its committees and work groups, the AAN is committed to addressing the unique professional and educational needs of APPs in neurology to ensure high-quality patient care; member career satisfaction; and efficient, cost-effective practices. The AAN is working to meet four goals:
- Increase APP membership and engagement of APPs in the AAN
- Ensure standardized, quality clinical education for APPs
- Ensure standardized, quality online practice education for APPs
- Improve neurology environment to one that is receptive to APPs in practice
The Academy recently created the Consortium of Neurology APPs (CNAPP) to provide a highly visible home for APPs within our organization. AAN leadership has made it a priority to appoint a number of APPs on our major committees, such as the Member Engagement Committee, the Practice Committee, and the newly created Drug Pricing Task Force. We are pleased with the high engagement of APPs at our conferences, in-person meetings, and through our Synapse online communities. And every day, we are focused on making sure they're valued, and that our programs, products, and services keep the APP in mind. Our strategic plan addresses the AAN vision, “to be indispensable to our members,” both for physician members and new APP members. APPs are essential members of our workforce who will enable us to fully address the AAN mission, “to promote the highest quality patient-centered neurologic care and enhance member career satisfaction.” Neurologist-led interdisciplinary teams will allow all health care professionals to practice together and more efficiently serve the growing number of neurology patients.
While APPs can help alleviate the “here and now” pressures on our neurology workforce, the second major initiative for our Academy is to enhance the pipeline of medical students choosing careers in neurology. We need to grow the number of future neurologists to reduce that projected 19-percent shortage we face. For too long, the proportion of US medical school graduates has remained stable at 2.5 percent annually choosing to enter a neurology residency. With a goal of increasing this number, we received a grant from the Conrad N. Hilton Foundation and created a special work group under our Education Committee. Our Medical Student Pipeline/Hilton Grant Work Group is diligently working to explore, develop, and enhance opportunities to engage medical students and increase their interest in choosing a career in neurology.
Like everything we do as an organization, we are generating data to provide evidence-informed approaches to address this issue. To better understand the challenges we face engaging students to go into neurology, the Exploration Sub Group has focused on analyzing survey and interview data. The Implementation Sub Group is focused on identifying and implementing activities and programs to raise awareness about neurology at the medical school level and attract high-quality medical students into neurology. At the 2017 Annual Meeting, we held focus groups of Year 1 and Year 2 medical students, a group of Year 4 medical students planning to enter neurology, a group of Year 4 medical students not entering neurology, and a group of adult and child neurology trainees. In addition, AAN staff has been conducting phone interviews with medical students at institutions from a variety of locations and with varying demographics. There are three interview subjects at each institution: a student who chose neurology, a student who considered neurology but chose another specialty, and a student who never considered neurology.
All of this data will be incredibly helpful as we design better ways to excite medical students about our field and grow the neurology professional pipeline. Remember that the Academy is home for our neurology clerkship directors and the Student Interest Group in Neurology (SIGN) that are a medical student's “first contact” with neurology. We plan to capitalize on that moment and provide our ambassadors with enhanced tools to bend the curve and increase the proportion of students choosing careers in neurology.
Furthermore, at the 2017 Annual Meeting:
- Eight talks in the Navigating Your Career Area were about SIGN or geared toward medical students.
- Of the 92 talks in the Navigating Your Career Area, 66 contained content applicable to medical student attendees.
- There were 65 one-on-one mentoring sessions with medical students, with neurology faculty and practitioner volunteers serving as mentors.
- Four neurologist-led poster hall tours were offered to medical students on three days, and 22 students participated.
- A digital scavenger hunt was piloted to help improve medical student engagement. Held Saturday to Wednesday, the hunt drew medical students to different areas and talks at the meeting, with up to three winners each day.
- The meetings of our Consortium of Program Directors and Consortium of Neurology Clerkship Directors hosted presentations about the medical student pipeline work. The consortiums were asked for feedback as well as interest in piloting our new, reformed SIGN program at institutions.
Growing our neurology workforce of APPs and neurologists is of paramount importance to AAN leadership and remains a top strategic priority. I am confident that our strategy and these, and other, tactics will be successful. Our “Neuroscience Is...™” campaigns and even our yearly Brain Health Fair held in our Annual Meeting host cities have the potential to inspire young minds to join us in our work to prevent, treat and cure neurological diseases.
You can help, too. Think back to what sparked your interest in neurology, and if you have the opportunity, share that spark with a child or a fresh-faced med student. You may help launch the career of a practitioner who brings tremendous skill and compassion to his or her patients, or a researcher who makes a great discovery or cure. Let's all be part of the solution to growing the workforce to meet the rising demands for neurology care.