Child Neurology

What are some important statistics around the specialty?

Child Neurology is a small but growing specialty with unique characteristics. As of the 2025 NRMP Match, there were:

• 83 programs offering 181 positions
• 9 unfilled positions
• A total of 319 applicants, 193 of whom matched (60.5% match rate)
• About half of the matched applicants were U.S. MD seniors

According to the 2024 Charting Outcomes in the Match, among matched U.S. MD seniors in child neurology:

• Mean number of contiguous ranks: 13.2
• Mean Step 2 CK: 253
• Mean number of research experiences: 4.2
• Mean number of abstracts, presentations, and publications: 9.1

Charting Outcomes in the Match, 2024 – Child Neurology

Pediatric neurologists are often paid similarly to general neurologists with pediatric adjustments. Pediatric neurologist salary estimates range widely depending on setting, but average around $250,000–$275,000, placing it close to general pediatrics compensation.

What general advice would you offer to someone considering this specialty?

Child Neurology offers the opportunity to combine the complexity of neurologic diagnosis with the continuity and developmental focus of pediatrics. You must be comfortable with diagnostic uncertainty and committed to understanding brain development across childhood. It’s a rewarding field for those who enjoy longitudinal patient relationships, solving medical puzzles, and advocating for vulnerable populations with chronic and often life-altering conditions. You’ll work closely with patients and families for years, often guiding major life decisions.

Child Neurology is a small world, so if you are considering it as a career path, make connections with child neuro faculty and be positive, enthusiastic, and make a great impression! Everyone knows everyone. 

What are the top three areas that students can focus on to help prepare themselves for a successful residency application and a successful transition to residency?

1. Sustained Interest in child neurology, shown through electives, research, or advocacy work.
2. Strong Clinical Performance, particularly in both pediatrics and neurology clerkships or electives.
3. Professionalism and Communication, especially given the complex social dynamics of neurologic illness in children.

What resources would you share with a student who is just starting to research their interest in this specialty and/or wants to learn more specifics of this specialty (anything from what a typical day may look like to specifics on rotations, specialty-specific residency info, fellowships)?

• So You Want to Be a Pediatric Neurologist
• Child Neurology Match Program Listings: FREIDA
• Child Neurology Career Guide: Child Neurology Society Resources
• "A Day in the Life" Video: UC Davis Child Neurology Resident
• Neurology Clerkship Guide: American Academy of Neurology – Medical Student Resources
• Brief background from a Child Neurologist 

What subspecialties exist with this specialty?

After completing a child neurology residency, many physicians pursue further fellowship training. Pediatric neurologists can subspecialize in a variety of areas, including:

• Epilepsy
• Clinical Neurophysiology
• Neuromuscular Medicine
• Headache Medicine
• Neurogenetics
• Movement Disorders
• Neuroimmunology (e.g., MS, autoimmune encephalitis)
• Vascular Neurology
• Sleep Medicine
• Pediatric Neurocritical Care
• Neurodevelopmental Disabilities (a separate categorical residency with overlap in training)

Note that some fellowships, such as epilepsy and neurophysiology, are accredited by the ACGME, while others are informal or offered at individual institutions.

What does a typical workday or work week look like (hours/schedule/shifts, work setting, team-based environment, acuity, etc.)?

A typical workweek varies depending on whether one works in academic, private, or hospital-based practice. Outpatient schedules usually follow standard weekday clinic hours (8a–5p), often 4–5 days/week, with call coverage rotating among colleagues. Inpatient roles may include neurology consultation or neurocritical care service, with shifts typically 8–12 hours and occasional nights or weekends.

Most work is team-based, especially in academic centers, where child neurologists collaborate with pediatricians, physical/occupational therapists, genetic counselors, and social workers. The acuity can range from routine headaches to life-threatening status epilepticus or neurodegenerative diagnoses.

What are the important traits, qualities, and/or considerations recommended for physicians in this specialty?

Child neurologists must be:

• Detail-oriented: Neurologic diagnosis requires nuanced exams and history-taking
• Communicative and empathetic: Many diagnoses are lifelong, complex, or emotionally heavy
• Comfortable with uncertainty: Workups can be long, and answers are not always clear
• Patient-centered: Involving families in decision-making is essential
• Collaborative: Neurology intersects frequently with genetics, rehabilitation, psychology, and education systems
• And of course, comfortable with interacting with and treating pediatric patients of all neurodevelopmental abilities 

How does the specialty work differ in various settings (e.g., private vs community vs academic environment)?

• In academic centers, child neurologists often sub-specialize, participate in teaching, and are more likely to be involved in research or complex multidisciplinary clinics.
• In private practice or community settings, physicians are more likely to practice broad general neurology, may have fewer resources (e.g., for EEG, MRI), and carry a higher clinical load.
• Hybrid models also exist — for example, large children’s hospitals that are community-based but not affiliated with universities may offer a mix of both.

What does training for this specialty look like (how many years, is a separate prelim year needed, etc.)?

The training path is structured as a 5-year categorical residency, often referred to as the combined pediatrics and child neurology track, sometimes called a combined residency and fellowship:

• Years 1–2: General pediatrics (PGY1 and PGY2)
• Years 3–5: Child neurology training (includes both adult neurology and pediatric neurology rotations, typically the third year is adult neurology-heavy, and the remainder is pediatric)

Some programs offer flexibility in the split of pediatrics vs neurology (e.g., 1 year peds + 1 year neuro, then blend), but all adhere to the ACGME requirement of 24 months pediatrics and 36 months neurology.

No separate preliminary year is required — applicants match directly into the full 5-year track.

What types of experiences might strengthen my future residency application, especially in areas of service, leadership, and research?

• Research in neuroscience, child development, genetics, or health equity can demonstrate relevant interest
• Sustained service with children with neurodevelopmental disabilities (e.g., volunteering with autism or cerebral palsy orgs)
• Leadership roles in interest groups, service projects, or tutoring/teaching roles
• Clinical experiences in both neurology and pediatrics show commitment and curiosity for the combined pathway

Is there a specialty interest group? If not, what other networking options would you recommend? Are there any specific national organizations or committees I should join?

UACOMP does not have a neurology interest group, but there is a pediatrics interest group (PIG). At the national level, students can:

• Several child neuro-specific organizations, including
  • The Child Neurology Society (CNS) as a student member: https://www.childneurologysociety.org/membership/student-membership/
  • Epilepsy Foundation of AZ {https://www.epilepsy.com/local/arizona }
  • Muscular Dystrophy Association {https://www.mda.org/ }
• Attend the CNS Annual Meeting (student-friendly and great for networking)
• Get involved in the American Academy of Neurology (AAN):
  https://www.aan.com/membership/students

What advice would you offer MS1s and MS2s who are interested in this specialty?

• Explore both pediatrics and neurology early to make sure the combined field feels like a fit
• Shadow child neurologists in the clinic or on service
• Don’t stress about needing a perfect research project — focus on building relationships and asking questions
• Consider electives in developmental pediatrics, genetics, or neuroimaging

How and where can I find other mentors for this specialty?

• Ask your clinical specialty advisor (CSA) for pediatrics and neurology, or the neurology clerkship director, to connect you with child neurologists
• Reach out to those on the Alumni networking site

Is there anything else in addition to the suggestions above that could aid my future application, now that Step 1 is P/F?

Yes — with Step 1 now pass/fail, other aspects of your application carry more weight:

• A strong Step 2 CK score will be helpful (ideally above 245–250 for top programs), but it is less emphasized compared to other aspects of the application
• Strong narrative letters from pediatricians or neurologists are helpful, but you must have a child neurology letter of recommendation, so look for a child neuro rotation early on
• High pass/Honors in your pediatrics and neurology clerkships
• Evidence of longitudinal interest (e.g., child development, neuro-related service, or research)

Which group and association memberships might strengthen my future residency application (e.g., AOA, GHHS, MSG, specialty-specific groups, etc.)?

No specific membership is required to match into child neurology, but the following may strengthen your application:

• AOA or GHHS: These are always viewed positively as markers of academic excellence and professionalism.
• Child Neurology Society (student member): https://www.childneurologysociety.org/membership/student-membership/
• American Academy of Neurology (AAN): Student membership offers access to national mentors, conferences, and publications.
• Active involvement in groups such as Students for Neurodiversity or pediatric advocacy organizations can also demonstrate your alignment with the field’s values.

Ultimately, sustained involvement is more important than passive membership.

How important are Step 2 scores to this specialty?

More important now that Step 1 is P/F. A competitive score is typically above 245, though you don’t need a 260+ to match. Solid scores combined with thoughtful application materials and strong clinical evaluations can carry equal or more weight.

Are publications important to this specialty? Is there a general number of publications or presentations I should be aiming for? How important is it for these to be within the specialty I am pursuing?

Research is helpful but not essential. Having publications or posters is not mandatory to match into child neurology, but it can demonstrate academic curiosity and follow-through. If you’re applying to top-tier programs, some research is expected — ideally 1–2 posters or abstracts, with or without publication. It doesn’t need to be in child neurology specifically, but it helps if it involves neuroscience, pediatrics, developmental medicine, or neuroethics.

Are there any special considerations when applying for residency?

Yes — child neurology applicants are applying to categorical 5-year programs, which include pediatrics and neurology in one application. A few programs may offer reserved (R) positions for those with prior pediatric training, but most medical students should apply to categorical (C) spots. 

Make sure you:

• Apply to both child neurology and neurology electives
• Get letters from a child neurologist, and if possible both pediatric and neurology attendings
• Attempt to secure a child neurology elective before applying, especially for an LOR
• Understand that some programs may interview you separately with both departments

In addition, a handful of programs may allow flexibility in the order or integration of pediatric and neurology training.

Finally, double dipping at the same program is discouraged, meaning if you apply to child neuro at a program, don’t apply to pediatrics at that same program as well. The child neuro interview will have leadership from the pediatrics residency, so it will seem odd and likely be a detriment to your chances. If you truly aren’t sure which residency you want to do, you can consider applying to both, but at different programs.

What is a general recommendation for how many programs to apply to (recognizing that this may vary based on student situation)?

Because child neurology is a small and moderately competitive field, most U.S. MD applicants match successfully when they rank 7–10 programs. If you’re a strong applicant (pass both steps, good letters, solid clerkship grades), applying to 10–15 programs is typically sufficient. Applying to more than 20 programs is rarely necessary unless:

• Your Step 2 score is below average
• You’re targeting highly competitive programs without a home neurology department

Source: NRMP Charting Outcomes – Child Neurology, 2024

What letters of recommendation are recommended for this specialty (e.g., from research, physicians within this specialty, academic, etc.)

The most helpful letters for child neurology are:

1. One letter from a child neurologist (ideally someone who supervised you clinically)
2. One letter from a pediatrician, preferably from your core pediatrics rotation or sub-internship
3. A third letter may come from another subspecialist, research mentor, or faculty member who knows you well

Letters should focus on your clinical ability, communication, professionalism, and commitment to a pediatric-neurology career path.

If other disciplines are appropriate for letter of recommendation writers, are there specific specialties you would strongly recommend?

Yes — letters from neuroscience-related specialties (e.g., psychiatry, genetics, neurodevelopmental pediatrics) are helpful if your clinical experience was strong. However, a strong letter from any field where you worked closely with the attending and demonstrated key traits (compassion, diligence, intellectual curiosity) is appropriate. Avoid impersonal or generic letters, even if the writer is prestigious.

How competitive are the residency programs in this specialty?

Child neurology is considered moderately competitive, primarily because of its small size and the complexity of training. In 2025, 83 programs offered 181 positions, with a match rate of about 60% overall.

While many U.S. MD applicants match, the top programs are increasingly competitive and may expect:

• Honors in relevant clerkships
• Strong Step 2 scores
• Research or other demonstrable interest in the field
• Leadership or service experience

Competitive programs include those affiliated with large academic children’s hospitals or highly ranked neurology departments (e.g., CHOP, Boston Children’s, UCSF, Stanford, Texas Children’s, Nationwide).

When do programs typically offer interviews?

Child neurology programs tend to follow the general residency timeline:

• Late September to mid-October: Interview invitations go out
• October through December: Interviews conducted

Because most are categorical programs, you will often receive interviews from both the pediatrics and neurology departments. Occasionally, the interviews are conducted jointly; in other cases, they’re separate but coordinated.

What is UA COM-P’s history with matching in this specialty?

UA COM-P has a strong match history in child neurology, with successful matches in recent years at both regional and national programs. Students with a clear and early interest in the field — and who engage in mentorship and electives — are generally successful in securing interviews and matching well.

Are away rotations required for this specialty, and if so, when should I plan to do them?

Away rotations are not required, but strongly encouraged if possible, and may be helpful if you have a particular interest in a program, especially one without much of a track record relationship with UACOMP/Barrow’s/Phoenix Children’s

Plan to do away rotations between before September of your MS4 year, and complete your sub-I beforehand that, if possible, so you’re prepared. Apply early, especially for large academic centers where slots are competitive.