Synergy in Child Neurology: Science, Collaboration, and Leadership – The 2024 Hower Award Lecture

Abstract

This is an exciting era in child neurology! The scientific state of the art is accelerating rapidly. New diagnostics and treatments are here – or are coming quickly. And our community of researchers, clinicians, and educators is becoming more diverse and increasingly representative of the children and families we serve.

Of course, we have our challenges. What does it take to be a successful researcher in the current climate? How do we best take care of the many patients who need us? How do we recruit new colleagues and retain them in the field? Who will be the next wave of child neurology leaders? None of these questions have easy answers, but the solutions come down to three fundamental values: great science, effective and consistent collaboration, and excellent leadership.

Since the state of the art is advancing so quickly, this is a crucial time to mindfully evaluate how the new data can be incorporated into clinical practice. Apart from our need for rigorous training in implementation science and quality improvement methodology, one of our field's main challenges is the limited number of clinicians available to care for children with neurologic disease.

In 2024, 177 medical students matched into US child neurology residency programs [47]. We do not currently have a systematic approach to quantifying the number of nurse practitioners or physician assistants in child neurology (personal communication, Mona Jacobson, president, ACNN), but such advanced practice providers are clearly a key element of expanded access to clinical care. To enable continued advances in the state of the art, it is crucial that every single one of these individuals succeeds and is retained in child neurology. And we need to recruit far more.

Early exposure to child neurology is an essential long-term strategy. From effective pipeline programs for school-aged children, to exposure to neurosciences in the undergraduate years, and learning from outstanding and inspirational clinicians in the early months of medical and nursing school, educators matter.

It is clear that we need to develop excellent leaders in child neurology. There are countless open positions for division chiefs, section heads, and program leaders – not to mention department chairs in Pediatrics and Neurology. The CNS now has a committee on Leadership, Diversity, Equity, and Inclusion. This team is working to develop appropriate programming, but it is clear that support for emerging leaders must come from a range of sources – from national organizations to medical school offices of faculty development, to individuals who are willing to advise, mentor, and sponsor.

For senior child neurologists, this is a critical time to actively identify and develop emerging leaders. Challenging high-performers so they are constantly learning and performing at their highest potential is key for retention and career satisfaction – with benefit to the entire field and the children we serve. For emerging leaders, please take advantage of the opportunities offered by mentors and sponsors. I encourage you to engage with your local career development resources, as well as leadership development opportunities offered through the CNS and other professional organizations. Develop your professional network – and let your colleagues, mentors, and potential sponsors know about your career aspirations. Be bold with your vision, and be willing to put in the patient, incremental, daily work required to achieve that vision.

Renée A. Shellhaas: conceptualization, investigation, writing – original draft, methodology, visualization, writing – review and editing, resources.

RAS receives a stipend for her role as President of the Pediatric Epilepsy Research Foundation, serves as a consultant for the Epilepsy Study Consortium, and receives royalties from UpToDate for authorship of topics related to neonatal seizures. She receives payment for her work as an executive coach for physicians. She also serves on the ACNS Editorial Board.