The Case for Subspecialization in Neurology: Movement Disorders

Within the world of medicine, the advent of new treatments and new technology has resulted in an increase in the number of specialties and subspecialties. This is especially true in neurology. A widely quoted article has demonstrated that 74% of neurology residents will do a fellowship (Larson et al., 2000), and given that the survey was done over 10 years ago, the number increased, as the most recent AAN resident survey gives a number of almost 78% (Resident Survey, 2008). Movement disorders is one of the many neurology fellowships that is nonaccredited. On the AAN webpage there are currently 44 programs listed in the United States and Canada that offer a movement disorders fellowship (Directory for Fellowship Positions: American Academy of Neurology, 2010). The AAN resident survey reported that 9% of residents going into a fellowship chose movement disorders (Resident Survey, 2008). The question under consideration is to determine when a general neurologist should refer a patient to a movement disorders specialist.