Developing a Curriculum for Functional Neurological Disorder in Neurology Training: Questions and Answers

Sara A Finkelstein; M Angela O'Neal; Gaston Baslet; Barbara A Dworetzky; Ellen Godena; Julie Maggio; Daniel Millstein; Tracey Milligan; David L Perez

doi:10.1016/j.ncl.2023.02.007

Developing a Curriculum for Functional Neurological Disorder in Neurology Training: Questions and Answers

Neurol Clin. 2023 Nov;41(4):711-728. doi: 10.1016/j.ncl.2023.02.007. Epub 2023 Mar 15.

Authors

Sara A Finkelstein¹, M Angela O'Neal², Gaston Baslet³, Barbara A Dworetzky⁴, Ellen Godena⁵, Julie Maggio⁶, Daniel Millstein⁵, Tracey Milligan⁷, David L Perez⁸

Affiliations

¹ Functional Neurological Disorder Unit, Division of Behavioral Neurology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA. Electronic address: safinkelstein@mgh.harvard.edu.
² Division of General Neurology, Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, 60 Fenwood Road, Boston, MA 02115, USA. Electronic address: maoneal@bwh.harvard.edu.
³ Division of Neuropsychiatry, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, 60 Fenwood Road, Boston, MA 02115, USA.
⁴ Division of Epilepsy, Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, 60 Fenwood Road, Boston, MA 02115, USA.
⁵ Functional Neurological Disorder Unit, Division of Behavioral Neurology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA.
⁶ Functional Neurological Disorder Unit, Division of Behavioral Neurology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA; Department of Physical Therapy, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA.
⁷ Department of Neurology, Westchester Medical Center Health Network, New York Medical College, Valhalla, NY, USA.
⁸ Functional Neurological Disorder Unit, Division of Behavioral Neurology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA; Division of Neuropsychiatry, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA.

PMID: 37775200
DOI: 10.1016/j.ncl.2023.02.007

Abstract

Functional neurologic disorder (FND) is a common condition for which neurology residents often receive little to no formal teaching. Using a question-and-answer format, this article puts forward a case for why an FND curriculum is needed and aims to provide guidance on possible curricular content including medical knowledge, clinical skills, communication, and team-based collaboration. The authors also discuss methods for teaching and evaluating this knowledge and associated clinical skills, linking this to current Accreditation Council for Graduate Medical Education neurology milestones. Finally, the authors consider how to better engage and energize neurology trainees around this underserved yet challenging patient population.

Keywords: Dissociative seizures; Education; Functional movement disorder; Functional neurological disorder; Functional seizures; Neurology; Psychiatry; Psychogenic non-epileptic seizures; Teaching.

Publication types

Review

MeSH terms

Curriculum
Education, Medical, Graduate / methods
Humans
Internship and Residency*
Nervous System Diseases* / therapy
Neurology* / education