Curriculum Innovation: A Master Clinician Residency Track in Neurology.

Background and Objectives: While academic centers have traditionally valued faculty research and educational accomplishments, clinical excellence is often assumed or underappreciated. Accordingly, neurology residency programs frequently offer structured pathways for aspiring clinician-scientists or educators, but few offer dedicated training to launch residents into academic careers focused on clinical mastery. Guided by self-regulated learning principles and the Master Adaptive Learner framework, the aim of this curriculum was to equip neurology postgraduate year (PGY)-4 residents with the foundational skills of the master clinician by advancing the following: (1) clinical acumen and diagnostic reasoning; (2) a scholarly and evidence-informed approach to their work; (3) outstanding communication, professionalism, and humanism; and (4) effective navigation and leadership within complex health care systems. Methods: Using the Kern six-step curriculum design framework, we developed a 6-month Master Clinician track that included didactics, customized clinical rotations, reflective patient portfolios, and a scholarly project. Didactics addressed topics such as cognitive bias, adaptive expertise, communication, and clinical uncertainty. Clinical rotations were learning-focused experiences tailored to resident interests. Track residents maintained 2 patient portfolios: one for in-depth case analysis ("depth" portfolio) and another to track diagnostic accuracy ("breadth" portfolio). The scholarly project reinforced a reflective approach to patient care and promoted academic inquiry skills. Assessments of the track included an exit survey on completion, patient portfolio audits, and post-track surveys for 3 years after graduation from residency. Results: Five residents completed the track in the first 5 years (2017-2022). Baseline residency milestone ratings were similar between participants and nonparticipants. Track components received high ratings (≥4.6 on a 5-point scale), with didactics on cognitive bias and teaching skills rated highest. Portfolios averaged 32 cases (breadth) and 8 cases (depth). Residents highlighted clinical uncertainty, communication, and cognitive bias as the most relevant sessions for patient care. Over 3 years of follow-up, high satisfaction with the track persisted and most enrollees elected academic clinical or clinician-educator careers. Discussion: A residency track that used didactics, customized clinical experiences, case-tracking, and reflective practices to foster clinical excellence was well received by residents. Neurology programs should consider similar tracks to develop academic clinicians focused on excellence in patient care.