Figure 2.

Flow charts describing possible academic neurology career paths. These career paths are based on (A) the period during which two of the authors trained (R.D. and S.M.) compared with (B) those expected for current trainees (J.S. and E.J.). The main changes are the addition to the neurology curriculum of training in internal medicine and stroke medicine as well as additional general and foundation training prior to neurology specialist training. The consequence is a longer period of training overall for a broader set of competencies but with constrained neurology experience. The changes make it much harder to acquire academic skills and progression, whilst still attaining the Certificate of Completion of Training prior to age 40. (C) This challenge becomes impossible if one considers the additional impact of parental leave and less than full time training (H.D.).