National Survey Highlights Educational Gaps in Women’s Neurology and the Need for Curriculum Reform

Addie Peretz, MD

A nationwide survey of neurology residents and program directors has revealed significant gaps in training related to women’s neurological health, including care during pregnancy, postpartum, and menopause. The findings point to a widespread lack of preparedness among trainees and calls for urgent curriculum reform.¹

The survey was sent to 263 neurology residency programs in the U.S., including 182 adult and 81 pediatric programs, targeting both directors and residents. Responses were anonymized, and no identifying data were collected. The survey evaluated how often women's neurological care is addressed in lectures, as well as respondents’ comfort and preparedness in managing related conditions.¹ 

To provide context on the survey’s timing, Addie Peretz, MD, a coauthor of the survey, told NeurologyLive®, “This survey was timed with the launch of the curriculum to assess the current state of women's neurology training and comfort with women's neurological care at the start of the curriculum launch.”

According to Peretz, the results were striking. All told, 41 neurology directors and 55 resident responders uncovered major gaps in education around women’s neurological health. Nearly half of residents said they “never” or “rarely” ask about family planning, and over 75% do not take obstetric histories. Reported barriers included perceived lack of relevance (72%), limited time (55%), and inadequate training (34%). Most residents felt unprepared, with 57% feeling “very uncomfortable” treating pregnant patients, 33% uncomfortable with postpartum care, and 41% uneasy managing menopause-related issues. Only 20% felt adequately trained. Among program directors, 61% said their programs include at least one lecture on the topic—down from 68% in 2019.¹ 

Beyond the clinical skills gap, the survey reflected a broader lack of sex and gender informed education in neurology as a whole. Migraine is a disorder predominantly affecting women, however current information on sex related headache is lacking. The survey investigated the state of sex informed education across all neurology disciplines, with data showing that research and education on women’s neurology is still in its infancy.

As academic centers begin implementing targeted training efforts through fellowships, national curricula, and interdisciplinary care models, long-term evaluation will be essential. Arathi Nandyala, MD, lead author of the survey study, told NeurologyLive that the team hopes to administer a similar survey in the future to assess the impact of curriculum changes.

She noted, “A similar study would allow us to make more direct comparisons. I think it could be interesting to ask about the gender of the respondents to see if this factor impacts the results in some way.” Looking ahead, she added, “I’m hopeful that we will see some positive changes and improvements in residents’ understanding of these topics so that they are better suited for their future practice as neurologists.” Measuring changes in resident confidence, clinical outcomes, and patient satisfaction will help determine how effectively these interventions close the knowledge gap and ensure that sex and gender informed care becomes foundational in neurology training.

READ MORE: Patients Voicing Key Needs for Migraine Care and Advocacy: Elizabeth W. Leroux, MD, FRCPC

These findings align with recent literature calling for formal recognition of women’s neurology as a distinct focus within medical education. In a related publication, Sara C. LaHue, MD, and colleagues similarly urged the need to formalize women’s neurology as a dedicated area of medical education. They explain how conditions such as migraine, epilepsy, and stroke, many of which disproportionately affect women, require a nuanced management strategy during key hormonal stages, including pregnancy, the postpartum period, and menopause. According to the study authors, these physiological transitions can impact disease expression and treatment efficacy yet are rarely covered in depth during residency.²

This call was echoed in a 2024 Neurology publication by Hayley F. Thornton, MD, and colleagues, who argued that women’s neurology should be treated as a population-specific subspecialty, much like child neurology or neuropalliative care. In their 2024 Neurology publication, the authors highlight how sex and gender are still poorly integrated into neurology research and education. Despite a growing body of literature, only 19% of neuroscience studies with both male and female participants are designed to detect sex differences. This lack of data leaves women’s clinicians with limited guidance for managing neurologic disease with proper care across key hormonal milestones.³ 

To address these deficits, the authors advocated for national curricular frameworks, inclusion of sex/gender milestones in residency training, and greater representation of women’s neurology content at academic conferences. Several promising efforts are underway, including the women’s neurology e-journal club and NIH-funded curriculum development efforts as signs of growing momentum in the field.³ 

Speaking to this progress, Peretz added, “The AAN Women's Neurology curriculum is an important first step. Experts involved in the development of this curriculum in addition to many other dedicated neurologists have created the INSIGHT network, a collaborative of neurologists developing an international network for Women's Neurology education”. 

REFERENCES:
1. Peretz A. Survey on Trends and Perceptions of Women’s Neurology Training Among Neurology Residents and Program Directors. 2025 AAN Annual Meeting; April 12–18; Chicago, IL. P-362.
2. LaHue SC, Paolini S, Waters JFR, O'Neal MA. Opinion and Special Article: The Need for Specialized Training in Women's Neurology. Neurology. 2023;100(1):38-42. doi:10.1212/WNL.0000000000201451
3. Thornton HF, LaHue SC, Bove R, Waters J, O'Neal MA, Bui E. Emerging Subspecialties in Neurology: Women's Neurology [published correction appears in Neurology. 2024 Mar 12;102(5):e209208. doi: 10.1212/WNL.0000000000209208.]. Neurology. 2024;102(1):e208009. doi:10.1212/WNL.0000000000208009