Fifty Years of Child Neurology Residency Training: A Conversation with Program Director Ruba Al-Ramadhani, MD
September 1, 2026
The Child Neurology Residency Program at UPMC Children’s Hospital of Pittsburgh has trained child neurologists for fifty years, beginning with a single resident in 1975 and growing into a program that matches four to five residents a year.
Ruba Al-Ramadhani, MD, assistant professor, pediatrics, Division of Neurology and Child Development; program director, Child Neurology Residency; and associate medical director, Pediatric Epilepsy Surgery Program, UPMC Children's, discusses how the residency program is built, what sets it apart, and what she often discusses with students and future residents about the considerations they should take into account when evaluating and deciding on a place to train.
Q: A student comparing child neurology programs sees a lot of similarity on paper. What should they actually be weighing?
A: Every program is going to teach you to become a child neurologist. The clinical training is largely the same wherever you go because of the national standards that exist, so that is not what should drive the decision, in my opinion. What matters is the environment you are choosing to spend five years in, and the people you will spend them with. Those people become a second family over the course of residency, and you want to land somewhere you can thrive, not simply finish the training. That is what I encourage students to weigh, because it is the part that sets one program apart from the next.
Q: How is the training tailored to each resident at UPMC Children’s and the University of Pittsburgh?
A: Individualized is the word I keep returning to, and I use it deliberately. The core clinical training is similar for everyone, because that is what produces a competent child neurologist, and it is non-negotiable. What we build on top of that core is what belongs to the individual. Roughly half of the child neurology training is elective time, shaped around the resident, their interests, and the direction they are heading. One resident might devote it to research, another to a particular clinical skill or a certification a future position requires. When an experience is not available here, we are flexible about away rotations at other institutions. A resident who already knows the fellowship they want can begin building toward it years in advance. Flexibility is part of it, but the real draw is the individuality, and that is what most applicants are looking for.
Q: How much input do residents have in how the program runs?
A: Considerably more than most applicants expect. The overall framework is fixed, roughly half inpatient and half elective, but the residents shape what happens within it. Each year the chief residents redesign how the core rotations run, so the program is fluid and evolves from one year to the next, largely because the residents themselves are making those decisions. A program has to be large enough to accommodate that, and ours is. This is not a matter of any one resident doing whatever they please. It is the group collectively shaping the program to work for the people in it.
Q: How is mentorship structured for residents in the UPMC and Pitt Program?
A: Mentorship begins on a resident’s first day. Every resident is paired immediately with a mentor who is there for the whole of the experience, professional and personal alike, not only the academic questions. From there, we add mentorship as a resident’s path comes into focus. If the original mentor does not align with a resident’s research interest, we assign a research mentor. If their interest lies in a subspecialty the first mentor does not practice, we match them accordingly. Just as often, residents build that team themselves, telling us whom they would like to work with as their interests take shape, and we help make those connections. A resident whose mentor is a neurogeneticist but who intends to pursue epilepsy, for instance, is given an epilepsy mentor to guide them through fellowship applications, the job search, and contract negotiations. The principle is simple: the person advising a resident should be someone in a real position to help that resident get where they want to go.
Q: What kind of clinical exposure do residents get across the five years?
A: A great deal, and across a wide range. This is a high-volume program, so over five years residents see the full spectrum. They manage the bread and butter, the conditions they will treat routinely throughout their careers, and they also encounter the zebras, the rare presentations many trainees only read about. By graduation, residents have seen considerable breadth, and because of how the training is structured, they have also had the time to go deep in the areas they chose to focus on.
Q: How would you describe the community among the residents in your program?
A: In tangible ways, not as a slogan. Five years is a significant part of your life, and you have to be able to rely on the people around you. Our residents are close. They spend time together well beyond anything the program organizes, and because they are friends first, they look out for one another. When someone is out sick or facing an emergency, it is handled among themselves before it ever reaches me or the faculty. That is rarer than it sounds. As programs grow, that closeness tends to erode, because everyone retreats into their own schedule. We have held onto it even at our size, and it is something we actively protect.
Q: How does Pittsburgh factor into a prospective resident’s decision?
A: I tell them not to underestimate it. Pittsburgh is far more affordable and more livable than many of the cities that host competing programs, and it has been earning real recognition lately, including a place among the destinations named worth visiting in 2026. Residents spend five years here, so the city is part of the training experience rather than an afterthought. Most people are pleasantly surprised by how much they come to love it. It can be a difficult thing to describe and accurately portray all that this city, region, and its communities have to offer, both personally and professionally. I would encourage residents to visit and experience it for themselves, and also talk to other residents and people who have been here in the past what it was like. What is happening in and around UPMC and the University of Pittsburgh right now is remarkable no matter what specialty or area one is interested in.
Q: The program is marking its fiftieth year. What does that legacy mean for the residents who train here?
A: It means a great deal to me, and I think it is the heart of the matter. We began in 1975 with one resident a year and a small handful of faculty. Today we are approaching thirty faculty training a full class, with more than a hundred graduates practicing across five continents. But the way I think about the legacy is this: people come and go, and faculty come and go, yet the training endures. It stays on your CV wherever your career takes you. That is what a division ultimately has to show for itself, and it is what will still be standing fifty years from now. When a resident chooses us, that legacy is what they are joining.
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