Neurophobia and its implications: evidence from a Caribbean medical school

BACKGROUND: Neurology is regarded as a difficult component of the medical curriculum. This has been so marked that the term neurophobia and its effects are being investigated. Given the impact of neurological disorders worldwide, neurophobia has the potential to affect the diagnosis and management of such cases. METHODS: A cross-sectional survey was done among clinical fourth and fifth year students at the Faculty of Medical Sciences, University of the West Indies, St. Augustine, Trinidad & Tobago. A survey tool successfully used in other schools was adapted to assess perceived level of difficulty, knowledge and interest in various medical sub-specialties including, neurology, cardiology, psychiatry, geriatrics, endocrinology, respiratory medicine, gastroenterology and pediatrics. Questions asked included: "What is your current level of interest in the following medical specialties?"; "What is your current level of knowledge in the given medical specialties?"; "Do you think the subject is easy or difficult?" and "Why do you think neurology is difficult?" Students were required to answer using a Likert scale and results were tabulated into mean scores and standard errors. RESULTS: The response rate was 65% (167/255). Neurology was identified as the subject which students found most difficult (score 3.89 ± 0.068) and had least knowledge of (2.32 ± 0.075). These scores were significantly different from those observed for the other disciplines (p < 0.001). The need to know basic neuroscience was identified as the biggest contributor to the difficulty associated with neurology (3.89 ± 0.072) followed closely by the complex clinical examination associated with neurology (3.69 ± 0.072). Greater clinical and practical exposure, more time being spent on the subject, and improved teaching skills of lecturers were put forward as suggestions for improving the teaching of neurology. CONCLUSION: This study provides empirical evidence that 'neurophobia' may indeed exist among the student population of the school. It suggests the need to re-visit the approach to neuroscience and neurology education and is consistent with similar trends worldwide.