Type of article: Medical Education Neurophobia among medical students and non-specialist doctors in Sri Lanka

Background: Neurophobia is the fear of neurosciences held by medical students and doctors. The objective of the study was to find out whether neurology is considered a difficult subject and evaluate reasons for such difficulties among medical students and non-specialist doctors from Sri Lanka. Methods: The study was conducted from May-June 2008. One hundred non-specialist doctors from Colombo South Teaching Hospital and 150 medical students from University of Sri Jayewardenepura were invited for the study. Data were collected by a pre-tested expert validated self administered questionnaire. The questionnaire was designed to assess the degree of perceived difficulty, confidence, interest and knowledge of Neurology as compared to other subjects. It also evaluated reasons and probable strategies to overcome the perceived difficulties or lack of interests. Results: All non-specialist doctors and 148 medical students responded to the questionnaire (response rate – 99.2%). The most favourite subject among medical students and nonspecialist doctors were Cardiology and Endocrinology respectively, while Neurology was ranked third. In all participants the current level of interest was most for Cardiology (3.52±1.36). Neurology was the least interesting specialty for majority of medical students (18.5%) and non-specialist doctors (25.0%). The current level of knowledge among medical students on the above specialties was most for Cardiology (3.12±0.86) and Neurology (2.53±0.96) was ranked fifth. The most difficult specialty for majority of medical students (50.0%) and non-specialist doctors (41.7%) was Neurology. All the participants were least confident when dealing with patients with headache (2.20±0.81), numbness of feet (2.07±0.79) and dizziness (2.07±0.78) when compared to dealing with all non neurological complaints. The commonest reasons ‘why neurology was felt to be a difficult subject’ were; the need to know basic neuro-anatomy (3.09±0.98) and having a complex clinical examination. The participants’ felt that clinical/hospital based teaching (3.49±0.65), case discussions (3.45±0.68) and teaching aids (3.10±0.89) were the most important teaching strategies to improve competency in Neurology. Conclusion: Neurology is considered difficult by the undergraduates and the non-specialist doctors of Sri Lanka. The main reason for the perceived difficulty was the lack of understanding of basic sciences and deficiencies in clinical teaching. This lack of confidence could have a significant impact on patient care.