The neurologist in the DGH: how to survive without on site neuroradiolgy.

Correspondence to: Dr Evelyn Teasdale, Department Of Clinical Neuroradiology, Institute Of Neurological Sciences, South Glasgow University NHS Hospital, 1345 Govan Road, Glasgow G51 4TF, UK; [email protected]. nhs.uk _________________________ W hat would be my advice to a young neurologist, boldly birthing from the womb of the neurosciences ivory tower training ground to practice in the reality of medicine that is found in the district general hospital (DGH)? How could it be possible to survive without the skills of the ever available super-expert neuroradiologist and the safety net of the all embracing specialist centre? The basic principles are of course simple common sense, and the specifics depend upon knowing and understanding radiologically useful neuroanatomy and the range of normal appearances. My remarks are directed primarily to the newly appointed consultant as she (or he) takes up a post which involves a mixed neurological practice of the hub and spoke variety or one based mainly in a district hospital. Established consultants will have either resolved the problems or alienated the local general department by insisting that all of her (or his) important examinations are referred up to the neuroradiology department for a ‘‘proper report’’. This is not the way forward that I would recommend! Instead I suggest you follow my simple survival course.