articleInterest in neurology during medical clerkship in three Nigerian medical schools

Background: This study sought to ascertain perception of Nigerian medical students of neurology in comparison with 7 other major medical specialties. To also determine whether neurology was the specialty students consider most difficult and the reasons for this and to appraise their opinion on how neurosciences and neurology were taught in their different universities. Methods: Self-administered questionnaires were used to obtain information from randomly selected clinical students from 3 medical colleges in Nigeria (University of Ibadan, Ibadan; University of Ilorin, Ilorin; Ladoke Akintola University of Technology, Osogbo). Results: Of 320 questionnaires sent out, 302 were returned given 94% response rate. Students felt they knew neurology least of all the 8 medical specialties, and were not confident of making neurological diagnoses. About 82% of the students indicated they learnt neurology best from bedside teaching, followed by use of medical textbooks. Close to 15% found online resources very useful for learning neurology and 6% indicated that group discussion was quite useful in the acquisition of knowledge on neurology. Histology and biochemistry were the preclinical subjects participants opined were least useful in learning neurology. The most frequent reasons students felt neurology was difficult were problems with understanding neuroanatomy (49%), insufficient exposure to neurological cases (41%), too many complex diagnoses (32%) and inadequate neurology teachers (32%). Conclusions: Nigerian medical students perceived neurology as the most difficult medical specialty and are not interested in specializing in it. Neurology education could be improved upon by provision of more bedside tutorials and increased availability of online resources to enhance learning. There is need to emphasize increased frequency of small group discussions amongst students so that they will be used to teamwork after graduation. Background The term "neurophobia" was originally coined by Jozefowicz to describe the fearful perception of neurology and neurological science by medical students [1]. However, the phenomenon has been a long-standing problem. Reported signs of neurophobia vary from confusion to display of intimidation, boredom and impatient desire for the class to end. Students with neurophobia during clinical posting are eager for the posting to come to an end [1]. Fear of neurology and avoidance of neurologic examination is very common amongst general practitioners (GP) [2,3]. In the survey by Thapar et al, GP rated themselves low in confidence and in caring for neurological disorders [2]. Patients have also corroborated this view that non-specialist doctors' show lack of confidence and are unwilling to manage neurological diseases [4]. Recently, there has been a change in the epidemiological pattern of diseases in most countries and neurological disorders are at the centre of this transition [5-7]. The number of acute and chronic neurological diseases seen in most out-and in-patient services are on the increase [810]. For example more cases of strokes, dementias and neurodegenerative disease have been reported [6,8] which may be a reflection of lifestyle changes in most communities toward western culture. The increased contribution of neurological diseases to the global burden of diseases has made the World Health Organization (WHO) to declare disorders of the neurological systems as a major public health problem [9]. In view of the fact that majority of these neurological disorders are often * Correspondence: emanuelosanya@yahoo.com 1 Neurology unit, Department of Medicine, University of Ilorin Teaching Hospital, PMB 1459, Ilorin Kwara State, Nigeria Full list of author information is available at the end of the article © 2010 Sanya et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Sanya et al. BMC Medical Education 2010, 10:36 http://www.biomedcentral. com/1472-6920/10/36 Page 2 of 6 first seen by the GPs before referral to the specialist [10,11], it is pertinent that GPs, especially those practicing in developing countries with limited facilities brace themselves for the challenges of managing patients with neurological disorders before referral. Reasons that have been adduced as to why students and doctors alike do not show interest in neurology include short duration of neurologic education, unfocused education and training, and the separation of basic neurosciences and clinical studies at medical schools [1,4,12]. This study therefore, sets out to ascertain the level of interest of medical students in neurology in comparison with seven other major medical specialties in three Nigerian universities. The study also sought to answer whether perception of neurology as a difficult subject poses a serious challenge to students when they try to learn and practice the subject and whether it influences their choice of specialization.