Neurophobia among medical students and non-specialist doctors in Sri Lanka

Neurophobia is the fear of neurosciences held by medical students and doctors. The present study aims to identify whether Neurology is considered a difficult subject by medical students and non-specialist doctors from Sri Lanka and evaluate reasons for such perceived difficulties. The study was conducted from May-June 2008. One hundred non-specialist doctors from the Colombo South Teaching Hospital and 150 medical students from the University of Sri Jayewardenepura were invited for the study. Data were collected by a pre-tested expert-validated self-administered questionnaire, 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 and/or lack of interests. All non-specialist doctors and 148 medical students responded to the questionnaire (response rate-99.2%). The most favourite subject among medical students and non-specialist 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), while 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 was most for Cardiology (3.12±0.86), while 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 other non-neurological complaints. The commonest reasons 'why Neurology was felt to be a difficult subject' were; the need to know basic neuro-anatomy and having a complex clinical examination. Participants' felt that clinical/hospital based teaching (3.49±0.65), case discussions (3.45±0.68) and teaching aids (3.10±0.89) would be the most important teaching strategies to improve their competency in Neurology. Neurology is considered a difficult subject by undergraduates and 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.