Confidence in Neurology: how Educators can help Junior Doctors fight Neurophobia

Aim: To study factors influencing junior doctors’ confidence when managing neurological conditions.
Methods: Using a previously-validated questionnaire, residents of a Singaporean Internal Medicine residency programme were retrospectively-surveyed on their confidence when managing neurological conditions against a 6-point Likert scale. Those who considered themselves confident were compared against those who did not, studying factors contributing to differences in their confidence.
Results: 54% (94) of eligible residents completed the survey, of which only 58% felt confident when surveyed, and tended to report adequate interaction with neurologists (69% vs 31%, p = 0.004) and patients (75% vs 24%, p = 0.0001), and that the training material (75% vs 44%, p = 0.023) and bedside teaching were adequate (69% vs 38%, p = 0.026). Of note, graduates from the United Kingdom, Republic of Ireland, and Australia reported feeling less-than-confident immediately upon graduation (31% vs 6%, p = 0.043). However, during graduate medical training, those who experienced improvement in their confidence tended to be males (46% vs 23%, p = 0.024), and were likelier to have received adequate training material (41% vs 20%, p = 0.032) and bedside teaching (67% vs 46%, p = 0.035).
Conclusion: Low confidence prevails amongst junior doctors when managing neurological conditions. Female trainees, and graduates of medical schools in culturally-different countries are likelier to require increased organizational support. Equity within the medical training framework is also vital for building their confidence.