‘Neurophobia’ of medical undergraduates: does it affect exam performance? The Sri Lankan perspective

‘Neurophobia’ is the ‘fear of neural sciences and clinical neurology held by medical students and doctors’. Neurophobia, results in doctors performing a poor neurological examination and referring patients indiscriminately to neurologist. It is said to originate in medical school. The extent of the problem in Sri Lanka is yet to be established. The present study aims to ascertain whether neurophobia actually affects the medical undergraduates’ performance at the final year examination or is a simple ‘perceived’ phobia without an impact on students’ performance.

Materials and methods: The marks of students’ for the Structured Essay Questions (SEQs) were analyzed at three consecutive final year examinations (2008-2010). Data were analyzed using SPSS v14. A p-value ≤ 0.05 was considered statistically significant.

Results: Sample size for years 2008-2010 were 160, 151 and 155 respectively, while the average marks (±SD) for all SEQs were 58.1±7.7, 54.5±7.7 and 59.8±9.2 respectively. In the 2008 batch the marks in neurology (59.8±14.6) was significantly higher only from marks for pulmonology question (53.1±12.7). In 2009 the marks for the neurology question (69.4±15.0) was significantly higher than all other questions, while in 2010 the marks obtained for the neurology (54.6±23.4) was significantly lower than the marks for the cardiology (61.8±9.2), pulmonology (77.6±9.6) and nephrology (60.9±9.2). The students’ overall average decreased significantly by exclusion of the neurology question in 2009 from 58.2±8.0 to 54.5±7.7 (p<0.001), but not in the other years studied. With the exclusion of the neurology question marks, the average of those having an overall average for all questions of <50 improved, but in the better students (overall average >50) the average remained unchanged.

Conclusion: The impact of neurophobia on the performance of medical undergraduates at SEQ examinations seems to be very minimal. However, further studies are needed in other areas to assess the impact of neurophobia, on clinical practice, on patient-based clinical examination and management.