Is clinical neurology really so difficult?

eurology, it seems, has a reputation among medical specialties of being particularly difficult. This was highlighted in the British Medical Journal in 1999 1 when the editor wrote, "the neurologist is one of the great archetypes: a brilliant, forgetful man with a bulging cranium....who....talks with ease about bits of the brain you'd forgotten existed, adores diagnosis and rare syndromes, and-most importantly-never bothers about treatment." The relevance of this view to the teaching of neurology was analysed in a not totally serious letter in 1994 by Ralph Jozefowicz 2 entitled "Neurophobia," in which the author claimed 50% of medical students at some stage have " a fear of neural sciences and clinical neurology." His explanation for this was students' inability to apply knowledge of basic sciences to the clinical situation. This letter was based on personal views not supported by what the BMJ called "evidence based education" in another editorial in 1999. We therefore set out to ascertain perceptions of seven major medical specialties among British medical students, senior house officers (SHOs), and general practitioners, principally in order to find out the actual perceptions of neurology in comparison with the other disciplines.