Send Correspondence to journal:
Re: Teaching the next generation of neurologists

Dr Elkind’s article is one of the most enlightening articles in the understanding of teaching in neurology today. [1] The concept of generational characteristics of residents is very useful in understanding the pattern of education, attitude, and probably motivation and goal seeking in neurologists of different age groups. Having this concept in mind, we will have to adapt to the challenges in educating the next generation of neurologists. This will be important not only for the Americas, but also Europe, where neurology has many national educational aspects. [2]

In many ways we are in a phase of transition, which is the change from the traditional person-to-person apprenticeship to a structured acquisition of summative and formative knowledge. Despite the knowledge that summative education has limits in practical day-to-day work, we introduce more professional methods of education [3], which may be more suited for industry purposes and ISO norms than for the education of medical doctors in particular neurologists.

Practical skills, practice performance, and sufficient exposure to outpatients need to be embedded in neurological education. [4] The basis of our daily work is becoming more dictated by studies with a growing amount of participants, and for residents and neurologists it becomes increasingly difficult to distinguish between biased and unbiased data. The dominance of evidence and study results, in combination with the inexhaustible sources of Google, Wikipedia, and Web 2.0 does not replace care, intuition, and implicit knowledge with advanced education.

Programs vary and the ACGME outcome projects six contents, of which two are medical and patient related and the four other items concern organizational and communicational aspects, which are far away from the bedside. [5] Dr. Elkind mentions that a decline in faculty time and reward for teaching occurs (Table 1 [1]). The time for this is unexpected, as neurology is increasingly becoming a field not only of excellent diagnostics and new scientific insights but also of new and exciting therapies.

Teaching neurology must reassure our neurological core competencies within medicine, must adapt to new methodology of teaching, and despite all aspects of major generational characteristics must be directed at the neurological patient.

References

1. Elkind MSV. Teaching the next generation of neurologists. Neurology 2009;72:657-663

2. Grisold W, Galvin R, Lisnic V et al. One Europe, one neurologist? Eur J Neurol. 2007;14:241-247

3. Aminoff MJ. Training in neurology. Neurology. 2008; 70: 1912-1915

4. Naley M, Elkind MS. Outpatient training in neurology: history and future challenges. Neurology 2006;66:E1-6.

5. ACGME Outcome project. Available at: http:www.acgme.org/outcome/

Send Correspondence to journal:
Re: Reply from the author

I appreciate Dr. Grisold’s comments that generational changes may play an important role in the education of future neurologists. In particular, he makes an important point in noting the evolution of neurology education from an apprenticeship, or a direct interaction between a teacher and student, to a more complex, multi-faceted transfer of information to trainees.

Residents today learn from a host of sources, including: teachers, books, journal articles, on-line media, colleagues, and even patients. New technologies, despite the wealth of information that they make available, cannot provide the direct mentoring and supervision of an excellent clinician-educator.

As educators incorporate new technologies and methods of instruction, they would do well to continue the fundamental traditions of bedside neurological education, as this is still where the patient is found.