Neurophobia in Medical Students and Junior Doctors in Singapore - Blame the GIK (P07.246)

Abstract

Objective: To create a definition of neurophobia and determine its prevalence and educational risk factors amongst medical students and junior doctors in Singapore. Background is a fear of clinical neurology. Several studies have explored neurophobia in different teaching environments and countries, and concluded that both medical students and doctors have low confidence, knowledge, and perceived high difficulty, despite variable levels of interest in neurology, as compared to other subjects in internal medicine. Design/Methods: We performed two cross-sectional surveys of undergraduate medical students and junior doctors in Singapore including questions about knowledge, interest, perceived difficulty in neurology, and confidence in managing neurology patients compared to other internal medicine specialties, as well as quality and quantity of undergraduate and postgraduate neuroscience teaching, clinical neurology exposure, and postgraduate qualifications. Neurophobia was defined as ≤4 composite score of difficulty and confidence in neurology. Results: Neurophobia prevalence was 47.5% in medical students, highest amongst all medical subspecialties, and 36.6% in junior doctors, more common than phobia of other medical specialties except rheumatology amongst doctors. Multivariate analysis revealed that for medical students, female gender (OR 3.0, 95% CI 1.3-6.7), low interest (OR 2.5, 95% CI 1.0-6.2), low knowledge (OR 10.1, 95% CI 4.5-22.8), and lack of clinical teaching by a neurologist (OR 2.8, 95% CI 1.2-6.6) independently increased the risk of neurophobia; for doctors, low interest (OR 3.0, 95% CI 1.3-7.0) and low knowledge (OR 2.7, 95% CI 1.2-6.2) independently increased the risk of neurophobia, and female gender was of borderline significance (OR 2.0, 95% CI 0.9-4.6). Conclusions: Neurophobia is highly prevalent amongst Singapore medical students and junior doctors. Low interest and knowledge are independent risk factors shared by both groups; female gender may also be a shared risk factor. The mnemonic GIK (Gender, Interest, Knowledge) identifies the risk factors to mitigate when planning teaching strategies to reduce neurophobia. Disclosure: Dr. Kam has nothing to disclose. Dr. Tan Shi En has nothing to disclose. Dr. Tan has received personal compensation for activities with Biogen Idec and Merck Serono as a consultant and/or speaker. Dr. Lim has received personal compensation for activities with Allergan and GlaxoSmithKline. Dr Lim has received (royalty or license fee or contractual rights) payments from McGraw Hill. Dr Lim has received research support from National Medical Research Council and the National University of Singapore. Dr. Koh has nothing to disclose. Dr. Tan holds stock and/or stock options in Pfizer Inc and Stryker.