The medical profession has traditionally been dominated by men but, with over 60% of medical students in the UK possessing two X chromosomes, this imbalance is likely to change. The UK is not alone in training more female medical students than men, but it is unclear whether this change in demographics, and the associated need to take time out for child-care, will alter the provision of neurological services in richer nations. A paper due to be published in the August issue of Clinical Medicine begins to answer this question. The authors of the study, led by Camille Carroll at the University Hospitals Coventry and Warwickshire, UK, used a questionnaire to examine the life choices made by neurology consultants and trainees, general medical senior house officers, and medical students. The investigators received 344 responses, including replies from 30% of the neurology trainees and consultants who were contacted. The findings, although preliminary and possibly unrepresentative because of the poor response rate and small sample size, are interesting and potentially relevant for planning the provision of neurological services in developed countries. Carroll's team found that more female than male consultant neurologists were childless (20% of 35, compared with 8% of 91). Additionally, female neurologists had on average fewer children than did male neurologists (1·9 vs 2·4), and had their first child later, at an average age of 33·4 years. The female neurologists were also more likely to relocate geographically because of their partner's work: 49% of female consultants had done so, compared with just 10% of male consultants. But perhaps the most important issue, in terms of service provision, to come out of the study is that both sexes would like to do more part-time work or have a career break. Around 87% of women at all four levels of experience were planning to work part-time at some point, primarily for child-care reasons. By comparison, 25% of working male doctors wanted to work part-time or take a career break to pursue sporting ambitions, to travel, or for semi-retirement. As the Profile on page 760 shows, women can reach the upper levels of academic neurology while being mothers. However, this involves sacrifices that many people will be unwilling to make. Because clinical neurology has a large outpatient component, it could offer more opportunities for part-time work than medical specialties that have greater out-of-hours commitments. But for this potential to be realised, many more neurologists will need to be trained, and employers will need to develop strategies to accommodate part-time workers. Karen Roos: treating neuroinfections in IndianaThe state of Indiana in the USA has undergone a huge demographic change, with around 200 000 immigrants, from all over the world, settling there in the past 5 years. Some of these people have brought with them infections of the nervous system that were uncommon in Indiana in the not too distant past. “We see a lot of tuberculosis, we see a lot of neurocysticercosis, that sort of thing”, explains Karen Roos, a professor of neurology at the Indiana University School of Medicine. “The immigrants are from all over the world. Full-Text PDF