Neurology Profile

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01
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Part
01

Neurologists: Demographic Profile

After an exhaustive search, we have determined that demographic data for European neurologists is largely unavailable. We found a few country-specific statistics related to gender, as well as some estimated income levels. However, data related to age, race, education, and religion were unavailable, as were statistics related to socioeconomic or marital status.

Gender

  • In Germany, there are approximately 3,500 female neurologists, out of approximately 7,500 total neurologists (screenshots here).
  • In Spain, 60.95% of residency program candidates who chose neurology as their specialty were women between the years 2007 and 2016, the most recent date for which data could be found. In 2016, that figure was lower than other years at 43.09%.
  • A somewhat dated (2014) fact sheet published by Biogen that examined neurologists treating multiple sclerosis in four European Union countries, plus the US, shows that 32% of neurologists are women, while 68% are men.

Income

Research Strategy

We searched European neurological professional associations, such as the European Academy of Neurology in search of membership statistics on the requested demographics, but no such data was available. In an attempt to triangulate the data, we searched for country-specific associations as well, but again, did not find adequate information. We also search for polls or surveys conducted among European neurologists, as well as country-specific physician assessments, but again, no such data turned up, other that a smattering of gender statistics, as outlined above. We also searched for statistics on neurological residency programs in hopes of finding a breakdown of program participants, but all data found was too old to be relevant.
Part
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Part
02

Neurologists: Psychographic Profile

Neurologists in Europe are interested in dictionaries, encyclopedias, news and media, science, and education.

Interests:

Reading Habits:

  • Neurologists visiting the European Academy of Neurology website are interested in alzheimer-europe.org which is a non-governmental organization aimed at raising awareness for all forms of dementia.
  • European neurologists like to visit bestpractice.bmj, which is a knowledge source for clinical decisions in neurology.
  • They also like to visit ebrain.net, which is a very large online learning resource for postgraduate neuroscience professionals.
  • Neurologists in Europe like to visit Dystonia Europe, which is a website that provide information about dystonia.

Research Strategy:

Unfortunately, information on the attitudes, affinities, habits, hobbies, likes, dislikes, and values of neurologists in Europe is not available. We began by searching for survey reports on the neurologists in Europe from sites like the European Academy of Neurology and the European Federation of Neurological Associations. We wanted to verify if any of the neurology associations have conducted research to understand the interest, attitudes, and values of neurologists in Europe. However, there was no relevant information about the subject.

We also looked for information in articles from sites that specialize in publishing information on Neurology like the European Brain Council, Neurologyadvisor, and Touchneurology. Unfortunately, we were only able to find information about the advances in neuro healthcare.

As information was scarce, we decided to take the Neurology association websites in Europe and perform a Similarweb analysis in order to get some of the visiotrs' preferences but there was no data found for EFNA site. However, we were able to gather some data on the neurologists' reading habits by using the web analytic tool Spyfu.
Part
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Part
03

Neurologists: Media Preferences

The research team identified several media resources where neurologists were likely to consume news and information related to their profession. However, because there was no information that explicitly detailed broad preferences or rankings, the team opted to select news, information, and education resources that illustrated clear popularity within the profession. Full details about our findings and approach are available below.

European Academy of Neurology

  • The European Academy of Neurology (EAN) boasts of 45,000 members, representing 47 European national societies; its conference attracts 6,000 delegates each year. One of the membership benefits includes free access to its peer-reviewed journal and regular news and updates via its website and newsletters.

NeuroMind

  • An abstract posted in Early Human Development, noted that the “global contemporary shift from paper-based to digital online resources has led to a revolutionary change in medical training.” The abstract also noted that medical mobile applications have facilitated medical training and the portability of updated medical resources. A search for medical apps revealed a popular source amongst neurologists:
    • NeuroMind appears to be a very popular app. It reports being the #1 app for neurology in the world with over 300,000 downloads. The app is an interactive clinical decision support tool and also offers clinical classification and grading systems. Additionally, it is supported by Surgical Neurology International and the European Association of Neurological Societies (EANS). This app was updated as recently as December 2019 and appeared on a list of must-have neurological apps for professionals.

Medscape & Medscape Neurology

  • 40% of doctors in the United States report reading Medscape regularly. Considering that Medscape is that popular among American physicians, there is a likelihood that it is also relevant in European nations; this assumption is coupled with the fact that it is offered in German, Spanish, French, and Portuguese. This digital warehouse of medical news, expert perspectives, and essential point-of-care drug and disease information reports being “the leading online destination for physicians and healthcare professionals.”
    • Medscape offers localized medical news (e.g., Medscape UK).
    • The Medscape app has ~10 million downloads; its CME/Education app has ~84,000 downloads; and its news app, MedPulse, has ~370,000 downloads.
    • The Medscape Neurology section can be accessed as its own section.

Others

  • Practical Neurology is the official journal of the Association of British Neurologists. It provides up to date information “for everyone who sees neurological patients” and is available to all subscribers of the Journal of Neurology, Neurosurgery, and Psychiatry which is housed under the very large and respectable umbrella of the BMJ (formerly, British Medical Journal).
  • Neurology is reported to be one of the most popular journals in the world. Its publication calendar (48 times per year) likely speaks to its popularity in the field.
  • In 2013, the Annals of Neurosciences (an American journal), compiled and published a directory of digital resources on neurology and neurosurgery to provide a way to keep their audience abreast and updated on the “ever wide access to a universe of online medical resources.” Within this long list of neurological resources, there were many sources relevant to European neurologists. While it is older, it may still be of value to peruse.
  • Another long list of neurological resources relevant to neurologists was compiled and ranked by the Scimago Journal which is a publicly available portal that includes the journals and country scientific indicators developed from the information contained in the Scopus database (Elsevier B.V.). The rankings show that The Lancet Neurology, Brain, and Nature Review Neurology, for instance, are top journals based in the UK.
Part
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Part
04

Neurologists: Challenges

Professional challenges that impact European neurologists include workforce shortages, political threats to medicine supplies, gender politics and disparities, and training inconsistencies. Day-in-the-life challenges include privacy issues and backlogs. More details about all of these insights are provided below.

1. Shortages

  • While it was noted that 2 in every 10 acute medical admissions in the UK were related to a neurological issue, a 2017 survey by the Association of British Neurologists revealed that 20% of UK acute hospitals had access to a neurologist only 3 or fewer days per week.
  • Shortages of neurologists increase wait times for many patients and creates backlogs for the neurologists as they face their workday. It also impacts the percentage of advice and guidance calls that get answered. For instance, in North East Essex, while more than 70% of requests for advice were being met by some specialties, neurology had an answer rate of 16%.
  • There is also a likelihood that an aging population could increase the incidence of disability and demands for neurological care amidst this shortage.
  • There are also threats to pharmaceuticals in the UK. A very public and recent exchange between a UK neurologist, David Nicholl, and a Commons leader, Jacob Rees-Mogg, centered around the role of Brexit on how certain political stances could impact medicine shortages and lead to patient deaths. After being criticized by the politician as “shameful,” the neurologist noted, “‘I am not bothered about Jacob Rees-Mogg. I’m not going to take a single word of health lessons from a muppet like him. What does he know about epilepsy or neuropathic pain? What I am worried about is my patients. To suggest I am wrong in what I say is defamatory. When, as I have done, I look people in the eye and say some of the drugs they are on might be in short supply and who are understandably worried, what he says about me is ridiculous.’”
  • This doctor-politician exchange highlights that neurologists may feel that their advice and concerns are not being listened to or appreciated by those that make decisions impacting them and their patients.

2. Women

  • While 60% of medical students in neurology are women, only 14% of neurology professors in France are women. One speaker, Prof. Catherine Lubetzki, at the 2018 European Academy of Neurology annual congress, spoke about the challenges of succeeding in the profession even with certain momentum behind her (her mother and grandmother were doctors). Things that help women to succeed in the profession include the French culture (she believes “working mother is the rule”), good mentorship, and having the right partner (this is beneficial for neurologists who want to have children).
  • Another professor, Jera Kruja (from Albania), highlighted that in Albania while 60% of students in secondary school are female, only 25% of neurology professors are women. This professor also spoke about the legacy of communism and the toll on families when professions are decided and dictated by the government.
  • Prof. Claudia Trenkwalder of Gottingen, Germany, highlighted the challenges of education during pregnancy for some women as it impacts rotation in ICU, stroke units, EMG laboratories for needles, ER, and neuroimaging/CT scans. Women are tasked with preplanning their education even prior to pregnancies in order to maintain a consistent educational flow. They have to “be proactive—go out and look for research/projects/collaborations” since the current way is not exactly designed for women who want children.
  • Selina Wray, Alzheimer’s Research UK Senior Fellow and Group Leader at the University College London Queen Square Institute of Neurology, noted that access to leadership roles within the male-dominated field (especially, related to leadership committees) is challenging for women neurologists because professionals tend to look to their “existing networks rather than consider how to use that as an opportunity to increase diversity.” Wray also notes that women tend to be pushed into more pastoral roles and get overlooked for scientific leadership. Wray is also, at times, hounded by lesser opinions of her or assumptions about her contributions. For instance, it was often assumed that work she led was led by her mentors, or that she was/is a post-doc rather than a group leader. These sorts of assumptions are an extra hurdle she has to jump in her profession that her male colleagues do not have to approach.

3. Training

  • There is no consensus on how to structure and deliver neurology training in the UK. While specialist training can be summarized to a certain consistency (neurologists are involved in a combination of apprenticeships, teaching, and self-directed learning) and there is a national curriculum that outlines the expected skills, knowledge, and experience required of trained neurologists, there is no consensus on structuring and delivering that training at the local level.
  • This can vary trainees’ experiences upon taking the national exam. As well, in the UK, neurology trainees rotate over 5 years between a set number of university-based teaching hospitals and district-based general hospitals within a deanery (of which there are 15 that can be further portioned into rotations).
  • “The General Medical Council’s annual National Training Survey indicates that the quality of UK neurology training is very variable.” Trainees who take this compulsory survey, report significant variability in their experience of training (within and outside of their deanery). Overall satisfaction with training varied from 42% to 98% in 2018. Also, while one site showed significant positive performance, three other sites performed significantly below standard.
  • Additional evidence of training variability in the UK showed that “median clinic attendance across 33 sites ranged from one to four clinics per week. It was fewer than two clinics per week at 12% of sites, and three or more clinics per week at 21% of sites.”

Daily Activities

*Please note that some of the below day in the life details were gathered from US-based neurologists due to the dearth of recent information from European specialists.
  • For many neurologists, their days might start with reading emails and/or a slew of EEG reports.
  • They might, then, move on to conferring with lab techs or other professionals.
  • They are often seen traveling between inpatient and outpatient settings or departments which might also be one of their daily challenges.
  • Daily traveling with materials on them is another pain point. One neurologist noted to have two laptops and a backpack though no longer in medical school.
  • In vlog-style YouTube videos, the professionals were, at times, whispering or in cramped locations, which may highlight a need for personal privacy or spaces for privacy might be one of the more unacknowledged challenges when neurologists are moving about in a large hospital setting.
  • In Germany, neurologists are noted to have a rather standard workweek (M-F, 40 hours, with overtime work being rare). They do not tend to have flexible work hours, however; but they receive 20 vacation days per year. The average monthly salary for a neurologist in Germany is $7,112 US.

Other Challenges

  • Some additional challenges that might be relevant to European neurologists were raised during an American Academy of Neurology (AAN) annual meeting lecture in 2019 by Ralph L. Sacco, MD during his presidential address to the AAN delegation:
    • Emerging practice paradigms like teleneurology need better technology, business models, and payment streams.
    • Barriers to quality care, reimbursement cuts, and increased drug prices describe the current atmosphere.
    • Neurology departments need improved focus on “neuroimmunology, neurogenic and gene therapy, neuromodulation, international care, and teleneurology.”
    • Neurologists in the United States are also challenged by gender in the workforce issues, workforce shortages, and health disparities.
Sources
Sources