Neurophobia or neuroavoidance: a student or educator issue?

Kelsey Andrews
Jack Riggs 
Morgantown, West Virginia, United States

 

“It is the supreme art of the teacher to awaken joy in creative expression and knowledge.”
– Albert Einstein

 

Human brain, the subject of neurophobia or neuroavoidance
The human brain – perhaps the most complex and interesting structure in the universe. That statement should make neuroscience a subject of attraction, not avoidance or phobia. Photo by Petr Kratochvil. Via Publicdomainpictures.net. Public domain.

Jozefowicz introduced a new term in neurology education literature in 1994, defining “neurophobia” as “a fear of the neurosciences and clinical neurology that is due to the student’s inability to apply their knowledge of the basic sciences to clinical situations.”1 This original delineation of the concept has gained considerable traction, and now has more than 250 citations. Using DSM-5 criteria, neurophobia would be classified as a specific phobia within the category of anxiety disorders.2 Diagnostic criteria for a specific phobia include “marked fear or anxiety about a specific object or situation” that is “out of proportion to the actual danger posed” and which “causes clinically significant distress or impairment in social, occupational, or other areas of functioning.”2

Integrating neuroscience with clinical neurology is difficult. Medical students perceive neurology as the most difficult clinical area of study and believe their knowledge and confidence in this subject to be the lowest.3 Most people tend to avoid these types of challenges. However, avoidance is not phobia. To be fair, Jozefowicz emphasized better neurologic educational exposure and opportunities as a “treatment” for neurophobia.1 Relatedly, the likelihood of medical students entering a neuromedicine residency correlates with their medical school having a required neurology clerkship.4

“Neurophobia: a chronic disease of medical students”5 recognizes that many carry this label, that better education is the treatment, and that the term “neuroavoidance” may be more appropriate. Neuroavoidance better places the challenge on the shoulders of educators, not students. Neuroscience educators must be more effective in stimulating and inspiring excitement in this seemingly complex and difficult subject. In the face of increasing demand, the future availability of specialists in neuromedicine is dependent on that effectiveness.6-7

 

References

  1. Jozefowicz, RF. Neurophobia: the fear of neurology among medical students. Arch Neurol 1994; 51: 328-329.
  2. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Washington DC: American Psychiatric Publishing, 2013.
  3. Schon F, Hart P, Fernandez C. “Is clinical neurology really so difficult?” J Neurol Neurosurg Psychiatry 2002; 72: 557-559.
  4. Albert DV, Yin H, Amidei C, Dixit KS, Brorson JR, Lukas RV. “Structure of neuroscience clerkships in medical schools and matching in neuromedicine.” Neurology 2015; 85: 172-176.
  5. Solorzano GE, Jozefowicz RF. “Neurophobia: a chronic disease of medical students.” Neurology 2015; 85: 116-117. 
  6. Chhetri SH. “E-learning in neurology education: principles, opportunities and challenges in combating neurophobia.” J Clin Neurosci 2017; 44: 81-83.
  7. Ridsdale L, Massey R, Clark L. “Preventing neurophobia in medical students, and so future doctors.” Pract Neurol 2007; 7: 116-123.

 


 

KELSEY N. ANDREWS, M.D., is a PGY4 neurology resident at West Virginia University.

JACK E. RIGGS, M.D., is a Professor of Neurology at West Virginia University.

 

Winter 2022  |  Sections  |  Neurology