Training of neurologists for the 21st century: cultural and professional skills

Training of neurologists for the near future is a challenge due to the likely advances in neuroscientific methods, which will change much of our knowledge on diagnosis and treatment of neurological diseases.

OBJECTIVE

to comment on what may be more likely to be a constant in the very near future and to recommend how to prepare the neurologist for the 21st century.

METHODS

through a critical review of recent articles on the teaching of Neurology, to present a personal view on the subject.

RESULTS

Diagnostic methods and therapeutic resources in Neurology will be greatly improved, but the central core of teaching young neurologists will continue to be the clinical/anatomical correlation. The neurologist must be prepared to be the primary physician in the care of patients with neurological disorders, although the roles of consultant and clinical neuroscientist must also be considered. In addition to technical knowledge, the neurologist must be prepared to discuss not only distressing issues related to the specialty, such as the risks of genetic diseases for family members of their patients, the inexorable progression of some diseases and the need for palliative care, but also problems not directly related to Neurology that cause anxiety and depression in the patient or that are the main reason for the initial consultation.

CONCLUSION

neurology will be an even more important area of medicine and the neurologist must be well prepared to be the primary doctor to diagnose, treat and follow the patient with neurological disorders. In addition to technical knowledge, training in doctor-patient relations should be highlighted.

The history of Mother-Baby Units (MBUs) in France and Belgium and of the French version of the Marcé checklist

Until fairly recently, mentally ill mothers were separated from their new-borns because of the potential danger to the baby. Over the past 50 years, however, we have learned more about the perinatal period, with the development of child psychiatry and interest in maternal postpartum disorders. This knowledge has led psychiatric departments to develop new ways to provide care without separating mentally ill mothers from their babies. Joint full-time admissions began in Great Britain in 1948. The first Mother-Baby Unit (MBU) in France opened in 1979 and in Belgium in 1990. In 2003, there are 17 MBUs in France and 3 in Belgium. From 1995 to 1998, Odile Cazas and Nine Glangeaud, working with a group of child and adult psychiatrists and psychologists, adapted the English Marcé Checklist to the French and Belgian health and child protective systems and added items useful for research.