Jan Mohammed M S
Department of Pediatrics, King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia.
J Child Neurol. 2004 Jan;19(1):1-5. doi: 10.1177/08830738040190010101s.
Pediatric neurology is considered a relatively new and evolving subspecialty. In Saudi Arabia, neurologic disorders in children are common, and the demand for trained pediatric neurologists is strong. The aim was to study the perception of the pediatric neurology specialty among practicing generalists and their referral practices. Attendees of a symposium on pediatric epilepsy comprehensive review for the generalist were included. A structured 25-item questionnaire was designed to examine their demographics, training, practice, and referral patterns. One hundred nineteen participants attended the symposium, and 90 (76%) questionnaires were returned. Attendees' ages were 22 to 70 years (mean 32 years), with 65.5% female physicians. There were 32% consultants, 51% trainees, and 17% students. Most physicians (67%) were practicing general pediatrics. Only 36% received a structured pediatric neurology rotation during training. Children with neurologic complaints constituted 28.5% of those seen in their practice, and they referred 32.5% of them to pediatric neurology. Only 32% were moderately or highly confident in making the diagnosis or providing the appropriate treatment. Those who received a structured pediatric neurology rotation felt more comfortable in their management (P = .03). Many physicians (38.5%) had no direct access to a pediatric neurologist for referrals. To conclude, pediatric neurologic disorders are common in daily practice. Most generalists did not receive a structured neurology rotation during their training and were not highly confident in diagnosing and treating these children. Given the limited number of pediatric neurologists, I highly recommend that generalists receive appropriate neurologic training.
儿科神经病学被认为是一个相对较新且不断发展的亚专业。在沙特阿拉伯,儿童神经系统疾病很常见,对训练有素的儿科神经科医生的需求很大。目的是研究执业全科医生对儿科神经病学专业的认知及其转诊行为。纳入了一个针对全科医生的儿科癫痫综合复习研讨会的与会者。设计了一份包含25个条目的结构化问卷,以调查他们的人口统计学、培训、执业情况和转诊模式。119名参与者参加了研讨会,90份(76%)问卷被收回。与会者年龄在22至70岁之间(平均32岁),其中65.5%为女医生。有32%的顾问、51%的实习生和17%的学生。大多数医生(67%)从事普通儿科工作。只有36%的人在培训期间接受过结构化的儿科神经病学轮转。有神经系统症状的儿童占他们执业中所见患者的28.5%,他们将其中32.5%的患者转诊至儿科神经病学。只有32%的人在做出诊断或提供适当治疗方面有中度或高度信心。接受过结构化儿科神经病学轮转的人在管理方面感觉更自如(P = 0.03)。许多医生(38.5%)没有直接联系儿科神经科医生进行转诊的途径。总之,儿科神经系统疾病在日常实践中很常见。大多数全科医生在培训期间没有接受过结构化的神经病学轮转,并且在诊断和治疗这些儿童方面信心不足。鉴于儿科神经科医生数量有限,我强烈建议全科医生接受适当的神经病学培训。