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International Issues: An international survey of young neurologists' perceptions of future health care and neurologyThe future occupations and interests of the medical profession have to be in some respects different from those of the past, and they have to be more various. 1Medicine continues to evolve in response to our greater understanding of disorders and the discovery of new therapies. As the 21st century begins, once again neurology finds itself in a pivotal evolutionary point of its eventful history. Breakthrough discoveries linked to molecular biology and genetic engineering have made personalized medicine foreseeable. 2Information technologies have paved the way for consultation of remote patients and have adapted to the educational demands of upcoming neurologists, patients, and caregivers. Moreover, there has been an increase in the percentage of women in the neurology workforce.3 Importantly, the voice of junior neurologists is increasingly recognized and incorporated in decision-making processes at the national and continental level. 4 The spectrum of neurology has been ever changing and frontiers have to be regularly redefined. In some countries, subspecialties have been established to deal with different needs required by acute and chronic neurologic diseases.5 Demand and allocation of specialized doctors is likely to be defined by 3 interconnected developments: the aging population, the parallel rise in chronic disease, and the affordability of health care. Indeed, contemporary health care is barely managing to cover its costs and gaps in sufficient neurology service have become evident across Europe. 6 There are limited data available on the current visions of neurologists for health care and neurology. It would be interesting to know whether the upcoming generation of neurologists is aware of global health care concerns. We aimed to garner ideas about current challenges and future development of health care among residents and junior neurologists from member states of the European Union and neighboring countries. We further assessed emerging constraints for clinical practice as well as perceptions for the development of neurology subdisciplines and core competences.METHODS Details on the Methods are in appendix e-1 on the Neurology ® Web site at Neurology.org. The questionnaire is provided in appendix e-2.RESULTS Demographics. A total of 86 participants completed the survey, yielding a participation rate of 80%. There were 45 in residency training (median 4.6 years [interquartile range (IQR) 1-12] since graduation from medical school) and 41 board-certified neurologists (for a median of 5.5 years ).

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