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Neuroanatomy Education Access by Country Income Level: A Mixed-Methods Analysis
Daniele S C Ramsay1, Benjamin J Nicholls2, Natasha Dixon3
1Faculty of Medicine, Imperial College London, London, UK; Imperial Brain and Spine Initiative, London, UK.
World Neurosurgery
|November 29, 2025
Summary
Neuroanatomy education faces challenges, particularly for trainees in low-middle income countries (LMIC) who report greater dissatisfaction and barriers like lack of specialist teaching. Improving neuroanatomy provision requires addressing these disparities for equitable access.
Area of Science:
- Medical Education
- Neuroscience
- Global Health Equity
Background:
- Neuroanatomy is crucial for clinical reasoning and neuroscience specialization.
- Perceived complexity and challenges in neuroanatomy education impact medical trainees.
- Disparities in neuroanatomy education exist between high-income (HIC) and low-middle income countries (LMIC).
Purpose of the Study:
- To analyze trainee perceptions of neuroanatomy education provision.
- To compare educational experiences between HIC and LMIC trainees.
- To identify barriers to effective neuroanatomy teaching.
Main Methods:
- A mixed-methods approach analyzed 519 pre-course questionnaire responses.
- Quantitative data (Likert scale) and qualitative free-text responses were compared.
- Multivariable regression and thematic analysis identified key differences and barriers.
Main Results:
- LMIC trainees reported significantly greater dissatisfaction with neuroanatomy provision (OR=2.34).
- Key barriers identified include need for multimodal teaching, lack of specialist instruction, systematic issues, and complexity.
- LMIC trainees were more likely to cite lack of specialist teaching (p=0.006).
Conclusions:
- Significant differences exist in neuroanatomy provision between HIC and LMIC.
- Lack of specialist-led teaching is a prominent barrier for LMIC trainees.
- Equitable neuroanatomy education requires focused interventions, potentially utilizing international online platforms.
