Global Perspectives

Abstract

Correspondence to Dr. Pelli-Noble: fnoble@tucbbs.com.ar BACKGROUND OF THE SOCIEDAD NEUROLÓGICA ARGENTINA: CURRENT STATE AND CONCERNS ABOUT NEUROLOGIC EDUCATION Neurology in Argentina emerged toward the end of the 19th century, following the origin of the specialty in Europe. Its development can be divided into 3 periods. The first is the specialty of neurology as part of internal medicine. Doctoral theses and publication about neurologic topics are found early in the history of medicine, but merged into internal medicine. The second period is the foundation of clinical neurology under the typical European influence, mainly French, when the first neurologists appear. This period started in 1885 with the creation of the Hospital San Roque de Buenos Aires’ first nervous diseases department. Its first chair was José María Ramos Mejía, MD. In 1887, 5 years after Jean-Martin Charcot was awarded the chair of neurology at the Salpêtrière in Paris, Ramos Mejía became the first professor of neurology in South America, at the University of Buenos Aires. The third period is the emergence of subspecialty practices. During the 1970s—reflecting the North American influence—there was a new paradigm favoring the division of different disciplines. Specialists in epilepsy, stroke, headache, dementia, and multiple sclerosis, among others, began to emerge. In 1952, the Sociedad Neurológica de Buenos Aires was established as an independent society, separate from other specialties such as psychiatry and neurosurgery. After the first International Congress of Neurological Sciences was organized in Brussels in 1957 by Ludo van Bogaert, the Sociedad Neurológica de Buenos Aires became the Sociedad Neurológica Argentina (SNA), a member of the World Federation of Neurology (WFN). One of the most important milestones was the organization of the World Congress of Neurology in 1997 in Buenos Aires, an event that convened 5,300 neurologists from 114 different countries (figure 1). The first journal of neurology in Argentina and in South America was the Revista Neurológica de Buenos Aires, created by Vicente Dimitri in 1936 (figure 2), which featured reviews, neuropathologic descriptions, clinical case studies, and notices and summaries of international congresses and lectures. This first Spanish publication in the discipline was very important because few physicians had a good handle on non-Spanish languages and few had access to international journals. In 1972, the journal was renamed Revista Neurológica Argentina and since 2009 has been called Neurología Argentina, the official journal of the SNA. Argentina is a country located between the parallels 21°469 S and 55°039 S, with 2,791,810 km of continental territory. The country is divided into 23 provinces and one autonomous city, with a total population of 40,117,096. The population is unequally distributed, with a large concentration in Buenos Aires province, where there are 18,515,235 inhabitants (census 2010). In Argentina, there are approximately 1,100 adult neurologists and 64% of them have their practice in Buenos Aires, with 36% in the rest of the country. This uneven distribution reveals that in Buenos Aires, there is one neurologist per 8,542 inhabitants and in the province of Santa Cruz, there is one neurologist per 32,800 inhabitants. An estimated 72% of the neurologists in the country are members of the SNA. The large land surface of the country and the unequal distribution of both population and neurologists represent important barriers for optimal neurology education. During recent years, the SNA has implemented a number of strategies to improve neurology education, particularly in areas far from Buenos Aires. Since 2003, Argentina has participated in the Continuing Medical Education (CME) program supported by the WFN. This program is a partnership among the WFN, the American Academy of Neurology (AAN), and the SNA. It provides 6 specially designed educational courses each year based on the AAN’s premier CME journal Continuum: Lifelong Learning in Neurology®. The program was developed in Argentina according to the country’s regional needs, geography, and human resources. The plan divided the country into 6 regions and appointed one or more regional delegates to lead the program within the region. There is also a national coordinator and the central headquarters are in