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Africa remains the continent with the lowest neurologist/population ratio. Despite an increase in training centres, many countries have a ratio of less than one neurologist per 1,000,000 people. With the aim of providing data on the barriers in neurology training in Africa, we carried out an online survey distributed in several countries.

18 residents and neurologists <5 years of completion responded to this survey. The training duration is generally 4 years except in Ethiopia (3 years). Few centres offers sub-specialized training such as epileptology, clinical neurophysiology, and pediatric neurology. Training on movements disorders, stroke medicine remains limited. There is about one full professor for every ten residents. In some centres, diaognostic tools (MRI, CT scan, EEG, EMG) are still unavailable. Genetic testing, neuromuscular biopsy and evoked potentials are scarce. Specialized therapies (thrombectomy, thrombolysis, DBS and botulinum toxin) are limited. In some centres, there are no facilities such as internet, library, scientific journals free access, webinars, research and scientific writing training. Few grants are available even though there is sometimes government funding. Attendance in international congresses, workshops and seminars are restricted by the lack of funding and difficulties in visa application.

Neurology training in Africa faces many challenges such as the lack in human resources, in sub-specialization training, in diagnostic tools, in specialized therapies, and limited access to international events. A frank collaboration between the different countries, the proper use of new technology (virtual events), and the support of partners could help to fill this gap for the benefit of patients/community.

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BACKGROUND:
Africa is the world's second-largest and second-most populous continent, after Asia in both cases, with 1.3 billion inhabitants. A 2006 World Federation of Neurology survey investigating the number and nature of neurology residency programs worldwide disclosed that the majority of training programs (67%) are located in high-income countries and the rest are found in low-income or medium-income countries.
ETHIOPIAN EXPERIENCE:
Neurological education in Ethiopia was established in 1973 with the opening of a Neurology Unit by the Department of Internal Medicine of Addis Ababa University, which trains both undergraduate medical students and post graduate internal medicine residents. In January 2006, the unit was upgraded, and the neurology residency (postgraduate) programs—the first of its kind in Ethiopia—was initiated at the Department of Internal Medicine. From its inception, neurology training in Ethiopia has been strongly supported by dedicated neurologist from the Mayo clinic. Currently, more than 60 neurologists are practicing in the country and close of 28 neurology residents are enrolled in the three years neurology training program at Department of Neurology, Addis Ababa University.
ROLE OF PARTNERS:
The role of international partners in development and fostering of neurological training in Africa should focus on the following vital areas of deficiencies: a) Capacity building for neurologists currently working in Africa; b) Increasing number of neurology training centers; c) Improving neurological care in Africa; d) Creating a collaborative networks with developed regions; e) Scale up of good training experience in the region (Ethiopia); f) Improving research outputs from the region.