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UCL Queen Square Institute of Neurology

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Experiences as a medical student at Queen Square

Dr Michael Finkel is a retired consultant Neurologist from Florida, USA who spent a summer in Queen Square in 1972.

The decade between 1965 and 1975 was an age of opportunity for medical students from the U.S.A who wanted to experience European methods of teaching neurology.  I was accepted at the National Hospital for Neurological Disorders at Queen Square for the summer of 1972 as a senior medical student. My principal interests were in neurology, and many of the great names of neurology were on the staff. They wrote many of the essential papers of the day. It was an exhilarating experience to learn from them, and to appreciate the way their teaching differed from those in the United States. Interestingly, several neurology and neurosurgical programs in the United States required their trainees to have a period of study at Queen Square at that time.


The need for a complete neurological history and examination of every patient was insisted upon and rigorously pursued. Although this was just before the entry of CT scanning into the field of neurology, we were taught that the initial thoughts for diagnosis were not to be found in the laboratory. The range of neurological diseases that we encountered was extensive due to the position of the National Hospital as a resource centre for the United Kingdom and Western Europe. Every day was exciting, but I soon learned not to arrive before 9am since nothing happened until after that time.
Denis Williams, Michael Kremer, Roger Gilliatt, Chris Earl, and Ian McDonald were excellent teachers, and MacDonald Critchley was dazzling. William Gooddy’s eccentric style was entertaining. I was fortunate to be assigned to Ian McDonald’s service, and he was an enthusiastic teacher and mentor.


I returned to the United States, graduated medical school, and took my neurology training at the University of Rochester, in Rochester, New York, where many of the faculty had also studied at Queen Square, and were consistent with the emphases on history taking and attention to the neurological examination.


I stayed true to what I learned from the teachers at Queen Square and from their disciples throughout my 37 years in clinical practice with clinical research. In later years I found that the rigorous application of the neurological history and examination was not followed by many younger neurologists, despite what they had checked off on the electronic notes for reimbursement purposes.  My patients frequently commented on the thoroughness of my examinations, even though I had adapted the shortened version that I learned from Michael Harrison.


The Queen Square methods remained valid even as the neurological laboratory and diagnostic machines became available. There were many cases in which the answer was only found by history and examination. I am grateful to Ian McDonald for his encouragement to establish the Queen Square Alumnus Association, and I am glad to know that US neurologists and neuroscientists still come to learn at Queen Square. That summer was one of the most memorable of my life, and I hope that others benefit from the same quality of  experience.