To assess whether targeted revisions to the neurology clerkship reduce “neurophobia”—fear or anxiety toward neurology—among third-year medical students.

Neurophobia is a common barrier to medical students’ interest and confidence in neurology. In 2023, the neurology clerkship was restructured. Key changes included a dedicated 4-hour standardized-patient neurological examination session on day 1, student-only didactic conferences, and individualized review of clinical notes.

Anonymous surveys were administered to third-year students over 20 months with consecutive blocks of 16 students. Surveys were distributed pre-clerkship, immediately following the day 1 standardized-patient session, and at clerkship completion. Each used 5-point Likert scales assessing fear of neurology, self-perceived competence, likelihood of pursuing neurology, and comfort with specific neurological examination domains. Because surveys were anonymous, responses were analyzed as independent samples using Kruskal–Wallis or Mann–Whitney U tests with Holm-corrected post-hoc comparisons.

A total of 121 pre-clerkship, 95 post-day-1, and 58 end-of-clerkship surveys were analyzed. Mean fear-of-neurology scores improved significantly across time (Kruskal–Wallis p < 0.001, ε² = 0.23), with the proportion reporting little or no fear rising from 36% to 88%. Self-rated competence increased from a median of 2 to 4 (p < 0.001), and comfort improved across nearly all examination subdomains, most prominently cranial nerves, motor, sensory, and neurological terminology (all p < 0.001). Neuroanatomy persisted as an area of relative apprehension, remaining the most frequent source of fear at clerkship completion. Interest in pursuing neurology trended upward but did not reach statistical significance.

Curricular modifications emphasizing early hands-on neurological examination practice and small-group, student-specific teaching were associated with significant reductions in neurophobia and gains in confidence across all clinical domains. Even single-day standardized-patient immersion produced measurable improvements by the end of day 1, sustained through clerkship completion. These findings support targeted, experiential, and feedback-driven strategies to improve attitudes toward neurology in undergraduate medical education.