By Michel K. Mengnjo, MD

I was delighted when I was accepted for the WFN travel fellowship to Christian Doppler Clinic (CDK) at the Salzburg University teaching hospital in Austria. My gratitude goes to the World Federation of Neurology, the Austrian Neurology Society (OEGN) as well as Prof. Alfred K. Njamnshi, my head of internship program in Cameroon, and Prof. Eugen Trinka for facilitating this fellowship.

Initially programmed for the Medical University of Innsbruck, I was later sent to Salzburg. Upon arrival, under the keen and permanent assistance of Hanna Vlogger (which I kindly extend my heartfelt gratitude for her availability and prompt reaction), I settled into the hostel, working on my learning objectives and anxiously reflecting on what awaited me the next day.

During the first week at CDK Salzburg, I was welcomed by the administration and immediately given the necessary orientation. I joined the residents and specialists in the ward rounds. During this week, I dedicated myself to getting more orientation and acquaintance with the residents, specialists, nurses, technicians, and neuro-rehabilitation assistants. I was taken by a kind and welcoming resident with whom we are good friends already (Dr. Matthias Mauritz) to the neurophysiology labs, the neuro-intensive care unit (NeuroICU), the invasive monitoring units, neuro-interventionists theatre, and introduced to all of the personnel.

The hospital internship ran from 8 a.m. to 4 p.m. daily, and with a much greater interest in stroke care and epilepsy. I participated in the daily ward rounds in the stroke unit, the radiology conference (for the interpretation of neuroimaging) after which I participated in the neurosonography unit for carotid Doppler and transcranial Doppler ultrasounds.

Indeed, I was in the Christian Doppler Clinic. The name sounded familiar; back in my college years, we were taught the Doppler effect in physics and mathematics. Yes! I was in a hospital named after Christian Andreas Doppler (Nov. 29, 1803-March 17, 1853) the Austrian mathematician and physicist who is celebrated for his principle known as the “Doppler effect,” that the observed frequency of a wave depends on the relative speed of the source and the observer. This theory is widely used all over the world in different domains and in the application of neurosonography (carotid Doppler US and TCD). This served as further encouragement for me to embark on stroke care management, and I was bent on learning how to perform carotid and transcranial Doppler US in a hospital named after this renowned scientist.

Fair enough, I couldn’t afford to leave this renowned hospital without acquiring these skills. Moreover, I was privileged to assist in one of neurointerventions (carotid stent placement and endovascular intra-aneurysmal coiling) by Prof. Monika Killer-Oberpfalzer, who taught me some aspects of neurointervention as part of the management of stroke.

In addition to the acquisition of experience in the stroke unit, I also went to the EEG lab to improve my skills in EEG interpretation under the supervision of Drs. Giorgi Kuchukhidze and Alexandra Rohracher who gave me useful tips and checklists to ease interpretation. My scope of knowledge on epilepsy management was expanded during the weekly epilepsy conferences where epilepsy cases were discussed among a multidisciplinary panel of neurologists, neurosurgeons, neuroimaging specialists, neuropsychologists, neuroradiologists, and neuro-rehabilitations specialists on the integrated up-to-date management of mostly refractory epilepsies. This multifaceted manner of epilepsy was intriguing to me.

Even though we are faced with numerous challenges in Africa, such as insufficient infrastructure, technical, and human resources, I think and remain optimistic that what I have acquired could be used to formulate and adapt to our settings in order to improve the quality of care in Africa and Cameroon in particular. My interest so far in stroke medicine and epilepsy has been fueled by my stay here, and I hope to acquire more skills in these two domains in the future.

I would like to humbly acknowledge the totally different spectrum of neurological disorders between Cameroon and Salzburg with a predominance of neuroinfections and epilepsies in the former compared to neurodegenerative and neuroinflammatory diseases in the latter. I wish to recommend and encourage that an exchange fellowship be done for neurologists from countries with low prevalence of neuroinfectious diseases to WFN collaboration centers in Africa and vice versa to expand our scope on neuropathologies and its management. It will be with great joy to receive them, and I am confident that this action would be considered in the nearest future as this will pave the way for future collaborations and joint research projects.

My stay in Salzburg was one full of rich memories, both socio-culturally, academically, and professionally. My thanks go to the Prof. Eugen Trinka, Drs. Slaven Pikija, Giorgi, Matthias, Nelel Bubel, Andreea Toma, Ivan Uradnicek, Eirini Mylonaki, and many more for easing my understanding, and sometimes translating the scientific presentations in a predominantly German language. This language, though a challenge for me in the beginning, became more and more fascinating and easy to comprehend. Once more, I say thanks to them for their companionship and assistance during my stay. Salzburg filled me with her history. Literally, the “Salt Fortress” and the birthplace of the famous composer Wolfgang Amadeus Mozart (which I had the opportunity to visit), the famous Mirabel Palace and its gardens best known because they famously starred in “The Sound of Music” during the scene in which Maria and the von Trapp kids danced around its Pegasus Fountain, singing “Do-Re-Mi.”

Once more, my humble appreciation goes to the WFN, OEGN, and the Christian Doppler Clinic Salzburg for granting me this opportunity. My gratitude goes to Prof. Eugen Trinka for accommodating me into his health facility and for his assistance through his team of neurologists whom I cherish and admire.

By María Eugenia Briseño Godínez

I am a resident of neurology at the National Institute of Neurology and Neurosurgery in Mexico City. I had the privilege to be selected for the WFN Department Visit Program 2019 in Canada. I did an observership for a month in the Montreal Neurological Institute. There, I chose to be in the two services that interest me the most as a training neurologist: epilepsy and neuromuscular.

The first two weeks I was under the tutoring of Dr. Kobayashi, who not only was kind but also shared her knowledge about the treatment of patients with epilepsy. This allowed me to spend some time in the epilepsy monitoring unit; there I saw how important it is for the management and diagnosis of the patient to have the right infrastructure.

During the last two weeks, Dr. Massie accepted me in the neuromuscular unit. There, I was impressed when I saw how the ALS clinic was organized; every patient attended there receives an amazing multidisciplinary care that impacts positively on their life quality. This example of care made me feel really motivated.

In conclusion, this experience was valuable to me, because it allowed me to see and learn how neurology is practiced in a place with all of the resources. It represented a life example that will improve my knowledge as a future neurologist and the way I will treat patients in my country.

This opportunity was mind opening and for sure will be for future residents. There is nothing but gratitude to this kind of program and to the people who made it possible. •

By Dr. Meriem Aoufi

Thanks to the World Federation of Neurology (WFN) for the German department visit grant, I have spent four weeks in the department of Prof. Helmuth Steinmetz in the Goethe University Johan Wolfgang Hospital in Frankfurt.

During my stay, I trained for two weeks in the comprehensive stroke care unit (20 beds) and for another two weeks in the epilepsy video-EEG-monitoring unit (8 beds).

In my hospital, where I am a resident in my fourth year, we don’t have a stroke unit, and thus we refer these patients to other hospitals with stroke units. We also don’t have video-EEG monitoring. Therefore, it was a great opportunity for me to acquire knowledge and skills in acute stroke management and vascular secondary prevention as well as complex epilepsy differential diagnoses and presurgical workup to select patients who are candidates to undergo surgery for refractory epilepsy.

Prof. Steinmetz and his team were nice and friendly, and although the language was a bit difficult for me, they were so kind to explain to me. Thanks to the team, I have learned novel skills and knowledge to bring home and also had friendships that will last hopefully a lifetime.

Frankfurt is a beautiful and prosperous city. One can spend one’s free time in numerous parks, museums, or especially near the Main river.

I highly recommend my colleagues to apply for these grants, and I am very thankful for this opportunity. •

Dr. Meriem Aoufi is a resident in her fourth year at the EHS Ben Aknoun, Algiers, Algeria.