VIII. Training, Education, Manpower, and Research for Stroke Care

The manpower required for diagnosis and management of the 500,000 patients who experience stroke in the United States annually encompasses numerous disciplines, beginning with the family physician. The medical specialists and allied health personnel chiefly involved in addition are the neurologist, internist/cardiologist, nurse, physiatrist, physical therapist, occupational therapist, and speech therapist. Besides these, services of the radiologist, neurosurgeon, vascular surgeon, psychiatrist, orthopaedist, urologist, ophthalmologist, and pathologist frequently are needed. Important support is given by the dietitian, social worker, psychologist, and vocational rehabilitation counselor. Statistics are included for manpower available at present in a number of these disciplines. Training and education extend throughout all levels, from the undergraduate through the postgraduate, and including continuing education. The knowledge and skills which each of these special groups should possess for competence in the area of stroke are described. The results of a survey are summarized, indicating the current status of stroke care in the curricula of United States medical schools and schools of osteopathy. The concept of a stroke team is presented, describing the advantages of interdisciplinary action and effective utilization of available personnel and resources for patient care and for educational and training functions. An example is cited to demonstrate its feasibility and to illustrate the methods of establishing a local stroke program. The list of research needs in the area of stroke is extensive--over 100 pertinent topics are cited. Recommendations of the study group are summarized.