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Neurologists in the United States actively involve in neurological emergency. Two factors have enabled such active contribution: (1) US residency training programs in neurology focus on management of neurological emergency as their initial training aims. Junior residents receive many lectures in emergent neurology in the initial month. (2) The numbers of the faculty members in neurology department in the US teaching hospitals are much more than those in Japan, such that each faculty member can share the teaching activities. Although the US teaching and residency systems in neurological emergency cannot be directly imported to Japan, devotion to emergency care in neurological diseases by neurologists should be incorporated into management and education in Japan.

Contribution of emergency medicine by neurologists in the western countries: residency training is the key