Mumbai is an interesting city with large population, cosmopolitan atmosphere and a penchant for quality of work. These aspects of this vibrant city reflect on the way in which various branches of medicines are pursued here.

The specialty of neurology is comparatively new and there are few neurologists practicing their art in the city of Mumbai. It has been estimated that there is only one neurologist to cater to approximately three million Indian people. Mumbai is probably a bit easy on this ratio and there are approximately 65 neurologists working at Mumbai. The academic base of Mumbai has been very true and there are five university teaching departments in the city, imparting training for DM in Neurology. One of them, the Grant Medical College has been the oldest neurology-training centre and has trained over one hundred neurologists till date. A proportion of neurologists venture to other parts of the world to further their knowledge and experience before settling down in Mumbai to practice the art and science of Neurology. In general, it may not be audacious to say that some of the finest exponents of the art of Neurology have been working at Mumbai and newer neurologists are benefited by their large presence. Thus, every large hospital in Mumbai has a well-staffed Neurology department with a mixture of experience and enthusiasm.

The branch of neurology is going through transition. The days of reliance on the clinical methods has given way to frequent use of a variety of investigations. In the past few years, the radiological investigations have developed immensely. The CT scans and MRI scans have revolutionized the diagnostic process and the nuances of the anatomical changes can now be appreciated with ease. The city of Mumbai has number of good quality MRI and CT scan machines and there are experts reporting on the scans. Just to put up a comparison, the number of CT and MRI units in the city of Mumbai, are in the multiples of the machines available for whole of England, Scotland and Wales put together. This is very much evident in the short time frame in which the out door patients are able to get their scans done. In some other places in the world, people have to wait for months for the scan appointment to come through. Most of the modern aspects of the scans like the 64 slice CT, diffusion and perfusion scans and volumetries are available to us at Mumbai and that has indeed increased the diagnostic yield immensely, at a rapid pace. The other ancillary branches of neurology like the electrodiagnosis, neuropathology and the neurorehabilitation are also available, though not as freely as the neuroradiology. Expert electrodiagnostic advise could be obtained with short waiting time in the large hospitals of Mumbai. The infrastructure available at the hospitals has improved vastly and neurological Intensive care units are emerging.

All the above-mentioned happenings have improved the care of a patient admitted to the neurology service and the clinicians are now confident in dealing with the plethora of neurological disorders that they encounter. Medical insurance has arrived in Mumbai and more and more people are now covered under the insurance policies. This gives a little freedom to choose the most appropriate therapeutic modality. In the years to come, as more people use the medical insurance, it will perhaps become easier to deal with diseases requiring expensive therapies.

Sub-specialties in neurology are taking roots in Mumbai. Speciality clinics and programmes dealing with epilepsy, strokes, movement disorders, muscle and nerve diseases are getting established. These programmes are expected to give further expert care for difficult neurological problems seen in the city of Mumbai.

The picture is not entirely rosy. Some things still need a sea change. One constant lament is that most of the neurologists have to use all their energies in patient care and there is very little time and effort directed to the research and teaching in Neurology. This is a very import aspect; which as yet has not received much attention. It goes without saying that local studies on the prevalence, behaviour and patterns of neurological diseases differs from place to place and we need to study them locally. Once the disease spectra are identified, local research on the local problems will yield rich dividend. This may not be possible till the number of neurologists increases many fold and research gets recognition and a place of pride in the minds of people and doctors.

The interaction of society with neurology specialists is sketchy and inconsistent. For awareness, this needs to be enhanced, as prevention is better than cure.

Thus, in spite of some limitations, the practice of Neurology in Mumbai is an enjoyable experience and is expected to get better in the time to come.