Neurology Beyond Borders: Germany

Send us Fan Mail From his office in Cologne late at night, Dr. Lukas Hensel walks us through what neurology in Germany really looks like on the ground, especially inside a university hospital where stroke, ICU-level decisions, and rare diagnoses show up disproportionately often. We follow his path into medicine and the “brain as a map” mindset that pulled him toward neurology, then zoom out to the structure of German neurology training. He explains a mentor-driven approach to specialization, the sharp divide between outpatient neurology and inpatient academic centers, and why protected research time can be both possible and precarious depending on staffing and grant funding. If you’re curious about academic neurology careers, acute stroke care, and neurologic intensive care medicine, his day-to-day description is as practical as it is honest. The conversation also gets clinical: the dominant stroke risk profile in a Western aging population, the rising mix of vascular injury with neurodegenerative disease, and the steady presence of inflammatory conditions like multiple sclerosis. Dr. Hensel shares a standout interdisciplinary case where persistence, repeat biopsy, and tight coordination across services changed the trajectory for a patient with recurrent embolic events. We close with what he wants next for German healthcare and neurology: more effective rehabilitation, smarter use of digital markers, earlier prevention, and clearer end-of-life communication so treatment matches patient values. Subscribe for more global neurology conversations, share this with a colleague, and leave a review if it helped you think differently. What part of the German neurology system would you want to borrow or change first? Support the show Hosts: Dr. Nupur Goel is a third-year neurology resident at Mass General Brigham in Boston, MA. Follow Dr. Nupur Goel on Twitter @mdgoels Dr. Blake Buletko is a vascular neurologist and program director of the Adult Neurology Residency Program at the Cleveland Clinic in Cleveland, OH. Follow Dr.  Blake Buletko on Twitter @blakebuletko Follow the Neurophilia Podcast on Twitter and Instagram @NeurophiliaPod