Another potential barrier to stroke treatment is the education of emergency department physicians regarding neurological emergencies. A survey (Settler, Jauch, Kissela & Lindsell, 2005) of 98 of the 126 accredited emergency residency programs in the United States found that very little time was spent on neurological emergencies beyond didactic material . A neurology rotation was required for only 16 programs and neurosurgery rotation for only 14 of the 92 programs. Only I required both a neurology rotation and a neurosurgery rotation, and I program required either a neurology or neurosurgery rotation. In 15 of the 32 required neurological rotations, 46.9% of time was spent in the intensive care unit only. The remaining 17 rotations used outpatient clinic and general floor neurology settings. Electives in neurology, neurosurgery and neuroradiology were available in 32 programs but were seldom used (Settler et al., 2005).