- Current gaps in FND education
- Impact of inadequate training on patient outcomes
- Core competencies for FND in medical education
- Integrating FND into existing curricula
- Collaborative approaches to curriculum development
Despite Functional Neurological Disorder (FND) being one of the most common causes of neurological disability in outpatient settings, formal coverage of the condition in undergraduate and postgraduate medical education remains limited or entirely absent. Many medical schools allocate little time to FND, often failing to include it as a core topic within neurology, psychiatry, or general medicine rotations. As a result, newly qualified doctors often lack the awareness and skills necessary to identify and manage FND appropriately.
Existing neuroscience and psychiatry modules tend to compartmentalise disorders into either “organic” or “psychological” categories, leaving FND—which straddles both domains—largely unaddressed. This dichotomy negatively affects students’ understanding, fostering misconceptions that FND is not a ‘real’ condition or that it lies outside the remit of legitimate clinical concern. Consequently, clinicians may misinterpret symptoms, leading to delays in diagnosis and inappropriate or inadequate treatment.
Clinical exposure to FND during training is also generally scarce. Few medical schools include structured patient contact involving individuals living with FND, which limits opportunities for students to learn from real-world consultations and patient narratives. Furthermore, assessments rarely test knowledge of FND, thereby reinforcing the message that it is less important than other neurological or psychiatric disorders.
The lack of standardised learning outcomes related to FND compounds the problem. Educational materials and case-based learning scenarios frequently overlook the condition, and teaching staff themselves may have had limited training in recognising FND, contributing to inconsistent instruction and variation across institutions. This poses challenges not only to student knowledge, but also to the attitudes of future clinicians, who may carry forward scepticism or discomfort in dealing with FND patients.
The combination of insufficient content, limited clinical exposure, and outdated conceptual models leaves a noticeable gap in current medical education. Bridging this gap is essential for equipping future doctors with the knowledge, confidence, and sensitivity required to care for patients with FND effectively and compassionately.
Impact of inadequate training on patient outcomes
Inadequate training in recognised approaches to Functional Neurological Disorder (FND) has a significant influence on the quality of care patients receive, often resulting in misdiagnosis, fragmented treatment pathways, and poor patient–physician relationships. When healthcare professionals are poorly equipped to understand or manage FND, patients frequently experience delayed diagnoses, inappropriate investigations, and referrals to multiple specialities without meaningful intervention. This can lead to increased healthcare utilisation and frustration among both patients and clinicians.
The absence of adequate medical education and awareness around FND contributes directly to the stigmatisation of the condition. Without a strong foundation in the biopsychosocial model and the clinical features of FND, medical practitioners may question the validity of symptoms, erroneously label individuals as malingering, or dismiss the condition altogether. Such attitudes undermine patient trust and can have a lasting psychological impact, sometimes exacerbating functional symptoms and decreasing quality of life.
Empirical studies suggest that patients with FND often report feeling invalidated or blamed during clinical encounters. This is particularly concerning given that reassurance and a clear, empathetic explanation of the diagnosis are central to effective FND management. However, where physicians lack the necessary training to communicate effectively about FND, patient adherence to treatment plans and overall prognosis can be adversely affected. Missed opportunities for early intervention not only prolong suffering but can also result in chronic disability that might otherwise have been preventable.
The consequences of insufficient FND education are also reflected in an over-reliance on costly and often unnecessary diagnostic tests. Without confidence in making a positive clinical diagnosis, practitioners may default to testing for alternative explanations, leading to redundant investigations and increased financial strain on health services. Moreover, this approach reinforces uncertainty and confusion for patients, who may become more entrapped in cycles of medical ambiguity and despair.
In contrast, emerging evidence shows that clinicians who receive targeted education and training in the recognition and management of FND are more likely to make timely, accurate diagnoses and refer patients to appropriate interdisciplinary care pathways. This not only improves patient satisfaction but also supports better functional outcomes. Therefore, addressing gaps in awareness and teaching within medical education is not merely an academic exercise—it has tangible, life-altering implications for individuals living with FND.
Core competencies for FND in medical education
Developing core competencies for Functional Neurological Disorder (FND) within medical education is a critical step in ensuring that future clinicians are equipped with the knowledge, skills, and sensitivity needed to care for patients with this often misunderstood condition. A competency-based approach allows for the systematic integration of FND into curricula, promoting consistency across teaching institutions and improving the standard of care that patients receive.
One foundational competency is a thorough understanding of the definition, epidemiology, and clinical presentation of FND. Medical undergraduates and postgraduates should be able to recognise the diverse and sometimes subtle manifestations of the disorder, including motor and sensory symptoms, dissociative seizures, and cognitive disturbances, and understand how these differ from organically caused conditions. The ability to make a positive diagnosis—based on rule-in signs rather than exclusion alone—is integral and should be emphasised early in training.
Another core competency involves familiarity with the current neurobiological and psychological models that underpin FND. This includes the application of the biopsychosocial model and comprehension of how factors such as trauma, stress, and neurological functioning may interact. Developing this knowledge base fosters informed clinical reasoning and helps professionals move away from dualistic thinking that separates mind and body, which has historically led to misconceptions about FND.
Effective communication is also essential. Medical students and junior doctors must be trained to deliver a diagnosis of FND with clarity, empathy, and authority. This entails explaining the condition in patient-friendly language, validating the patient’s experience, and avoiding language that may imply that the symptoms are ‘imagined’ or voluntary. Simulating these conversations in teaching sessions and clinical training helps build the interpersonal skills required for real-life consultations and may reduce patient anxiety and improve acceptance of the diagnosis.
An additional competency is understanding appropriate treatment pathways and the importance of interdisciplinary care. Students should learn when and how to refer patients for neurological review, physiotherapy, psychology, or occupational therapy, and understand how these services interact to provide holistic care. Awareness of evidence-based therapeutic interventions—such as physiotherapy tailored to FND symptoms or cognitive behavioural therapy—enables clinicians to guide patients towards beneficial management options rather than resorting to unnecessary or unhelpful investigations.
Finally, cultivating professional attitudes that promote trust, respect, and non-judgement is key. This means fostering awareness of implicit biases and recognising how stigma associated with functional disorders can affect clinical decision-making. Including reflective practice as part of training can help future healthcare professionals examine their assumptions and improve their capacity to provide compassionate, patient-centred care.
Embedding these competencies within medical education helps not only to prepare doctors for clinical practice but also signals that FND is a legitimate, important, and prevalent condition deserving of rigorous academic and clinical attention. Doing so will aid in shifting cultural attitudes within medicine and ultimately improve the experiences and outcomes of patients living with FND.
Integrating FND into existing curricula
Integrating Functional Neurological Disorder (FND) into existing medical curricula requires a thoughtful and practical strategy that aligns with broader educational priorities while enhancing awareness, skill development, and clinical sensitivity. Rather than creating entirely new modules, educators can incorporate FND-related content within established disciplines such as neurology, psychiatry, general medicine, and even primary care to ensure broad exposure across different stages of training. This integrative approach ensures that FND is encountered by all students, not just those with a specialist interest, and reinforces the idea that managing FND is part of general clinical competence.
One effective method for embedding FND in medical education is through case-based learning. Realistic clinical scenarios can illustrate the diagnostic process, communication challenges, and multidisciplinary management of FND. These cases can be incorporated into existing problem-based learning sessions or clinical skills training, where students are already encountering similar formats for other conditions. Having students diagnose and construct management plans for patients with symptoms such as functional tremor or dissociative seizures fosters familiarity and demystifies the condition.
Simulation-based education also offers significant potential. Role-play and standardised patients presenting with FND allow students to practise their diagnostic acumen as well as delivery of sensitive explanations regarding the diagnosis. This experiential learning not only develops clinical reasoning but also strengthens empathy and confidence in communicating about functional symptoms—outcomes that are difficult to achieve through didactic teaching alone.
Lectures and seminars can further support integration by ensuring FND features within core teaching about neurology and psychiatry. These sessions should move beyond outdated dichotomies of ‘organic’ versus ‘psychological’ and present FND using current scientific frameworks. Inviting experts in FND care, such as specialist neurologists or neuropsychiatrists, to deliver these sessions can increase the accuracy and nuance of the content while inspiring interest among students. In addition, including perspectives from people living with FND through video recordings or invited talks can humanise the condition and challenge prevailing stigma through personal narrative.
For postgraduate and continuing professional development, FND-focused workshops, online modules, and multidisciplinary training can be introduced into foundation year and speciality training programmes. These can include practical guidance on diagnosis, red-flag signs for organic disease, pathways for referral, and examples of collaborative care involving physiotherapists, psychologists, and occupational therapists. In this way, training becomes more applicable to real-life clinical contexts and encourages a team-based approach to care, which is central to positive FND outcomes.
Assessment is another area where FND can be meaningfully integrated. Including questions on FND in written examinations, Objective Structured Clinical Examinations (OSCEs), or clinical placement evaluations reinforces its relevance within the wider spectrum of conditions that students are expected to understand and manage. This also serves to normalise FND within academic evaluation and ensures that learners take the condition seriously during their preparation and revision processes.
To support faculty in delivering this material, investment in educator training is crucial. Staff involved in curriculum design and teaching must possess up-to-date knowledge and be confident in their understanding of FND. Providing short courses or resources for faculty development in this area can help overcome previously embedded misperceptions and ensure consistency across teaching environments. Textbooks and educational resources should also be revised to include modern representations of FND, removing outdated or dismissive language and providing examples of clinical best practice.
The integration of FND content into medical education depends not only on curriculum structure but also on the prevailing educational culture. Emphasising FND as a scientifically grounded and clinically important condition sends a powerful message to learners about its legitimacy and about the medical profession’s obligation to serve patients with functional symptoms with the same respect and diligence as any other diagnosis. Ultimately, strategic integration helps close the gap between educational theory and clinical practice, ensuring that graduates are both intellectually equipped and emotionally prepared to manage FND patients effectively and compassionately.
Collaborative approaches to curriculum development
Developing a comprehensive and inclusive curriculum for Functional Neurological Disorder (FND) requires collaborative efforts across a range of stakeholders within the field of medical education. Effective curricular reform cannot be undertaken in isolation; successful integration depends on consultative partnerships between academic institutions, clinical experts, patient advocacy groups, and regulatory bodies. This multi-angled approach ensures that curricular developments are both educationally robust and clinically relevant, while also reflecting the lived experiences of individuals with FND.
At the core of this collaborative process is the involvement of clinicians with direct expertise in diagnosing and managing FND. Neurologists, psychiatrists, neuropsychologists, physiotherapists, and general practitioners who regularly care for patients with FND can provide critical insights into what students need to learn at various stages of their training. These clinical perspectives help shape practical learning objectives that reflect not only evidence-based practice but also the realities of interdisciplinary care. Academic clinicians can also champion the inclusion of FND in national and institutional curricula, advocating for its place alongside longer-established medical conditions.
Equally important is the contribution of patients and patient representatives. The voices of people living with FND offer a crucial dimension to curriculum development by highlighting gaps in clinician understanding, barriers to care, and the impact of stigma. Their narratives help contextualise the symptoms, bring urgency to the need for better awareness, and underscore the human cost of inadequate training. Involving patient groups in curriculum consultations can shape teaching content that is more empathetic, nuanced, and attuned to real-world complexity, ultimately fostering a more compassionate approach among future healthcare practitioners.
Medical education researchers, too, play a vital role in guiding curriculum development through evidence-based strategies. Their expertise in pedagogy, outcomes assessment, and curricular design ensures that FND content is delivered in ways that are engaging, measurable, and aligned with broader educational goals. Researchers can also evaluate the impact of implemented changes on learner competency, confidence, and attitudes, enabling iterative improvements backed by data rather than assumption.
National bodies responsible for medical education standards—such as medical schools councils, accrediting organisations, and examination boards—must also engage in the collaborative process by officially recognising FND-related learning outcomes. By embedding relevant competencies into national frameworks and assessment blueprints, these organisations help standardise expectations across training pathways and signal that FND represents an essential component of clinical training. This top-down support reinforces the legitimacy of teaching FND at all educational levels and encourages institutions to allocate appropriate time and resources.
Institutional leadership, such as deans of medical education and curriculum committees, have a coordinating function in this collaborative endeavour. Their role includes identifying existing curricular entry points, fostering cross-departmental cooperation, and ensuring alignment with institutional values around diversity, mental health, and patient-centred care. A facilitator within the institutional framework can help streamline communication between clinicians, patients, and educators, making the process more efficient and goal-oriented.
Professional societies and charitable organisations focused on FND can also contribute by developing freely accessible teaching resources, organising workshops, and offering continuing professional development (CPD) sessions. These initiatives support both undergraduate and postgraduate training and can serve as practical tools for institutions seeking to enhance their FND education without starting from scratch. Resources such as modular presentation slides, patient video interviews, and clinical checklists help bridge the knowledge gap in areas where educator awareness may previously have been limited.
A successful collaborative model requires an ongoing dialogue rather than a one-off intervention. As research into FND continues to evolve, so too should the curriculum. Regular curriculum reviews informed by data from clinical audits, student feedback, and developments in the scientific literature allow medical education providers to update content accordingly. Long-term partnerships across disciplines and sectors thus offer a sustainable mechanism for keeping FND education responsive and relevant over time.
Collaboration in curriculum development not only enhances content accuracy and diversity of perspectives but also builds a wider community of awareness and advocacy. By drawing on the strengths of each stakeholder—clinical insight, patient experience, pedagogical rigor, and policy enforcement—such efforts can overcome the fragmentation that has historically plagued FND training. In doing so, medical education can begin to address longstanding deficiencies and cultivate a new generation of clinicians who are knowledgeable, confident, and empathetic in their care of patients with FND.
