Vlad Tiu ^1,2* João Durães ³ Francesco Di Lorenzo ⁴ Nina Vashchenko ^5,6 Alicia Gonzalez-Martinez ^7,8 Alice Accorroni ⁹ Vanessa Carvalho ^10,11 Giacomo Sferruzza ^12,13 Luca Cuffaro ¹⁴

• ¹ Elias University Emergency Hospital, Bucharest, Romania
• ² Department of Neurology, Carol Davila University of Medicine and Pharmacy, Bucharest, Bucharest, Romania
• ³ Serviço de Neurologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Coimbra, Portugal
• ⁴ Santa Lucia Foundation (IRCCS), Rome, Lazio, Italy
• ⁵ Danish Headache Center, Copenhagen University Hospital, Glostrup, Denmark
• ⁶ Rigshospitalet, University of Copenhagen, Copenhagen, Capital Region of Denmark, Denmark
• ⁷ Princess University Hospital, Madrid, Madrid, Spain
• ⁸ Institute for Health Research, Princess University Hospital, Madrid, Madrid, Spain
• ⁹ Département des neurosciences cliniques, Faculté de médecine, Université de Genève, Geneva, Geneva, Switzerland
• ¹⁰ Hospital of Santa Maria, University Hospital Center Lisbon Norte, Lisbon, Portugal
• ¹¹ Hospital de Egas Moniz, Lisbon, Portugal
• ¹² San Raffaele Scientific Institute (IRCCS), Milan, Lombardy, Italy
• ¹³ Vita-Salute San Raffaele University, Milan, Lombardy, Italy
• ¹⁴ Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy

: Introduction: Neurosonology is a vital paraclinical investigation in modern Neurology. However, access to education and certification in Neurosonology for neurology residents and young specialists in Europe is challenging, and comprehensive data regarding this topic is scarce. Information regarding difficulties in neurosonology training across Europe may help bring this topic under the spotlight and act as a call for the harmonization of curricula across the continent. Methods: We performed an online survey targeting European neurology residents and young specialists, focusing on Neurosonology training and certification. The survey was conducted between May and September 2023 and received responses from 282 participants representing 37 European countries. Results: There were disparities in neurosonology training during residency, with 6/37 (16.2%) six countries reporting a dedicated curriculum. The respondents expressed overall lack of satisfaction with theoretical knowledge (rating their experience as very poor 28.0%, poor 20.2%, neutral 25.9%, good 19.3% and very good 6.6%) and practical skills gained during their training (rating their experience as very poor 30.9%, poor 18.9%, neutral 22.6%, good 18.1%, very good 9.5%). A total of 16/282 (5.7%) of the respondents held a national certification in neurosonology, claiming obstacles such as high costs of certification and a limited number of certifying centers. Discussion: This survey reveals significant variations in neurosonology training across Europe, indicating difficulties in obtaining certification. Despite the increasing importance of neurosonology, many neurologists feel inadequately prepared and lack practical training during residency, emphasizing the need for better and more standardized access. Conclusion: The survey underscores challenges and disparities in neurosonology training and certification in Europe. Standardization of curricula and increased awareness about available certifications are crucial to address these issues. The interest in European Certification suggests a potential solution for enhancing neurosonology training at the international level.