Insufficient awareness persists in the general medical community regarding risk factors, warning signs, and prevention strategies for stroke. A survey of 308 internal medicine residency programs showed only 144 (46%) required neurology compared with cardiology (97%, P <0.001). Furthermore, an inverse relationship was identified between the number of medicine residents completing neurology rotations and the stroke mortality by state (r = 0.41; P = 0.001). Underrepresentation of neurology in internal medicine residency programs may contribute to stroke outcome.