Emerging Subspecialties in Neurology: Headache medicine

Dhaem, Olivia Begasse de; Minen, Mia T.

doi:10.1212/wnl.0000000000003763

Cited by 5 publications

(5 citation statements)

References 15 publications

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“…This may be related to the low status and the stigma assigned to many chronic pain patients. Hopefully, with the emerging improvements in the understanding and treatment of headache disorders, this will change (34).…”

Section: Discussionmentioning

confidence: 99%

Neurology residents’ knowledge of the management of headache

2019

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Background In Norway, as in most other countries, the training program for clinical neurology has no mandatory headache program. Knowledge in headache management must therefore be acquired during everyday clinical training. The objectives of this study were to investigate neurology residents’ knowledge of headache. Methods A questionnaire survey was undertaken among neurology residents in Norway. Results All 17 neurological departments in Norway participated, and 143 residents responded (86%). Sixty percent were women, mean age was 32.5 years, and the respondents had an average of 28 months clinical training in neurology. Fifty-six percent knew the approximate prevalence of migraine and chronic headache. Thirty-seven percent asked their patients about disability, quality of life, and social functioning at every consultation. Further, 72% would prescribe prophylaxis for chronic tension-type headache and 97% for very frequent migraine. One third wrongly stated that use of the most common headache prophylactics could lead to medication-overuse headache. Headache diaries were used regularly by 63% for diagnostic purposes, and 73% requested an MRI for all long-lasting headaches referred to neurological outpatient clinics. Conclusion Although a major public health problem, headache knowledge is moderate at best, and its management clearly varies. There is an unmet need for a better and more structured headache training program in Norway.

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Section: Discussionmentioning

confidence: 99%

Neurology residents’ knowledge of the management of headache

2019

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“…The field of headache medicine has recently been reframed as an emerging subspecialty of neurology based on fellowship program credentialing and advances in therapeutics, though the discipline has existed for over a century and the burden of illness of headache disorders is immense . Our study results suggest that the under‐emphasis of headache education within neurology residency training is strongly associated with the lack of neurologists interested in headache medicine in academic leadership faculty who are best positioned to effect change in graduate educational curriculum.…”

Section: Discussionmentioning

confidence: 92%

“…Despite the burden of illness and the tremendous need for care, specialists in headache medicine are few and poorly distributed geographically in the United States . Despite recognition as a dynamic scientific and therapeutic field of neurology, few neurologists pursue headache medicine fellowships and careers, with only 8.3% of recent neurology residency graduates planning to subspecialize in the field . Headache education in graduate neurology training programs is also under‐represented …”

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confidence: 99%

Headache Interest in Academic Neurology Leadership: A Cross‐Sectional Study

Robbins

Rosen

2017

Headache

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Background.-Headache disorders are exceedingly common, debilitating neurological conditions, and there is a striking paucity of headache specialists nationally. However, headache education is underrepresented in the curriculum of neurology residency programs and few neurology residents elect to pursue headache medicine fellowships. We aimed to explore the possibility that a low degree of headache interest among neurology department chairs and residency program directors (PDs) underlies this mismatch.Methods.-We performed a cross-sectional analysis of chairs and PDs associated with ACGME neurology residency programs. Data sources included the ACGME program list, faculty profiles on institutional webpages, Doximity profiles, the American Headache Society (AHS) membership directory, and the roster of United Council for Neurologic Specialties (UCNS) headache diplomates. A headache interest was deemed to be present with the presence of a declared headache or concussion interest, completion of a headache fellowship, active AHS membership, or UCNS certification.Results.-Our review included 137 residency programs comprising 127 department chairs, 132 PDs, and 5 faculty who were both chairs and PDs. Of all faculty, 62 (23.5%) were women. Headache expertise was declared by 10 (7.6%) chairs and 13 (9.5%) PDs. Headache fellowship training was pursued by 1 (0.8%) chair and 5 (3.6%) PDs, and among all faculty was the 10th most common subspecialty fellowship pursued. Three (2.3%) chairs and 7 (5.1%) PDs were AHS members. Seven (5.3%) chairs and 10 (7.3%) PDs were UCNS headache certified. An overall headache interest was present in 29 (11.0%) faculty, including 14 (10.6%) chairs and 15 (10.9%) PDs. A graduate degree aside from an MD (eg, PhD, MPH) was more likely to be achieved in faculty without a headache interest (29.4%) than faculty with a headache interest (6.9%, P 5 .0076). Residency programs where either the chair or PD had a headache interest were just as likely to feature a UCNS headache fellowship program than programs without chair or PD headache interest (25.0 vs 23.0%, P 5 .83).Conclusions.-Current neurology department chairs and residency PDs have low rates of headache interest, which may influence the emphasis of headache education in neurology training. Headache interest is associated with lower rates of other graduate degrees, and future analysis should examine if academic faculty interested in headache are less likely to be in leadership positions because of a lack of research funding, opportunities, or accomplishments.

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“…We advocate for more formal headache training programs locally, regionally, and nationally as such opportunities raise awareness about our field and introduce trainees to potential mentors and research opportunities. There are many reasons to be hopeful that our field will continue to expand 15 . By highlighting the sources of inspiration of what led people into the field, it will be a voice to try to deal with any challenges.…”

Section: Resultsmentioning

confidence: 99%