Robbins, Matthew S

Abstract Objectives/Background The intent of this review is to provide practical guidance for trainees considering a headache medicine fellowship and examine key factors that contribute to program selection. Headache medicine continues to gain appeal as a neurologic subspecialty, and the number of headache fellowship programs across the country has paralleled that growth. Residents who develop interest in the field must decide whether to pursue fellowship for more specialized training. Establishing a framework for navigating this process can help trainees better evaluate programs and make informed decisions. Methods This narrative review was conducted as an initiative by the New Investigators and Trainees Special Interest Group of the American Headache Society in collaboration with a group of academic leaders and headache clinicians who participated in headache fellowship and/or the match process. Topics were selected based on themes identified in existing literature on fellowship selection across other disciplines. Headache‐specific information was obtained from a review of literature on headache education and fellowship, along with relevant professional society and program institution websites. This information was supplemented by the authors' perspectives when available evidence was limited. Results Physicians choose headache medicine for various reasons. This career path derives from inspiration through mentorship received during residency, exposure to a diverse patient population during training, and the desire to provide new therapies and procedural interventions. Headache medicine fellowships offer structured and in‐depth training through clinical, educational, professional, and scholarly activities. Programs may vary in size, structure, support, and patient care settings. These factors can help trainees decide whether to pursue fellowship and what to evaluate in different programs. Conclusion This review identifies key factors in pursuing a headache medicine fellowship, allowing trainees to seek programs that support professional interests and career aspirations.

Headache disorders are among the most common and disabling medical conditions worldwide. Pharmacologic acute and preventive treatments are often insufficient and poorly tolerated, and the majority of patients are unable to adhere to their migraine treatments due to these issues. With improvements in our understanding of migraine and cluster headache pathophysiology, neuromodulation devices have been developed as safe and effective acute and preventive treatment options. In this review, we focus on neuromodulation devices that have been studied for migraine and cluster headache, with special attention to those that have gained food and drug administration (FDA) clearance. We will also explore how these devices can be used in patients who might have limited pharmacologic options, including the elderly, children, and pregnant women.