Importance of Headache Education in Medical Training: Q&A With Noah Rosen, MD, FAHS

Dr. Noah Rosen believes that through active mentorship and a standardized approach to headache education, current specialists can help grow the field of headache medicine

The need for headache specialists is greater than ever, with nearly 37 million Americans living with this debilitating disease and approximately 550 headache specialists in the U.S. Noah Rosen, MD, FAHS, director of Northwell Health’s Headache Center in Great Neck, New York, recently spoke with us about the benefits of educating young trainees about headache medicine early in their training, and how medical schools can better incorporate the headache medicine education into their curriculum.

How do medical schools currently approach the study of headache medicine?
Unfortunately, there’s no standardized approach. Headache medicine education varies tremendously from place to place. In general, less than a couple of hours for the four years of medical school are dedicated to headache medicine education. Most schools don’t spend enough time teaching headache disorders despite the high prevalence of headache disorders. Patients with headache disorders are most commonly seen and treated in primary care, pediatrics, OBGYN, emergency rooms and many other medical specialties. However, not enough students in these fields, as well as neurologists, receive the training they need to recognize and treat headache disorders.

At what stage of medical school are young doctors exposed to headache medicine?
In most cases, it’s not until students reach clinical care that they are exposed to headache cases. Historically, clinical exposure begins toward the third or fourth year of medical school, but many newer institutions are starting to incorporate clinical care even from day one. I first became interested in headache medicine during clinical training. I was seeing patients with severe headache disorders coming into the emergency room every day, and I wanted to know more.

How can medical schools better incorporate the study of headache medicine into their curriculum?
It’s important to have a standard teaching method across all medical schools that incorporates the latest science, pathology, physiology and demographics of headache care, as well as modern treatments. It’s important that students of all different specialties have this exposure, and having a basic standard will help medical schools achieve that. Furthermore, headache medicine education should start as soon as students arrive. I regret that I didn’t learn about the basics of care of headache medicine until later on in my training. It would’ve been very helpful to know more about the field when I was trying to care for patients.

How can headache specialists inspire students to pursue careers in headache medicine?
I think, by far, the most important thing is mentorship. Being a headache specialist means more than just caring for patients; it also involves educating your peers and students. Through mentoring, headache specialists can help foster further interest in the field. Many medical schools have associated headache specialists. There are also 41 approved fellowships in headache medicine, which is a lot more than even 10 years ago. So, the opportunities are there, but if there aren’t mentors available at your specific medical school, there is a thriving online community through the American Headache Society.

What are some of the current obstacles that the field of headache medicine is facing?
Medicine itself is strapped for manpower. Both residency and fellowship programs have been capped since 1997, without further government funding to help support those programs. Institutions also have caps on how many trainees they can accept, which has limited fields like neurology and headache medicine from growing further.

Headache medicine is drastically underserved and underrecognized. This is changing, though, as more determined specialists have dedicated their careers to serve the population and train more professionals. And as technology improves over time, we’ve been better able to spread the word about headache disorders, and that there are ways to manage these conditions through recognition, education and further specialization.

Noah Rosen, MD, FAHS, is a member of the American Headache Society, a professional society for doctors and other health care workers who specialize in studying and treating headache and migraine. The Society’s objectives are to promote the exchange of information and ideas concerning the causes and treatments of headache and related painful disorders, and to share and advance the work of its members. Learn more about the American Headache Society’s work and find out how you can become a member today.

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