The headache fellowship is a 1-year United Council for Neurologic Specialties (UCNS) accredited fellowship which accepts one applicant each year. Headache fellows are exposed to the spectrum of headache conditions with intense clinical training under the supervision of 5 faculty members. Outpatient and inpatient management of headache is emphasized, with additional training in botulinum toxin injections and pericranial nerve blockade provided. Opportunities exist for elective time in neuro-otology, neuro-ophthalmology, pain, pediatrics, and head trauma/concussion subspecialties.
Fellows will spend the majority of their time assessing and treating patients with headache and facial pain disorders. A total of nine 1/2-day clinics will be required each week during outpatient clinical rotations. These outpatient rotations will be based at the Headache Center, and fellows will be expected to evaluate 8 patients per clinic day (4 new and 4 return visits) under the guidance and supervision of faculty. There will be a formal inpatient/consultation rotation that will include emergency room consultation when required. There will be 2 blocks of elective time that can be used for either research or a pain medicine rotation. Call will not exceed 2 weekends per month.
Goals
The University of Pittsburgh Headache Medicine Program is designed to develop the knowledge base and clinical skills of physicians interested in a clinical career in Headache Medicine. We aim to create knowledgeable, skilled, and compassionate experts in Headache Medicine who will be completely prepared to function independently in clinical or academic environments. Fellows will be expected to pass the UCNS Headache Certification examination upon completion of the training program.
Objectives
Fellows completing this training program will be expected to be proficient in the following areas:
- Detailed headache history skills
- Communication skills in educating and discussing clinical issues with patients, families, and staff
- Focused headache/neurological examination skills
- Appropriate diagnostic evaluation of the patient with headache, including neuroimaging arrangement and assessment
- Rationale headache diagnosis and detailed understanding of differential diagnosis
- Principles of non-pharmacological management of headache disorders
- Principals of pharmacological preventive and acute therapies for headache disorders, using evidence-based medicine
- Headache –related therapeutic procedures: occipital/supraorbital nerve blocks, trigger point and Botulinum toxin injections
- Headache-related diagnostic procedures: lumbar punctures
- Principles of management of headache patients in inpatient and emergent/urgent care setting
- Principles of optimal systems management to optimize the quality and cost-effectiveness of care
- Basic principles of conducting or analyzing scientific research in the field of Headache Medicine
- Resource utilization to optimize continued self-education
Conference/Didactic Schedule
A weekly conference will be conducted at which time the Headache physicians provide didactic lectures and supervise clinical discussions with the fellow. A required syllabus for reading will be completed by the culmination of the fellowship year. A clinical research project or review paper will be required during the academic year, with an expectation for either presentation at a scientific meeting or publication.
The weekly lecture schedule will include lectures in the following:
- Epidemiology & Comorbidity
- Anatomy and Physiology
- Headache Classification and Diagnosis
- Evaluation and Diagnostic Testing
- Treatment
There will also be a monthly Journal Club.