2023 American Academy of Neurology Abstract Website

Objective:

To review the history of training in Headache Medicine in the 20th and 21st Century in America and provide insights into key dates and events that shape current practice.

Background:

Headache is a burgeoning field within Neurology with 49 fellowships now UCNS accredited. These accredited centers represent signficant growth over short period. Unofficial apprenticeships date to the 1940s with Montefiore Hospital. The last 14 years accreditation has been under UCNS with subsequent exponential growth of programs.

700+ candidates hold certificates with invagination of training programs into academic centers around the country making higher level care available to more.

Design/Methods:

The timeline of UCNS was reviewed and information gathered about which programs became certified with the data graphed out and compared to yearly certification numbers of specialists.

Individuals at centers including the Diamond Institute, the Graham Institute, the Jefferson H Center and Montefiore Center were interviewed and primary sources were contacted to discuss the history.

Finally, a literature search was performed to look into what headache centers existed prior to inception of the UCNS and to understand what model of education was performed and how successful those centers were at developing new headache specialists in practice.

Results:

The last 15 years led to more formalized structure for accreditation of programs and certification of specialists under the UCNS. Historically training centers were limited, idiosynchratic and followed an apprenticeship model. The current growth in training programs has led to 49 current acccredited programs and dozens of yearly graduates.

Several named centers have trained a large volume of providers and have fostered practitioners who have created other centers.

Conclusions:

Schools of thought in Headache Medicine have grown around several centers with roots in an apprenticeship form of education. Over 15 years fellowship training has become more formalized, clearer in objectives and in expectations for trainees with dramatic growth.