Pursuing a headache fellowship: A narrative review

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.