Interest in and exposure to headache disorders among neurology residents in Denmark: A nationwide cross‐sectional survey

Abstract

Headache disorders constitute a leading cause of disability worldwide, but there is a consistent absence of awareness and educational activities for healthcare providers across regions. Thus, we found it timely to identify potential structural challenges and factors that may affect acquisition of knowledge of headache disorders and their management during their 4-year residency. Materials & Methods: We conducted a nationwide cross-sectional survey of residents in neurology in Denmark including, but not limited to, questions on interest in neurological subspecialties and disorders, adequacy of training in headache disorders, exposure to headache disorders during training including time spent on headache disorders, exposure to specialist outpatient clinics, whether their hospital have a tertiary headache clinic, training in specific procedures (anesthetic blockade, e.g., greater occipital nerve blockade, and onabotulinumtoxinA for headache), and an estimate of proportion of cases with headache among patients managed in the last week. Results: The survey was distributed to 127 residents in Denmark between March 2022 and April 2022. Of these, 59 (47%) completed all questions of the survey. Headache disorders were the fourth most popular subspecialties among respondents (n = 15 [25%]) following movement disorders (n = 27 [46%]), vascular neurology (n = 26 [44%]), and neuromuscular disorders (n = 25 [42%]). The mean number of hours spent in a course or a structured educational activity in headache disorders during residency was 12.1 h. Half of respondents (n = 27 [46%]) reported that they perceived their training in headache disorders to be inadequate. Conclusions: Even in Denmark, a country with excellent headache services, half of residents in neurology report an inadequate training despite a higher-than-average number of hours of structured educational activities. These findings should incentivize stakeholders to make structural changes to improve education in headache disorders during the most fundamental years of training.

The Migraine Stigma Kaleidoscope View

“…Intervention strategies to reduce migraine stigma can be conceptually understood as intrapersonal, interpersonal and structural. At all three levels, the impact on productive and working activity takes on an important share of alertness in today's world [16][17][18][19].…”

Accuracy of migraine diagnosis and treatment by neurologists in the Baltic states: e-survey with clinical case challenge

“…Reasons for insufficient migraine diagnosis include low awareness among the patients [ 9 ], insufficient knowledge of migraine between the doctors [ 10 , 11 ], a lack of biological migraine markers, and the patient history being the sole basis of migraine diagnosis [ 1 ]. In addition, it has been demonstrated that headache subspecialization is not highly prestigious or attractive among neurologists [ 12 – 14 ]. Insufficient migraine diagnosis results in poor quality of life, economic burden, medication overuse and increases the risk of chronic migraine, comorbidities, and treatment refractoriness [ 15 , 16 ].…”