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Headache Medicine Fellowship

Overview

The United Council of Neurology Subspecialties (UCNS)-accredited Headache Medicine Fellowship at the University of Utah is a one-year fellowship focused on training fellows to effectively manage patients with complex headaches and associated comorbidities.

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View Headache Fellowship Brochure

Goal

To be able to practice headache medicine ethically, thoughtfully, comprehensively, independently, and confidently through clinical work, research, teaching, and presentations. The fellow will gain experience in both adult and pediatric headache disorders from five United Council for Neurologic Subspecialties (UCNS)–certified headache specialists and eight adult and one pediatric faculty, as well as other experienced headache specialists.

As a graduate of the program, you will be eligible to sit for the UCNS Headache Medicine Examination and ultimately become certified in headache medicine by the UCNS.

Expectations

Presentations

  1. Present at AHS's annual meeting (original work)
  2. Teach residents and students headache medicine
  3. Present at the University of Utah Department of Neurology's Grand Rounds
  4. Present clinical cases at division meetings on Wednesdays at 10 a.m. 
  5. Present clinical case or original research work at the Western Intermountain Neurologic Organization (WINO) meeting
  6. Deliver two to three virtual Headache School talks (second Tuesday of the month)

Research Goals

  • Formulate research project in consultation with Drs. Brennan and Digre/Pham/Cortez at the start of the fellowship
  • Write two to three papers (case studies and/or related to research)

Skills

  • Headache structured history and examination
  • Botox for chronic migraine
  • Trigger point injections and nerve and SPG blocks
  • Neuro-ophthalmology training to diagnose headache disorders

Advocacy

  • Miles for Migraine's ACT NOW: Join at least seven of the nine live/recorded ACT NOW programs offered on alternating Tuesdays and Thursdays at 8 p.m. EST beginning in July. This includes participation in Facebook private group discussions and a final proficiency project in April.
  • Headache on the Hill participation (usually in February)

Conference Attendance

  • Weekly neurology Grand Rounds (9–10 a.m. on Wednesdays)
  •  AHS annual scientific meeting (usually in June)
  •  AHS Scottsdale meeting (usually in November)

Reading

  • Wolff’s Headache, 8th edition. Editors Stephen D. Silberstein, Richard B. Lipton, and David W. Dodick, Oxford University Press 2008 (9th edition soon to be published)
  • Headache in Clinical Practice: Editors Stephen D. Silberstein, Richard B. Lipton, and Peter J. Goadsby, ISIS Medical Media, 1998

Research

  • You may be mentored in the development and execution of individual research or quality improvement projects.
  • You may be formally trained in epidemiology, biostatistics, and research methods.

Education

  • You will participate in the American Headache Society’s quarterly journal club via teleconference.
  • You will participate in the clinical teaching of medical students and residents from four different departments during their rotations in headache clinic.
  • You will have the option to participate in the Headache Medicine Lecture Series for the residents and medical students.

Clinical

  • Adult Headache Clinic: You will be trained in the diagnosis and management of complex headache patients.
  • Pediatric Headache and Integrative Medicine: Your training will encompass medical and nonpharmacological management of headaches in adolescents and children (one half-day per week).
  • Nonpharmacological Management of Complex Headaches: You will be trained in stress relief techniques, biofeedback, and cognitive behavioral therapy.
  • Anesthesia/Physical Medicine & Rehabilitation: You will have the option to complete rotations in anesthesia, pain medicine, or PM&R.

Proposed Schedule

(Changes will be considered for fellows from family medicine, pediatrics, internal medicine, and physical medicine and rehabilitation backgrounds)

July: epidemiology and biostatistics and research training
Any Chosen Month: one to two days per week for a one-month rotation in the pain clinic 

Clinics

Monday: Bartell, Baggaley, and Pham
Tuesday: Digre, or when she is out of town: VA HCOE with Bartell or INC with Pham
Wednesday: Neurology Grand Rounds and Division of Headache & Neuro-Ophthalmology meeting (mornings) and pediatric headache clinic (afternoons) 
Thursday: Baggaley, Pippitt, Bokat, and Pham; Translational Neuroscience Rounds on Thursday evenings once a month
Friday: Brennan, Cortez (occasional), and Pham

We have plenty of time built in for clinical research or other research opportunities.

Core Curriculum

Training will address the following core concepts:

  1. An adequate knowledge of general neurology to critically evaluate the history and physical examination of the patient presenting with headaches
  2. The neuroanatomy, neurophysiology, and neurochemistry of the processes underlying head-pain syndromes and associated problems including comorbidity, neuropsychiatry, and cerebral vascular disease
  3. The anatomy and pathogenesis of migraine headache and its relevance to all forms of cephalgia—primary or secondary
  4. The pathophysiology of the recognized subtypes of head pain including cluster headache and other trigeminal autonomic cephalalgias, trigeminal and other craniofacial neuralgias, and tension-type headache
  5. The classification of headache employing the International Headache Society Classification, 3rd edition
  6. The adequate teaching of headache medicine requires extensive knowledge of the epidemiology, economic and pharmacology of migraine, and other headaches
  7. The characterization, typical clinical signs and symptoms, and recognition of secondary or symptomatic headache (a headache specialist must be facile in the diagnosis of these illnesses)
  8. The evaluation and treatment of complex headache disorders

Application

Eligible applicants:

  • Must be BC/BE neurologists or individuals who have completed their ACGME-accredited neurology residency training by the fellowship start date
  • Must be a US citizen or permanent resident. Unfortunately, we are unable to accept applicants who are in need of J1 visa sponsorship at this time.

To apply, please email your current CV, three (3) letters of recommendation, a personal statement, your USMLE scores, and your ECGMG certification (if applicable) to neuro.fellowship@hsc.utah.edu.


We abide by the recommendations of AAN and AHS

  1. to begin the fellowship application process no earlier than March 1 of PGY‐3 Adult/PGY‐4 Child and NDD year and
  2. to provide fellowship job offers no earlier than August 1 of PGY‐4 Adult/ PGY‐5 Child and NDD year.

Our program participates in the NRMP Match.

Faculty

Kendra Pham, MD, MPH
Headache Medicine Fellowship Director

Susan Baggaley, FNP
Jared Bartell, MD (also at the VA Headache Center of Excellence)
KC Brennan, MD
Kathleen Digre, MD

Meghan Candee, MD, Pediatric Headache
Karly Pippitt, MD, Family Medicine
Christina Bokat, MD, Pain Medicine
Melissa Cortez, DO, Autonomic Neurology
Erica Marini, Pharm D, Pharmacist for Headache

Other clinic participants:
Dorothy Williams, MD
Jamie Jaynes, RN
Jenn Mayer, RN 
Sharon Poulter, RN

VA Headache Center of Excellence (HCOE) Staff
Lynn Horton, RN 
Anthony Minjarez, PharmD
Nancy Hennig

Adjunct Faculty to Headache Program
Scott Junkins, MD, Pain Medicine
Lisa Ord, PhD, Psychology
Sarah Maulden, MD, VA hospital
John Speed, MD, Rehabilitation