University of Ottawa, Ottawa, Canada.
Ottawa Headache Centre, Ottawa, Canada.
BMC Med Educ. 2023 Aug 17;23(1):581. doi: 10.1186/s12909-023-04571-z.
Headache disorders are the most common neurological disorders worldwide. Despite their widespread prevalence and importance, the topic of headache is inconsistently taught at both the undergraduate and postgraduate levels. The goal of this study is to establish a better picture of the current state of Headache Medicine (HM) training in Neurology postgraduate programs in Canada and describe the impact of the current pandemic on training in this domain.
Online surveys were sent to senior residents of adult Neurology programs in Canada. We also conducted telephone interviews with Neurology Program Directors. Descriptive statistics were analyzed, and thematic analysis was used to review free text.
A total of 36 residents, and 3 Program Directors participated in the study. Most of the teaching in HM is done by headache specialists and general neurology faculty. Formal teaching is mainly given during academic half day. Most of the programs expose their residents to Onabotulinum toxin A injections and peripheral nerve blocks, but they don't offer much formal teaching regarding these procedures. Residents consider HM teaching important and they would like to have more. They don't feel comfortable performing interventional headache treatments, despite feeling this should be part of the skillset of a general neurologist.
Our study is the first to establish the current state of headache teaching in post-graduate neurology programs as perceived by trainees and program directors in Canada. The current educational offerings leave residents feeling poorly prepared to manage headaches, including procedural interventions. There is a need to diversify the source of teaching, so the educational burden doesn't lie mostly upon Headache specialists who are already in short supply. Neurology Residency programs need to adapt their curriculum to face the current need in HM.
头痛障碍是全球最常见的神经疾病。尽管头痛的普遍性和重要性很高，但在本科和研究生阶段，头痛的教学都不一致。本研究的目的是更好地了解加拿大神经病学研究生项目中头痛医学（HM）培训的现状，并描述当前大流行对该领域培训的影响。
我们向加拿大成人神经病学项目的高级住院医师发送了在线调查。我们还对神经病学项目主任进行了电话访谈。我们分析了描述性统计数据，并使用主题分析来审查自由文本。
共有 36 名住院医师和 3 名项目主任参与了这项研究。HM 的大部分教学由头痛专家和普通神经病学教师完成。正式教学主要在学术半天进行。大多数项目让其住院医师接触肉毒杆菌毒素 A 注射和周围神经阻滞，但他们并没有提供太多关于这些程序的正式教学。住院医师认为 HM 教学很重要，他们希望有更多的教学。尽管他们认为这应该是普通神经科医生技能的一部分，但他们对进行介入性头痛治疗感到不舒服。
我们的研究首次确立了受训者和加拿大研究生神经科项目主任对头痛教学现状的看法。目前的教学提供让住院医师感到对头痛管理，包括程序干预，准备不足。需要使教学来源多样化，因此教学负担不会主要落在已经短缺的头痛专家身上。神经病学住院医师项目需要调整其课程，以满足当前 HM 的需求。
