Interest in headache and other neurological subspecialties among neurology residents in Denmark: a nationwide survey

Abstract text (incl. figure legends and references)

Introduction: 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 residency.

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 amongst patients managed in the last week.

Results: The survey was distributed to 127 residents in Denmark between March 2022 to April 2022. Of these, 59 (47%) completed all questions of the survey. Headache disorders were the fourth most popular subspecialties amongst respondents (n= 15 [25%]). The mean number of hours spent in a course or a structured educational activity in headache disorders during residency was 12.1 (±12.9) hours. 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.