The State of the Headache Fellowship Application Process and Attitudes towards the Match: Interview of US Headache Fellowship Program Directors (569)

Objective: Examine the current Headache Medicine fellowship application process and propose recommendations for a more unified, fair, and transparent process. Background: The Headache Medicine fellowship match took place between 2015–2017. In the most recent match, 16 UCNS-accredited programs, representing 21 fellowship positions, participated in the match. There were 13 applicants and 11 positions were filled. Because of lack of program participation/cooperation, the Consortium of Headache Program Directors suspended use of the match in 2018. Design/Methods: Using the UCNS certification database, 42 headache fellowship programs were identified. Program directors were contacted through email and individual telephone interviews were conducted. Qualitative data coding allowed for identification of emerging themes. Quantitative data were summarized using descriptive statics. The Stanford University Institutional Review Board reviewed the protocol and deemed it exempt as quality improvement project. Results: 40 (95%) program directors (34 adult, 6 pediatric) responded. Emerging themes included: 1) There are benefits and disadvantages to having a match, 2) If the Match was reinstated, programs would only participate in the match if all programs participated, 3) There should be consequences for programs that do not participate. If the Match was reinstated, 37.5% of program directors responded that their program would participate in the Match without conditions. 37.5% would only participate in the Match if every program was required to participate. 15% would not participate in the Match and 10% were not sure if they would participate in the match. 40% supported sanctions against programs that did not participate in the match. Conclusions: The Fellowship Match can potentially level the playing field for both programs and applicants; however, it does not currently appear to be a feasible option for the field of Headache Medicine. Until the number of applicants exceeds the number of programs, we recommend instituting a universal timeline for applications and offers. Disclosure: Dr. Zhang has nothing to disclose. Dr. Armand has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Biohaven. Dr. Berk has nothing to disclose. Dr. Friedman has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Alder Biopharmaceuticals, Allergan, Amgen, Biohaven, electroCore, Eli Lilly, Promius, Revance, Supernus, Teva, Theranica and Zosano. Dr. Friedman has received personal compensation in an editorial capacity for Neurology Reviews. Dr. Friedman has received research support from Allergan, Autonomic Technologies, Eli Lilly, Merck, and Zosano.