Is headache training improving during neurology residency in Spain? A ten-year comparative study from the dual perspective of residents and tutors.

INTRODUCTION

Residency is a key stage for acquiring the clinical and research competencies required in neurology. Although headache disorders are highly prevalent and disabling, they do not always receive adequate attention during training. In 2015, a national survey revealed major gaps in headache training among neurology residents in Spain. This study aims to assess the current situation (2025) and compare it with previous data, while incorporating the perspective of residency tutors.

MATERIAL AND

METHODS

We conducted a cross-sectional, observational study based on an anonymous online survey distributed to neurology residents and tutors across Spain. The survey collected data on rotations, technical procedures, perceived quality of training, and research involvement. Current results were compared with those from 2015, as well as between residents and tutors.

RESULTS

A total of 109 residents and 54 tutors participated. Eighty-eight percent of residents had rotated through a headache unit vs 48% in 2015. Forty-four percent reported being proficient in techniques such as botulinum toxin injections or nerve blocks vs 36%. Only 47% of residents considered their headache training adequate, compared to 83% of tutors. While 21% of residents had participated in headache-related research, tutors estimated this at 62%. Eighty-nine percent of tutors supported making headache rotations mandatory.

CONCLUSIONS

Although progress has been made over the past decade, headache training is still perceived as insufficient by many residents. We recommend implementing a mandatory rotation in headache, reinforcing hands-on training in technical procedures, and promoting structured research mentorship.