Education Research: Trends in the National Resident Matching Program Headache Medicine Match Data: A Retrospective Observational Study.

Background and objectives: The objective of this study was to examine the trends in the National Resident Matching Program (NRMP) Headache Medicine match data since inception and the evolution of the Headache Medicine fellowship application process. The NRMP Headache Medicine fellowship match was implemented for appointment years 2016-2018 and then suspended, in part because of the small number of applicants relative to available positions and participation outside of the match. In 2019, the American Headache Society (AHS) Consortium of Academic Program Directors accepted the American Academy of Neurology (AAN) Fellowship Application Timing Position Statement. The Headache Medicine match was reinstated for appointment year 2023 and has continued since that time.

Methods: We obtained NRMP match data for appointment years 2016, 2017, 2018, 2023, 2024, and 2025 with permission and assistance from the NRMP Data and Research department. Quantitative data were summarized with descriptive statistics. The study was reviewed and approved by Stanford University's Institutional Review Board (Protocol ID: 71480).

Results: We compared the averages (for number of certified programs, certified positions, program fill rate, and certified applicants) of appointment years 2016-2018 with the averages of appointment years 2023-2025. There were 2.4 times more certified programs participating in the most recent 3 cycles of the match. There were 2.6 times more certified positions in the most recent 3 cycles of the match. The range of program fill rate was 26.7% (2017) to 81.0% (2025). The program fill rate nearly doubled (1.8 times greater) in the most recent 3 cycles of the match. For the number of certified applicants, the range was 7 (in 2017) to 61 (in 2025). There were 4.5 times more certified applicants in the most recent 3 cycles of the match.

Discussion: The Headache Medicine fellowship application process has undergone a significant transformation from 2015 to 2024. The number of programs and applicants participating in the NRMP match increased significantly over time in the setting of implementing the AAN's unified application time line and launching the AHS National Headache Fellowship Opportunities website, and with increasing total number of Neurology and Child Neurology graduates.