Opinion & Special Articles: Navigating Your First Academic Job Search. Pearls, Pitfalls, and Lessons Learned

Most graduating neurology residents plan to pursue an academic career after completing residency or fellowship training. Although a career in academic neurology has many benefits, the path to finding the right first academic job can be challenging. For many, this may be their first professional job, and finding an ideal academic position requires a tailored approach, focus, timeline, and scope. In this article, we outline a roadmap for navigating the first academic job search after neurology training and share pearls and pitfalls related to the job search.

The Neurology Fellowship Application Conundrum: Finding Common Ground.

For many neurologic subspecialties, the fellowship application process begins early in the first half of the second year of neurology-specific training (PGY3 for adult neurology residents and PGY4 for child neurology residents). In 2019, the American Academy of Neurology (AAN) published a position statement recommending communication between fellowship candidates and training programs begin no sooner than March 1 of the penultimate year of training and that programs offer fellowship positions no sooner than August 1 of the final year of training. A few pilot subspecialties adopted this timeline for 2021 recruitment for positions beginning in 2022. All United States-based AAN-affiliated neurology and child neurology residents who recently completed the fellowship application process received a survey about their fellowship application experience. Of the 291 residents who responded to the survey, 96% agree that applications should not be submitted before March 1 of the penultimate year of training and 72% believe that August 1 of the final year is a reasonable time to begin offering positions. Nearly half (49%) of residents believe that there is too little time for subspecialty/clinical exposure before applying for fellowship and 88% feel the current process and timeline are stressful. Residents who applied to programs in pilot subspecialties report more time to choose, less stress, and a lower number of time-pressured offers. A large majority of residents (89%) prefer to submit a single application through a centralized system. The survey results suggest that residents who just completed the fellowship application process agree with the AAN recommended timeline for all subspecialties and that all neurology subspecialties should consider adopting a fellowship match. Programs can help facilitate a better fellowship application experience by providing earlier exposure to a broad range of neurologic subspecialties and ensure that residents are given opportunities to attend national meetings and participate in appropriately scoped scholarly endeavors.

Heredity, genes, and headache.

It is well recognized that headache, and especially migraine, runs in families. Recent studies into the heritability of primary headache subtypes, migraine, cluster and tension headache, and conditions in which headache is a prominent feature, such as the mitochondrial disease, mitochondrial encephalopathy, lactic acidosis, and strokelike episodes, and the arteriopathy, cerebral autosomal-dominant arteriopathy with subcortical infarctions and leukoencephalopathy, are improving our understanding of the genetic contribution to headache. Studies of the rare familial hemiplegic migraine are leading to advances in understanding the pathophysiological mechanisms of the more common migraine types. Current knowledge of hereditary and genetic features of headache subtypes is reviewed and the implications for understanding the pathophysiology of migraine are discussed.