Hospital Clinico Universitario de Valencia (Valencia, Spain)

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1 Hospital Clinico Universitario de Valencia (Valencia, Spain) Carla Buonanotte Sanatorio Allende Cerro / Hospital Misericordia, Cordoba, Argentina It was a wonderful experience for me being with Dr Miguel Láinez and his colleagues at the hospital. I had the opportunity to be with Dr Láinez during patient headache consultations and I learned a lot about different treatments and different ways of treating patients. Dr Láinez taught me how to use botulinum toxin and other treatments in refractory migraine. I also had the possibility of being with residents at the Neurology Service and see inpatients from the hospital. I also shared some academic and educational activities with other neurologists. Dr Láinez also taught me about scientific investigations in chronic migraine. This experience will help me in to be more secure in treating my patients in my daily practice, and knowing how to treat and I talk to my patients.

2 Hospital Ruber Internacional (Madrid, Spain) Carolina Guerra Department of Clinical Neurology, Universidad CES / Instituto Neurologico De Colombia, Medellin, Colombia When I was first notified by the warm and welcoming Carol Taylor that I was the lucky winner of the scholarship, I was so very thrilled to accomplish a great goal and a dream of my career. An opportunity to learn from a headache neurology rock star as Dr Margarita Sanchez del Rio, and of course, the chance to go to one of the most popular, and famous hospitals in private practice in Madrid. Back home, everyone was so proud of me. Dr Michel Volcy, my mentor, almost like a father, reminded me before I left that we will always be students no matter what, that that headache world is constantly changing and that I am just a sponge and should try to absorb as much as I can from this experience. So with that as my mantra I took a plane to Madrid with high hopes, a light suitcase (which is a challenge for a woman ) and my best smile. The first thing on the schedule was the IHC Valencia was as beautiful as I remembered. The congress was another great experience, because you get to meet old friends from all over the globe, and make new acquaintances to improve the quality of our work. It was amazing to finally meet Carol, who has been so helpful and willing, and to learn from so many legends, and great headache celebrities. There I also got to meet Dr Sanchez in one of the Spanish lectures. Getting to Madrid, the excitement was even greater. The clinic has a neurology service with a movement disorders neurologist, epilepsy neurologist, phonoaudiologist, neuroophthalmologist, neuropsychologist, physiotherapist and headache neurologist. There is a very modern and comfortable rehabilitation gym, and a fabulous phonoaudiologist, Carmen, who helps Dr Sanchez with patient problems such as posture, breathing, vocal therapy, and modulation of mechanical habits. On my first day it was a big surprise to realise that I was the only resident in the entire service, something different from my experience in Barcelona at the Vall d Hebron Hospital, where there were about six residents per service. In Colombia, usually we work more like Dr Sanchez in a one on one teaching way. Dr Sanchez explained her daily routine of interviewing the patient, and it was very interesting to see how many things we don t usually ask our patients, mainly about dental diseases such as bruxism. She is very persistent about snoring and vocal fatigue during the course of the day. At Ruber there is a weekly neurology staff meeting where we can discuss several cases of all sources. During one meeting I had the chance to discuss a case of a patient with SMART

3 syndrome, the only one I have seen in my practice, but apparently, the third in that hospital. I found the staff very challenging, and nourishing for any resident, because you can discuss with neurosurgeons, psychiatrists, psychologists, neurologisit, so it makes it really fun, interesting and passionate. Another very interesting point in Dr Sanchez s practice is the use of devices such as the Cephaly, among others. In Colombia we had a couple of these devices, but our health system was so problematic that we could try it on a very few patients. At the investigation level unfortunately I got to the rotation on a stand by time, because they had recently finished a trial, and were making preparations fo the next project. From the many advantages I found in this experience, I particularly enjoyed the fact that I got to learn how to use so many medications I had read about, but I never got to use in Colombia, such as the entire triptans arsenal, to mention just a few. It was very interesting to compare the outcome of migraine patients in Spain with our outcomes in Colombia, considering the limited resources. Finally, and by far, the most important thing to take home was Dr Sanchez s humanity. She is always giving, she is passionate for her work, generous and kind to everyone. That is something that you will never learn from a book or a trial, and in my opinion, it s the greatest legacy a mentor can provide.

4 Hospital Universitario Central de Asturias (HUCA) (Oviedo, Spain) Marta Ramos Ramero Department of Neurology Hospital Occidente de Kennedy - La Sabana University, Bogotá, Colombia My stay in Oviedo was not only the opportunity to learn more about headache, it was also an opportunity for my personal growth. In the IHC congress in Valencia, besides attending the scientific programme, I had the chance to present three posters we had made with my neurology group in Bogotá, Colombia. Being able to view the other presentations and posters was really useful because I discovered in which topics other groups are working, and with that I took new ideas back home for my investigation group. However the greatest surprise was that in the final conference presented by Dr Dodick, one of our works about venous sinus thrombosis appeared. I was a very gratifying experience and I felt it was a great recognition of our work. The next week I began my academic activities in Oviedo with Dr Julio Pascual. I have to say, before anything, that I met a neurology group with an excellent human quality and academic performance, mostly reflected by their chief Dr Pascual, and that helped me to adapt easily to the city and the hospital. During the week, each morning I participated in the discussion of the patients that had been seen the night before. After this, we distributed to all the different activities of the service. I attended the outpatient headache clinic with Dr Pascual and I was able to assist some days with the activities of the neurovascular team, from whom I learned new concepts. In the headache clinic, I was given the opportunity to see various patients and make an initial clinical diagnosis. This tested my previous knowledge and helped me to learn more. I also had the opportunity to participate in the application of botulinum toxin and get to know the process of study of the levels of CGRP in the patients with headache, a process that has been made long before in this institution. I learned new ways to approach patients with headache and also how to make appropriate treatment based on the characteristics of each patient and the available drugs. One of the other achievements of my stay in Oviedo was a poster to be sent to the national congress of neurology in Spain, which will take place in November The theme of the study was the prevalence of neurogenic bladder in the patients with chronic migraine. This work was

5 accepted for oral presentation in the above mentioned congress, and after the presentation we will write a manuscript to be sent to a medical journal. This has been one of the best experiences in my life. I had the opportunity to live in another culture and to visit new places, and all of this helped me with my academic and personal growth.

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