Changes in medical students’ knowledge of medication-overuse headache after a dedicated educational course

Headache disorders are leading causes of disability across the lifespan, yet many physicians receive limited teaching and frequently report low confidence in their management, including the awareness and treatment of medication-overuse headache (MOH). We assessed whether a dedicated headache medicine course in undergraduate curriculum improved medical students’ knowledge of MOH. In this single-group pre-test–post-test study, the same eight-item multiple-choice test, with four response options per item, was administered one week before and within 24 h after a dedicated headache medicine course. The course, which was integrated into the ambulatory medicine clerkship, comprised five learning resources and a three-hour headache clinic session. Pre- and post-tests were linked at the individual level by a unique participant identifier, yielding 200 matched 5th year medical students from May 2024 to January 2026. The total score (0–8) was compared with the paired t-test; item-level change with exact McNemar tests (Holm-adjusted); and the association of sex, cumulative grade-point average (GPAX), and age with the odds of improvement with logistic regression. The mean total MOH knowledge score increased significantly from 5.81 (SD, 1.55) before the course to 6.75 (SD, 1.13) after the course, representing a mean increase of 0.94 points (95% CI, 0.73–1.15; P < 0.001). The largest item-level improvements from pre-test to post-test were observed for the indications for preventive treatment (Q4: +20.5% points; 95% CI, 13.5–28.0), the medication-use threshold for combination analgesics associated with medication-overuse headache (Q7: +17.0% points; 95% CI, 10.5–23.5), and the acute medication associated with the highest risk of MOH (Q8: +18.0% points; 95% CI, 11.5–25.0). Sex, GPAX, and age were not associated with the odds of improvement. A focused headache medicine course, with particular emphasis on MOH, was associated with a short-term improvement in knowledge of the condition. Controlled studies using validated parallel assessment forms and delayed follow-up are needed to confirm the effectiveness of the intervention and evaluate long-term knowledge retention and clinical application.