Franchesca Fiorito, MD
2026 Nominations: Member at Large
I still remember it was 2012, during my Neurology residency at Boston Medical Center, when my program director told me, “I think you should consider Headache Medicine. Your heart is in returning to Puerto Rico, and you would be the first specialist there.”At the time, I felt both confused and intrigued. Headache medicine had not been on my radar. Shortly thereafter, I attended the New England Headache Cooperative Annual Meeting and was captivated by a field I had barely known existed. That meeting changed my trajectory. From that moment forward, I committed to building a career in headache medicine, and I have never looked back. That moment in my life demonstrated the profound impact that meetings and mentorship can have in guiding physicians into the field of headache medicine. From then on, I knew I wanted to contribute in the same way for those who are interested in this specialty.
I went on to complete my Headache Medicine fellowship at Montefiore Medical Center, where I trained under extraordinary mentors. Although I was encouraged to remain on the mainland, I knew my purpose was to return to Puerto Rico. Returning home was both inspiring and sobering. Puerto Rico, though a U.S. territory, functions very differently within the healthcare system. For six years, I was the only fellowship-trained headache specialist on the island. I cared for highly refractory and disabled patients within a very complicated healthcare system. Although the transition back was professionally demanding, I felt extremely grateful, and even proud, to take on such a challenge.
Professionally, I have practiced in a hybrid model that combines private practice and academic affiliation, an arrangement common in Puerto Rico due to limited academic funding. I developed a headache curriculum and specialized headache clinics for the Neurology Residency at the University of Puerto Rico, and I am proud to say that since then, eight residents have pursued careers in headache medicine. I have also served on the Board of the Puerto Rican Academy of Neurology, progressing from Treasurer to Vice President and ultimately President (2022–2024), and I currently serve as Past President. These leadership experiences provided me with a strong foundation in guiding nonprofit initiatives, creating and implementing educational programs and strategic organizational planning.
I remember the first time I attended the Southern Headache Society Annual Meeting in 2023. From the very beginning, I felt genuinely welcomed. The atmosphere was warm, collegial, and deeply supportive, reflecting not only a commitment to scientific excellence but also to community. I was struck by the diversity of topics presented, ranging from practical strategies that directly enhanced daily clinical practice to timely discussions on emerging and even controversial topics in headache medicine. It was clear that the Society values both innovation and inclusivity. What stood out most was the sense of mentorship and collaboration. As someone practicing in Puerto Rico, often navigating unique systemic challenges, it meant a great deal to feel connected to colleagues across the southern region who were open to sharing ideas, resources, and encouragement. That first meeting reinforced my desire to remain actively involved and to contribute meaningfully to the Society’s growth.
I have greatly enjoyed serving as co-chair of the SHS Education Committee, particularly in helping shape programming that is clinically relevant and responsive to the needs of both academic and private practice clinicians. I am especially grateful that Puerto Rico is now included within the Southern Headache Society community, which represents a meaningful step toward greater representation and collaboration.
I am honored to submit this statement for consideration to serve on the SHS Board of Directors as Member-at-Large. I am deeply committed to advancing the mission of SHS by expanding educational initiatives, enhancing communication to broaden outreach, and strengthening member engagement. I believe that board service is a natural extension of this commitment. I am deeply grateful for the community SHS has already provided me, and I am eager to give back by contributing meaningfully to its continued growth, helping shape a future that is inclusive, innovative, and supportive of all health care professionals dedicated to improving the lives of patients with headache disorders.