Movement Disorders Fellowship at the University of Pittsburgh

Overview

The Movement Disorders Fellowship Program at the University of Pittsburgh brings together resources of the University of Pittsburgh, Pittsburgh Institute of Neurodegenerative diseases (PIND) and the University of Pittsburgh Medical Center (UPMC) to provide a unique educational environment with extensive resources available for clinical and research training in the field of movement disorders. The fellowship program seeks candidates committed to an academic career in the neurosciences with specialization in Movement disorders.

This program emphasizes both clinical and research training in a 2 year training program. All fellows will be thoroughly trained in clinical evaluation and management of Movement Disorders. In addition to developing clinical expertise to become a Movement Disorder Specialist, each fellow will also participate in one of three individualized research tracks: a Clinical research track, a basic science research track, or a translational research track which combines elements of clinical and basic science research.

The description that follows serves only as a guide, as each fellowship will be individualized based on the applicants interests and goals.

Fellowship Goals and Objectives

  1. To be prepared for a career in academic neurology as a movement disorders specialist.
  2. To gain clinical expertise in the recognition and treatment of all Movement disorders including Parkinsonian disorders, Huntington disease, Dystonia, tremor, Tourette Syndrome, chorea, athetosis, tardive dyskinesia/medication-related movement disorders, ballism, myoclonus, tics, spasticity, rigidity, restless legs syndrome, gait disorders, ataxia and other movement disorders.
  3. To understand the pathophysiology (biochemical, pharmacologic, genetic and physiologic mechanisms) of movement disorders.
  4. To learn how to employ pharmacologic, surgical, physiotherapeutic and other treatment approaches to movement disorders. This includes learning techniques in botulinum toxin injections and programming of deep brain stimulation and intestinal levodopa gel devices.
  5. To become familiar with counseling patients and families with movement disorders.
  6. To acquire skills in clinical, basic science or translational research essential to research methodology of interest to the applicant. Examples include critical appraisal of relevant literature, clinical rating scales in the assessment of movement disorders, grant and manuscript writing skills, the conduct of clinical trials, study design, secondary data analysis or laboratory techniques for a particular project.
  7. To develop and present results of clinical, basic science and/or translational research in movement disorders. This may take the form of a peer-reviewed publication and/or presentation at a scientific meeting.

Fellowship activities

The above goals are accomplished by an experience organized around the following areas:

Clinical Activities

Each fellow will gain expertise in outpatient management of movement disorders under supervision of faculty. Our faculty represents a diverse range of interests in movement disorders and is committed to teaching fellows. In addition to outpatient clinics with a wide range of movement disorder patients, specific opportunities exist in the following fellowship experiences:

  1. Comprehensive Movement Disorders Clinic: Daily clinic, the fellow has an opportunity to work with multiple movement faculty examining and treating a variety of movement disorders. A physical/occupational therapist and neuropsychiatrist are on-site to assist in evaluating and treating our patients. Once a month, the Movement Disorders division holds a live patient Grand Rounds as well as fellow-driven Video Rounds evaluating interesting cases in the field of movement disorders. The fellow will participate weekly in their own Movement Disorders Continuity Clinic.
  2. Huntington’s Disease Clinic (Huntington’s Disease Society of America Center of Excellence): Once a month, this multidisciplinary clinic serves individuals with Huntington disease. This includes patient visits with a movement specialist, psychiatrist, social workers, genetic counselor, dietician, and physical/occupational/speech therapists.
  3. Botulinum Toxin Clinic: Daily clinic, patients with a variety of disorders are evaluated and treated with botulinum toxin injections. Fellows have the opportunity to learn different techniques for injecting during their training.
  4. Tourette Syndrome Clinic: Once a month, this multidisciplinary clinic at Children’s Hospital evaluates pediatric movement disorders, primarily tic disorders. This includes an adult movement disorders specialist, pediatric neurologist and a psychologist.
  5. Deep Brain Stimulation: Our clinic is involved in pre-surgical evaluations, postoperative programming and management of a large number of patients treated surgically with deep brain stimulation. We work closely with neurosurgery and have bimonthly interdisciplinary meetings with neurology, neurosurgery, and neurophysiology to discuss cases as well as clinical/scientific aspects of DBS therapy.
  6. Progressive Supranuclear Palsy Clinic: Once a month, this clinic evaluates patients with a variety of clinical manifestations of this atypical parkinsonism variant.
  7. Veteran’s Hospital Movement Disorders Clinic: Once a week experience, this clinic provides veterans with healthcare via our Consortium Center for Parkinson’s disease and other movement disorders.
  8. Movement Disorders Telemedicine Clinic: Once a month, this clinic evaluates a range of Movement Disorders through telemedicine for those patients that may not be able to travel to the University of Pittsburgh.

Research Activities

An individualized program for each fellow will be developed in consultation with faculty in one of three research tracks:

Fellowship Curriculum

Regardless of the track selected, the goal of the Fellowship program is two-fold: (1) To become an expert in the clinical management of movement disorders, and (2) To successfully develop an area of research expertise. Fellows are expected to complete at least one research project from conception to publication by the end of fellowship (typically two years). Because clinical experience informs research activities, fellows will have an initiation period of the first several months engaged in mostly outpatient movement disorders clinics (approximately six half-days a week). The remainder of the time during this period is to be used to develop plans for research. By the end of the initiation period, a project and mentor(s) should be identified, at which point more time will be reserved for research for the remainder of the fellowship (clinic time may range from 2-5 half-days a week). The duration of the initiation period has an estimated range of 3-6 months. These numbers are meant to serve only as a guideline to give applicants and idea of what to expect as research and clinical time will vary based on individual interests, needs and goals.

Learning experiences

There are a variety of learning experiences during the course of the Movement disorders fellowship. In addition to mentorship and faculty supervision during outpatient movement disorder clinics, there are Movement disorder rounds every two weeks. During these sessions, faculty or fellows present a patient or videos to review with the faculty from the Movement Division, housestaff and medical students. A Movement disorder fellow organizes these sessions. There is also a movement disorders lecture series given by faculty. Fellows may also wish to attend grand rounds and review our collection of videos of movement disorders. Each fellow will have access to a video camera to document movement disorders seen in clinic and then review them with faculty so that each new patient is discussed in detail. Research methodologies specific to the fellow’s project will be reviewed, and a timeline for clinical and research activities will be established at the beginning of fellowship to ensure goals are accomplished in a timely fashion. Fellows will receive feedback regularly on their progress, and fellowship program activities will be flexible to cater to individual needs. It is expected that fellows will attend at least one relevant scientific meeting per year and present their research project at such a venue and/or in a peer-reviewed publication.

Faculty

Resources

The University of Pittsburgh, PIND and UPMC provide a rich and unique academic environment for career development in the neurosciences. The Movement Disorders division is comprised of seven faculty, clinical staff and research associates who specialize in clinical care of movement disorders and have a broad range of research interests spanning basic, translational and clinical research. The division also has a digitized movement disorder video database as a learning and research tool. Additionally, the PIND movement disorder research registry is a rapidly expanding resource of patients who have expressed interest in participating in clinical research, and have been consented to be contacted for research activities. PIND also has several basic science opportunities for research and we have ongoing collaborations with the Departments of medicine, psychiatry and epidemiology at the University of Pittsburgh. Fellows have access to all of these resources during their Movement disorder fellowship at the University of Pittsburgh.

Application Information

Applicants to the fellowship program must have completed a three-year Neurology residency at an approved training program and be board-eligible or board-certified by the American Board of Psychiatry and Neurology. Visitors from other countries must possess adequate immigration status at the time of application. Applications must include an introductory letter from the candidate, a curriculum vitae and bibliography, and three letters of recommendation, including one from the candidate’s chairman of neurology. Applications will be reviewed and selected candidates will be invited for interviews and a tour of facilities.

Fellowship duration: 1-2 years

Start Date: July 1

Training Pre-requisites: Completion of a three-year Neurology residency at an approved training program and be board-eligible or board-certified by the American Board of Psychiatry and Neurology. Visitors from other countries must possess adequate immigration status.

Application requirements: Applications must include an introductory letter from the candidate, a curriculum vitae and bibliography, and three letters of recommendation, one of which is from either the candidate’s department chair or residency program director.

Application deadline and process:

The University of Pittsburgh Movement Fellowship participates in the SF Match and follows those policies and deadlines. Applications are to be sent directly to the University of Pittsburgh (contact information below). Applications are received throughout the year and interviews are extended to candidates only after applications are complete.

About the Match: Please visit www.sfmatch.org for details. The match takes place in September and will be used to process all applicants who want to start their Movement Disorders Fellowship training in July of the following year. Applicants are responsible for ensuring they meet all prerequisites for eligibility prior to registering for the match. All match participants must agree and abide by the SF Match rules and policies as well as any additional rules stated by the sponsoring group.

The Movement Disorders Fellowship Match was established in 2012. Its goal is to coordinate appointments, thus relieving the pressure of uncoordinated appointments and forced early choices. The participating programs will not make any appointments until the match has been completed. This match operates under the designation of Movement Disorders Fellowship Match. Movement Disorders Fellowship Match Network sponsors the matching process and is responsible for enforcement of applicable rules.

The SF Match neither sponsors nor approves any of the participating programs. The function of the matching program is strictly limited to processing of the match. Listing or not listing of any program in the directory does not imply any form of approval, disapproval or endorsement.

Contact:
Samantha Kunvatanagarn
GME Academic Manager
University of Pittsburgh Medical Center
Dept. of Neurology
Kaufmann Medical Building
3471 Fifth Ave., Suite 811
Pittsburgh, PA  15213
Phone:  412-648-2022
Fax:     412-624-3661
Email:  essass@upmc.edu