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. Consequently, 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
- To be prepared for a career in academic neurology as a movement disorders specialist.
- 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, stiff-person syndrome, ataxia and other movement disorders.
- To understand the pathophysiology (biochemical, pharmacologic, genetic and physiologic mechanisms) of movement disorders.
- 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 for deep brain stimulation.
- To become familiar with counseling patients and families with movement disorders.
- 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.
- 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.
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:
- Comprehensive Movement Disorders Clinic: Clinical training of fellows occurs in a multidisciplinary setting, under supervision of specialist movement faculty and with psychiatrists, psychologists, physical, and speech therapists on site to assist in evaluating and treating movement disorders.
- Huntington Disease Clinic: Once a month, this multidisciplinary clinic serves individuals with Huntington disease. This includes patient visits with a movement specialist, social worker and genetic counselor.
- Dystonia/Botulinum Toxin Experience: Our center sees a high volume of patients with dystonia and other disorders treated with botulinum toxin. Fellows receive hands-on training incorporating anatomy, dosing, and administration.
- Deep Brain Stimulation: Our clinic is involved in pre-surgical evaluations and postoperative programming and management of a large number of patients treated surgically with deep brain stimulation. We work closely with neurosurgery and have regular interdisciplinary meetings with neurology, neurosurgery, and neurophysiology to discuss cases as well as clinical/scientific aspects of DBS therapy. Fellows gain experience with the breadth of DBS system technology available.
• Research Activities
An individualized program for each fellow will be developed in consultation with faculty in one of three research tracks:
Clinical research track: Clinical research may include a wide range of topics with any movement disorder including epidemiology, observational studies, clinical trials, retrospective case reviews, physiology or other areas of clinical research based on the fellow’s interest.
Basic Science research track: Basic science research opportunities exist within any of the wide variety of laboratories associated with the PIND and the University of Pittsburgh neuroscience community, encompassing work on in vitro/in vivo disease modeling, pathology, and neurophysiology as well as genetic, molecular, biochemical, and behavioral aspects of neurodegenerative diseases and other movement disorders
Translational research track: This track emphasizes applying basic science concepts to clinical research. Examples of translational research include investigations of biomarkers, genetic studies or pilot studies for novel diagnostic or treatment interventions.
• Learning Experiences
There are a variety of learning experiences during the Movement disorders fellowship. In addition to mentorship and faculty supervision during outpatient movement disorder clinics, there are movement disorder Grand Rounds every two weeks. During these sessions, faculty or fellows present a patient or videos to review with the faculty from the Movement Division, house staff 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. Research methodologies specific to the fellows’ projects 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.
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 six 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 who have 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 these resources during their Movement disorder fellowship at the University of Pittsburgh.