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Movement Disorder Fellowship Program

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The Movement Disorders fellowship training program at Beth Israel Deaconess Medical Center (BIDMC) was established in 1999. Since that time, 12 fellows have completed our training program since its inception. The fellowship is a 12 month long training program.

Prerequisite Training

Candidates must complete a three-year ACGME accredited residency training program in Neurology prior to starting the Movement Disorders fellowship. Clinical fellows are required to be licensed to practice medicine in Massachusetts prior to beginning the fellowship.

Goals and Objectives for Training

The educational purpose of the program is for the fellow to progressively gain the clinical knowledge and skills necessary to diagnose and manage a wide range of movement disorders.

a) Expertise in the diagnosis and treatment of movement disorders, such as Parkinson's disease, Huntington's disease, dystonia, tremor, myoclonus, tics, gait disturbances, chorea, tardive dyskinesia, and other disorders of the basal ganglia, in different settings (Emergency, inpatient, and outpatient), including diagnostic evaluation, treatment, management, counseling and prevention.

b) Demonstrate physical examination skills to elicit physical findings to aid in the diagnosis of a movement disorder.

c) Understanding the pharmacology of commonly used medications for treatment of various movement disorders.

d) Understanding of the basic anatomy, pathophysiology of the basal ganglia as it pertains to movement disorders.

e) Development of competence in the therapeutic use of botulinum toxin injections for dystonia, hemifacial spasm, and related disorders.

f) Development of competence in screening, pre-operative evaluation and post-operative care for patients receiving deep brain stimulation.

g) Work effectively with multidisciplinary teams oriented to the care of these patients.

h) Ordering and interpretation of laboratory and imaging tests in patients with movement disorders.

i) Development of a core of clinical and basic science knowledge relevant to the field of movement disorders.

j) Evaluate biomedical and clinical literature relevant to movement disorders.

k) Develop the capacity to pursue an academic career in the field of movement disorders.

Resources:
Teaching Staff:

The Movement Disorders staff includes: Dr. Daniel Tarsy, M.D, Dr. David Simon, M.D., Ph.D, Dr. Ludy Shih, M.D, Dr. Daniel Press, M.D., Dr. Clifford Saper, M.D., Ph.D., and Dr. Veronique van der Horst, M.D., Ph.D. Drs. Tarsy, Simon and Shih directly supervise the fellow in weekly outpatient clinics. The patient is seen by the fellow and the case is presented to the attending who then sees and evaluates the patient. We also have strong collaborative services in neurosurgery, sleep neurology, and psychiatry. There are more than 2000 outpatient visits by movement disorders patients to our center each year. Our patient population provides an excellent clinical and research base. We have a computer-based electronic medical record system for access to our clinical record. The movement disorders service is involved in many research projects including clinical trials for treatment of Parkinson's disease, tremor and dystonia.

Facilities:

Training includes clinical experiences at Beth Israel Deaconess Medical Center only, with no outside rotations.

Educational Program - Basic Curriculum:
Clinical and Research Components:

Fellows spend a minimum of 22 hours weekly of direct patient care in the outpatient setting, with additional clinical time spent on inpatient consultations or extended day clinic evaluations of Parkinson's disease patients. At least one half day each week is devoted exclusively to administration of botulinum toxin injections. Deep brain stimulator programming and reprogramming occurs weekly on an ongoing basis.

Research interests are highly encouraged. Fellows are expected to carry out clinical research under the supervision and mentorship of the movement disorders faculty which may entail study design and implementation, data collection, results interpretation and manuscript preparation. In addition, fellows encouraged to write up case reports, start collaborative research projects with our extensive faculty within and outside our division and present findings at an annual conference, such as the Movement Disorders Society or the American Academy of Neurology. Fellows may also participate in the ongoing clinical trials by helping with approval process with the Institutional Review Board. If there is significant research interest, fellows are guided to apply for funding for further support.

Fellow's Patient Care Responsibilities:

Fellows see approximately 8-10 new patients and 15-20 follow-up patients weekly. They are responsible for conducting the clinical history and examination and then concisely summarizing the case, and making diagnostic and treatment plans with attending guidance and supervision with each visit. Additionally they are responsible for these tasks for inpatient consultations as well. Fellows are also responsible for ongoing care and correspondence with patients that may occur in between clinical visits. Fellows also take part in the weekend home call coverage schedule.

Didactic Components:

Video conference, journal club, DBS team meetings and guest lecturers are scheduled once a month, so that there is a didactic session once a week. Fellows often help write review articles, book chapters and conduct medical student and resident conferences.

To apply:

The applicant should send a CV and 3 letters of reference. Applications will start to be reviewed by April 2014 for a July 2015 start date.

For more details, contact Ludy Shih, MD, Movement Disorders Fellowship Program Director at lshih@bidmc.harvard.edu.

Contact Information

Parkinson's Disease and Movement Disorders
Department of Neurology
Beth Israel Deaconess Medical Center
330 Brookline Avenue, Boston MA 02215
Information: 617-667-9903
Appointments: 617-667-0519