Welcome to BIDMC Neurology

BIDMC – Neurology Fellowship: Movement Disorders

The Movement Disorders Fellowship Program at Beth Israel Deaconess Medical Center (BIDMC) was established in 1999. The fellowship is a 2-year program with an option of completing a 1 year clinical fellowship 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.

Overview

There are more than 2,000 outpatient visits by movement disorders patients to our center each year. Our patient population provides an excellent clinical and research base.

National Parkinson Foundation Center of Excellence
Our PD center has been designated as a Center of Excellence by the National Parkinson Foundation (NPF), which provides us with a “gold seal of approval.” This award acknowledges our preeminence in comprehensive care, research, community outreach, and education, all hallmarks of a leading-edge program in PD.

We have a computer-based electronic medical record system for access to our clinical records. The Parkinson’s Disease and Movement Disorders Center is involved in many research projects, including clinical trials for treatment of Parkinson’s disease, Huntington’s Disease, tremor and dystonia.

Our team includes the following specialty areas: Neurology, Neurosurgery, Rehabilitation medicine (including occupational, physical, speech, voice, swallowing, and cognitive therapy), Neuropsychiatry, Neuropsychology, Sleep disorders, Autonomic disorders, Neurogenetics, Social work and community resource specialists, Urology, and Palliative Care.

Deep Brain Stimulation Program (DBS)
Beth Israel Deaconess was the first hospital in New England to perform DBS surgery. This treatment is for a subset of moderate or advanced PD patients for whom medications become complicated to manage. DBS uses a surgically implanted device called a neurostimulator to deliver electrical stimulation to targeted areas in the brain that control movement. After surgery, the stimulator is monitored and adjusted as needed during outpatient visits.

Fellowship training includes clinical experiences at Beth Israel Deaconess Medical Center.  Pediatric patients with movement disorders are seen with in collaboration with Boston Children’s Hospital once monthly.  All other clinical activities take place at BIDMC.

Clinical and Research Components

Fellows spend a minimum of 22 hours weekly in the first year 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.  Clinical care is 1-2 sessions per week in the second year of fellowship and based on the clinical interest and research to be pursued.

During the first year, 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 are 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 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.

Patient Care Responsibilities

Fellows see approximately 8 to 10 new patients and 15 to 20 follow-up patients weekly. They are responsible for conducting the clinical history and examination, concisely summarizing the case, and making diagnostic and treatment plans with attending guidance and supervision with each visit.

Additionally, fellows are responsible for the occasional 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

There is a weekly session that rotates through video conference, journal club, DBS team meetings, Parkinson Foundation Center of Excellence meetings and guest lecturers are scheduled once a month, so that there is a didactic session once a week.Fellows will also help with the teaching of residents and medical students.  There is a weekly session with the fellowship director. 

 

Goals and Objectives for Training

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

Develop expertise in the diagnosis and treatment of movement disorders in different settings (emergency, inpatient and outpatient), including diagnostic evaluation, treatment, management, counseling and prevention of:

Parkinson’s disease, Huntington’s disease, Dystonia, Tremor, Myoclonus, Tics, Gait disturbances, Chorea, Tardive dyskinesia, and other disorders of the basal ganglia.

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

Understand the pharmacology of commonly used medications for treatment of various movement disorders.

Understand the basic anatomy and pathophysiology of the basal ganglia as it pertains to movement disorders.

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

Develop competence in screening, pre-operative evaluation, and post-operative care for patients receiving deep brain stimulation.

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

Order and interpret of laboratory and imaging tests in patients with movement disorders.

Develop a core of clinical and basic science knowledge relevant to the field of movement disorders.

Evaluate biomedical and clinical literature relevant to movement disorders.

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

Curriculum

Drs. Simon, Luo, Fox and Frank directly supervise neurology fellows in weekly outpatient clinics.

Patients are seen by the fellow and the case is presented to the attending physician, who then sees and evaluates the patient.

Our neurology fellowship program also has strong collaborative services in neurosurgery, sleep neurology, and psychiatry.

How to Apply

We participate in the San Francisco Match program ( sfmatch.org).

Applicants should register with SF Match and send their application materials directly to SF Match, including a CV, short personal statement, and three letters of reference. Registration opens April 1 and interviews will take place from May to July.

For questions about our program, please contact Julie Beckerdite, MBA, Administrative Director, Graduate Medical Education , jbeckerd@bidmc.harvard.edu

Faculty

David Simon, MD, PhD, Chief, Movement Disorders

Daniel Tarsy, MD

Samuel Frank, MD

Daniel Press, MD

Clifford Saper, MD, PhD

Veronique VanderHorst, MD, PhD

Lan Luo, MD

Michael Fox, MD, PhD