Fellows’ clinical responsibilities include patient evaluation and management, call-backs, communication with patients and referring physicians and preparation for conferences. The fellows are also trained to develop skills in various clinical rating scales, interpretation of whole exome and whole genome sequencing and other genetic tests, botulinum toxin (BoNT) injections, and programming of patients with deep brain stimulation (DBS). They are also directly involved in teaching medical students and neurology residents and participate in a variety of outreach programs.
Although fellows spend nearly all their time in the Parkinson’s Disease Center and Movement Disorders Clinic on the ninth floor of McNair building, they also attend an outpatient Smith Clinic in Harris Health System, where they evaluate and manage patients under the direct supervision of one of the PDCMDC faculty.
Fellows who obtain a Texas medical license receive faculty appointments as instructors in neurology. This allows them to have their own half-day follow-up clinic in which they develop independent clinical judgment and decision-making, skills necessary for future practice as movement disorders specialists. The follow-up evaluation of new patients provides each fellow the opportunity to see how their conditions changed based on the treatment initially prescribed in close consultation with the attending. The fellows also review patient’s laboratory tests and respond to their questions posted on MyChart or by voice or e-mail messages. This positive training experience by the fellows during their MDFTP was reviewed in an article, authored by some of the past fellows: Adam et al. Education Research: Patient telephone calls in a movement disorders center: Lessons in physician-trainee education. Neurology 2009;73:e50-2.
Through a one-on-one mentoring, weekly teaching video rounds (which also include pediatric cases from Texas Children’s Hospital (TCH), monthly journal clubs, deep brain stimulation consensus conferences, genetics meetings, and many other teaching conferences the fellows acquire skills in phenomenology, pathophysiology, and therapeutics of all types of movement disorders.
Fellows also participate in and initiate research projects; publish original articles, reviews and book chapters and present abstracts at national and international conferences.
- Evaluating primarily new patients in the clinic and in the hospital and providing follow-up information to referring physicians, describing our findings and therapeutic recommendations.
- Gaining an understanding of the biochemical, pharmacologic, genetic, and physiologic mechanisms of the various movement disorders.
- Learning about therapeutic approaches used to alleviate these disorders, including developing skills in botulinum toxin injections and programming patients after deep brain stimulation surgery.
- Becoming familiar with various clinical rating scales and videotape protocols; developing and managing a computer database for various movement disorders and research projects.
- Participating in ongoing clinical research projects conducted in the BCM Movement Disorders Clinic.
- Reviewing literature, participating in, conducting, and preparing educational material (e.g. videotapes), for video rounds, movement disorder conferences, journal clubs and other educational activities.
- Preparing abstracts and scientific papers and presenting research data at scientific meetings; preparing research grant proposals for funding by NIH and other agencies and foundations.
- Analyzing, summarizing, and critiquing published articles; working with the movement disorder nurse coordinators and other research staff in facilitating various research studies.
- Videotaping patients and participate in specimen collections (CSF, blood, urine).
- Evaluating patients on the consultation service and performing pre-operative and post-operative assessments on patients undergoing surgical interventions.