Faculty availability is a high priority in the Movement Disorders Fellowship Program. Your rotations, clinic schedules, and research time are designed to maximize your interaction with faculty members. Although you will learn and see patients with many specialists, you will develop your own style for evaluating and managing patients.

Clinical training

The Movement Disorders Fellowship includes seeing patients in the clinic under the supervision of senior movement disorders staff. There is an emphasis on feedback and discussion from the movement disorders faculty to assist in diagnostic and treatment decisions.

A wide variety of both hypokinetic and hyperkinetic movement disorders are seen in the Movement Disorders Clinic, including:

• Parkinson's disease and a variety of other parkinsonian disorders
• A variety of hyperkinetic conditions, such as dystonia, myoclonus, chorea, tic disorders, and stereotypies
• Psychogenic movement disorders

Referrals to the clinic come both internally and externally. Some patients referred to the Movement Disorders Clinic have already been seen by neurology staff, who feel further input is needed regarding diagnosis and treatment.

You also will have the opportunity for intensive training in movement disorders neurophysiology. The movement disorders laboratory administers botulinum toxin for dystonia and other hyperkinetic muscle contraction states. Diagnostic neurophysiology studies are also performed, helping to distinguish myoclonus, dystonia, stiffman syndrome, and tremor from similar conditions that may masquerade as such.

The clinical training is not precisely specified at the beginning of the fellowship. Rather, you will have the opportunity to design the schedule to align with your training goals. The schedule will include adequate integrated time for research.

Didactic training

Clinical conferences, seminars, small discussion groups, journal clubs, didactic courses, and one-on-one instruction are an integral part of Mayo Clinic's Movement Disorders Fellowship Program.

Course work

Formal didactic courses are available during the fellowship. Understanding statistical principles as applied to biomedical investigation is an important component of the fellowship. Mayo Clinic offers a number of courses in epidemiology, biostatistics, and the design and conduct of clinical trials.

Conferences

Throughout your fellowship you will participate, and periodically present, at weekly conferences:

• Mondays - Weekly departmental teaching conferences (Grand Rounds). At Grand Rounds, research presentations are given by Mayo Clinic faculty, visiting faculty, or neurology residents. Clinical pathological conferences are held several times a year.

• Wednesdays - Clinical case conferences. Clinical case conferences are held at Mayo Clinic Hospital, Saint Marys Campus, and alternate between the adult inpatient neurology, child and adolescent neurology, neurosurgery, and neuro-ophthalmology divisions.

• Fridays - Subspecialty conferences. These conferences focus on the pathophysiology, diagnosis, and management of neurological disorders. Subspecialty conferences are presented on a rotating basis by all subspecialty divisions of the Neurology Department.

In addition to the regularly scheduled departmental conferences, you will attend resident conferences on Tuesdays. Residents and fellows also participate in an evidence-based medicine journal club.

Visiting professors have small group discussions with neurology residents and fellows. Topics covered include child and adult neurology vignettes and neuroethics.

Research training

Research is a valuable component of this fellowship. A variety of research options are available and you are encouraged to choose your own topics based on your interests and career goals.

If you are interested in bench research, you may choose to work with a basic scientist in neuroimmunology, neurochemistry, or molecular biology.

Your research training will include design and laboratory techniques, data analysis, and basic epidemiological principles.

Off-site rotations (optional)

As part of the Movement Disorders Fellowship, you may choose to take a rotation at either Mayo Clinic in Scottsdale, Arizona, or Mayo Clinic in Jacksonville, Florida. Mayo Clinic funds the authorized additional costs of travel, housing, auto rental, and licensure fees, as well as travel expenses and lodging for you and your family. Our past fellows consistently rate these rotations highly valuable.

Evaluation

To ensure that you acquire adequate knowledge and develop your technical skills, your performance is monitored carefully during the course of your program training.

At the completion of each rotation, fellows are evaluated by the faculty to whom they were assigned. This is accomplished through Mayo Clinic's Residency Management System, MedHub. MedHub is linked to the six core competencies identified by the Accreditation Council for Graduate Medical Education (Patient Care, Medical Knowledge, Interpersonal Skills and Communication, Professionalism, Practice-Based Learning and Improvement, and Systems-Based Practice).

Completed faculty evaluations are reviewed by the program director, who assigns a pass/fail grade based on the scores and comments by the faculty member. Upon approval of the evaluation by the program director, the evaluation immediately becomes available electronically to the fellow in the MedHub system.