As a trainee in the Multiple Sclerosis and Autoimmune Neurology Fellowship, approximately 60 percent of your time will be spent in clinical activities and 40 percent in research activities. Clinical rotations with other specialty areas involved in the multidisciplinary care of MS patients are available. Opportunities to collaborate with basic science investigators on Mayo Clinic's campus in Scottsdale are also available.

You will have the option of electing clinical rotations with specialists in multiple sclerosis and related disorders at Mayo Clinic in Rochester and Mayo Clinic in Jacksonville.

Clinical training

Over the first three months of the fellowship, you will undergo a period of acclimation, during which your role as a physician in the care of patients is reviewed by mentors.

During this period, you gain insight on how to inform new patients of the clinical trials available to them, and you will be trained in the comprehensive evaluation of patients with MS and related disorders.

This includes experience in the management of relapses and progressive disease and the appropriate choice of medicine for each disease stage.

Research training

Mayo Clinic is a premier site for the conduct of clinical trials involving the use of new prescription drugs, combination therapies, rescue treatments, and novel therapeutic agents. You are expected to participate actively in clinical trials that enroll patients in the early stages of their disease, as well as those that enroll progressive patients.

You will participate in these trials as an examining physician and gain experience in the use and interpretation of clinical outcome measures such as the EDSS score, the multiple sclerosis functional composite score, nine-hole peg test, paced auditory serial addition test (PASAT), and MRI outcome measures.

Most clinical trials in MS have an MRI component as an outcome measure. A neuroradiologist with special expertise in multiple sclerosis is responsible for the acquisition and analysis of the MRIs. A portion of your training time is devoted to the review of the MRIs connected with the trials. This provides experience in using the MRI as a diagnostic tool as well as an outcome measure in the evaluation of therapeutic interventions in MS.

If you are interested in basic research, you may have the opportunity to work in conjunction with one of the faculty members who have funded research programs.

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 Multiple Sclerosis and Autoimmune Neurology Fellowship program.

Course work

Formal didactic courses are required 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 design and conduct of clinical trials.

Conferences

Throughout your fellowship, you will participate or make presentations in weekly teaching conferences.

The departmental neuroscience conference occurs every Wednesday. Research presentations are given by either Mayo Clinic or visiting faculty and by neurology residents. There are numerous conferences teleconferenced from Mayo Clinic in Rochester, including their Neurology Grand Rounds and subspecialty teleconferences.

In addition to the regularly scheduled departmental conferences, there is an evidence-based medicine teaching program called the MERIT Center.

Teaching opportunities

You will have the opportunity to teach Mayo Clinic Alix School of Medicine students and visiting students from other medical schools through bedside instruction and formal didactic lectures. As a fellow you will also have an important role in the education of neurology and other residents, and medical students.

Evaluation

To ensure that you acquire adequate knowledge and develop your technical skills, your performance will be monitored carefully during the course of your program training. You will be evaluated formally by your supervising faculty member after each clinical rotation and will meet with the program director to review these evaluations. In addition, you will regularly evaluate the faculty to ensure that your educational needs are being met.