Movement Disorders Fellowship
The Neurology Department at UC Davis is offering a one- to two-year fellowship program in Movement Disorders. The first year is dedicated to clinical training. A research-intensive second year is optional but encouraged. The fellowship program is not ACGME-accredited.
The first year of the fellowship focuses on clinical evaluation and treatment of Movement Disorders through direct patient contact primarily in the outpatient Movement Disorders clinics but also in the in-patient setting for patients with deep brain stimulator therapy or for patients with acute neurological issues who require in-patient care at UC Davis Medical Center in Sacramento. The program offers clinical experience with all types of movement disorders, including Huntington’s disease, Parkinson’s disease, ataxia, dystonia, tremor, myoclonus, and other disorders.
The fellow will also gain experience in the conduct of clinical trials through faculty membership in the Huntington Study Group and the Parkinson’s Study Group, and will be heavily involved in the CIRM-sponsored study entitled PRE-CELL, performing HD-specific neurological and functional assessments as well as lumbar punctures. Education requirements include participation in case conferences, research meetings, journal clubs, lectures, seminars, symposia, and weekly meetings with faculty mentors.
At least 20 hours of Category 1 of continuing medical education in Movement Disorders must be completed during each year of the fellowship. The fellow will become proficient in conducting neurological assessments using the Unified Huntington’s Disease rating Scale, the Unified Parkinson’s Disease Rating Scale, the Burke-Fahn-Marsden dystonia rating scale, the Toronto Western Spasmodic Torticollis Rating Scale, and tremor rating scales.
Fellows choosing to participate in the research-intensive second year are expected to seek funding (intramural and/or extramural) to support a targeted research project. The program offers extensive resources to develop, mentor, and support the fellows’ research, from basic science to social science, with a strong emphasis on clinical translational research. The Neurology Department has a long and ongoing history of state, federal, and privately funded research projects. Current studies include cutting-edge research into stem cell treatment for Huntington’s disease funded by the California Institute for Regenerative Medicine. Fellows will have access to one of the largest and most diverse clinical cohorts with Huntington’s disease in the nation. as well as a large patient population with Parkinson’ disease, dystonia, and other movement disorders.
- Both inpatient and outpatient clinical exposure to a wide variety of movement disorders.
- Movement Disorder specialties among clinical faculty include Huntington’s disease, Parkinson’s Disease, ataxia, dystonia, tremor, restless legs syndrome, Parkinson's plus syndromes, and botulinum toxin therapy for dystonia, spasticity. and tremor.
- An HDSA Center of Excellence for family services and research, integrating state-of-the-art care with cutting-edge research.
- Designated Genetically Handicapped Persons Program Clinic through state of California, responsible for new referrals and annual evaluations for a large cohort of regional patients with neurogenetic disorders, including Huntington’s disease, spinocerebellar ataxias, and some neuromuscular disorders.
- A community-based, multi-ethnic cohort recruited from a very large geographical region, primarily Northern California but including patients from Southern California, Nevada, and other states.
- A cohort of approximately 300 patients with Huntington’s disease, 1000 patients with Parkinson’s disease, several hundred patients with essential tremor, 75 patients with deep brain stimulators, several hundred patients with dystonia, and approximately 100 with ataxia.
- Research is conducted at UC Davis Medical Center in Sacramento, through the Clinical Translational Science facilities on the Sacramento Campus and at the VA Mather.
- A wealth of clinical, neuropsychological, and neuroimaging and data available for hypothesis-driven analyses of current interest.
- A leader in the investigation of Huntington’s disease.
- A variety of clinical trials for movement disorders.
- Specialized neuropsychology.
- Extensive clinical data.
- A wide range of intensive research opportunities, including HD-, PD- and dystonia specific multicenter trials.
This is a clinically-oriented fellowship with abundant research opportunities, to be at least 12 months in duration. Duties in the first year will be approximately 50% clinic-based and 50% research-based.
Clinical activities include various rotations in Neurology specialty clinics (5- half-days per week), reviewing and interpreting diagnostic tests. and evaluating patients with movement disorders such as ataxia, dystonia, essential tremor, myoclonus, Huntington’s disease, and Parkinson’s disease. In addition, an elective inpatient rotation (2-4 weeks) on the Psychiatry liaison consult service may be included in the curriculum, where a variety of psychiatric conditions related to Movement Disorders are diagnosed and managed.
Research time in the first year will allow fellows the opportunity to work on an individual mentored research project and, if desired, to develop a second-year research proposal. In the optional second year, priorities will switch to approximately 75% research and 25% clinical duties.
Goals and Objectives
The primary goal of the fellowship program is to enable fellows to develop the professional skills and competencies necessary to practice independently in the area of Movement Disorder neurology. The secondary goal is to enable fellows to attain proficiency as a Movement Disorders specialist in clinical or basic science research.
Major objectives include the development of expertise in the recognition, diagnosis, treatment, management, and rehabilitation of inpatients and outpatients presenting a broad range of Movement Disorders, through supervised clinical practice and research activities that include exposure to the following areas of neurology, neurobiology, and related disciplines as they apply to Movement Disorders:
- Clinical neurology: adult and pediatric
- Emergency medicine for management of acute development of or decompensation of movement disorders
- Psychiatry for interface of movement disorders in primary psychiatric conditions, drug-induced movement disorders, and psychogenic movement disorders
- Neurorehabilitation for acute and chronic reeducation techniques
- Neuroimaging: MR, CT, SPECT patterns in movement disorders
- Neuroepidemiology: population patterns and epidemiological issues relative to Movement Disorders
- Molecular biology, neuropharmacology, neurochemistry, and neurophysiology
- Neurosurgical interventions for Movement Disorders
- Cellular biology in relation to primary neurodegeneration, apoptosis, and trophic influences on cell function
- Neurological Education: Movement disorders teaching experience with physicians, health professionals, patients, and the public.
The following outcomes should be achieved after 12 months of training:
- Develop a research project that will ultimately result in publication
- Prepare to present findings to the leading medical journals
- Function as an integral member of an outpatient multidisciplinary team
- Evaluate a minimum of 150 new adult patients with movement disorder symptoms
- Provide continuous care to 100 adult patients with movement disorders
- Attend a minimum number of the required departmental conferences, including clinical case conference, CPC conferences and journal clubs
- Enhance office based time management skills
- Develop management skills for patients with movement disorders
- Function as role models and mentors for other trainees (e.g., neurology residents and fellows, medical students) in neurology
Scholarly activities will include:
- Research Journal Club: Held monthly; faculty attend and discuss clinical research papers and issues relevant to Movement Disorders
- Neurology Grand Rounds presentation
- Attendance at annual meeting(s) at the American Academy of Neurology or American Neurological Association Annual Meeting, the Movement Disorders Society
- Research Project: Fellows will be encouraged to develop a well-defined research project related to movement disorders and to prepare a poster and paper for the annual neurology meetings.
Alexandra Duffy, D.O.
The fellowship program is directed by Alexandra Duffy, D.O., Assistant Clinical Professor and Director of the Neurology Resident Program. Dr. Duffy specializes in movement disorders seeing patients with Parkinson’s disease and atypical parkinsonism, Tremors, Dystonia and Huntington’s disease. She is trained in Deep Brain Stimulation and Botulinum Toxin Injections for treatment of movement disorders.
Dr. Duffy’s research interests are focused on participating in clinical trials in Huntington’s disease. She also dedicates her time as the Neurology Residency Program Director mentoring and teaching the next generation of neurologists.
In addition to Dr. Duffy, other faculty from several disciplines will be involved in the educational opportunities presented by this fellowship. Those with specific expertise in Movement Disorders include:
Supporting Clinical Faculty with associated specialties in cognitive neurology, neurosurgery, neuroimaging, and psychiatry:
- Charles DeCarli, M.D. - Behavioral neurology and neuroimaging
- Sarah Farias, Ph.D. - Neuropsychology
- Kiarash Shahlaie, M.D., Ph.D. - Neurosurgery
- Lorin Scher, M.D. - Psychiatry, co-director HDSA Center of Excellence
- Laura Sperry, R.N.-C. - Nurse Practitioner, DBS program
Supporting Basic Science and Research Faculty:
- Jan Nolta, Ph.D. - Director, Institute for Regenerative Cures (IRC)
- Kyle Fink, Ph.D. - Neurology and IRC
We offer a one-year fellowship program for Movement Disorders. Qualified candidates will hold an M.D. or D.O. degree from an accredited institution, will have completed a residency in Neurology, and must possess a license from the Medical Board of California or apply for one at least 4 months in advance. Foreign medical graduates will be considered if they have completed a U.S.-based residency program.
We will consider applicants the year and a half prior to the start date of July 1. Interviews are scheduled on a rolling basis as we receive completed application packages.
Candidates with a high level of interest and potential in pursuing pre-clinical/translational or clinical research as a major focus of their career plan and who have a long-term goal of entering clinical research as a career will be preferred. Candidates seeking a long-term specialty clinical practice in Movement Disorders will also be considered.
If interested in pursuing this fellowship training opportunity, qualified applicants must submit three Letters of Recommendation, Curriculum Vitae, and Letter of Intent to the Fellowship Coordinator, and complete the online Fellowship Application survey.