Subspecialty Fellowship Offered
The Columbia Movement Disorders Fellowship Program was founded by Stanley Fahn, and has been training movement disorders fellows since 1980. A total of 130 fellows have been trained, including many current and former chairmen (eg, Bressman, Giladi), and Movement Disorders Division heads (eg, Dauer, Frucht, Henchcliffe, Kang, Louis, Xie). About 80% of fellowship graduates are in academic and industry research positions. In a survey of 47 movement disorders fellows trained at Columbia between 2000 and 2012, 10 (21%) fellows have obtained NIH grants (K or R awards) as PIs worth a total of $8.1 million since their graduation (excluding industry trials and foundation grants). Since 2010, graduates of the fellowship were awarded 2 AAN Foundation Fellowship Awards, 3 NIH K awards, a Brookdale Leadership in Aging Award, a DMRF James C. Kilik Memorial Research Award, and a HDSA Human Biology Project Award. In addition, they received competitive Columbia University-wide awards including 2 Gerstner awards, 2 endowed Assistant Professorships, and 1 Janssen Fellowship in Translational Neuroscience. Many of the fellows who are in private practice are the only movement disorders specialists in their areas, covering 26 states and 15 countries outside the North America. See some of our former and current fellows.
Description of Training Program
The Movement Disorders Fellowship is a 2-year program that offers a unique combination of superb clinical training and intensive research opportunities. While the fellowship design is tailored to meet the individual academic goals and background of each fellow, there are two broadly defined tracks for training. The clinician track emphasizes clinical training, ensuring coverage of all relevant skills, including DBS and botulinum toxin injection. Fellows will engage in tailored research training and projects, such as authoring review articles, book chapters, or case series, or participating in clinical trials. The research track aims to provide fellows with the foundations for a research-centered career in academic neurology. The program provides protected time in the 2nd (and, if applicable, 3rd) year to devote to research activities. Fellows in this track are expected to apply for mentored research awards/grants. Research can be in basic science or clinical, with opportunities for earning an advanced degree in Neuro-epidemiology.
A. Clinical Training:
The clinical goal of the fellowship program is to train neurologists to become experts in the diagnosis and treatment of Parkinson disease and other movement disorders. The core component of their clinical education consists of evaluating outpatients and hospitalized patients at Columbia University Medical Center. The fellows perform clinical evaluations of patients under the faculty's direct supervision, review management decisions and write up the evaluation letter. Follow-up care is as important as the initial evaluation, and fellows follow the patients closely with subsequent outpatient visits and non-office contact, i.e. phone calls and emails. Furthermore, longitudinal follow-up of the same patient over time is particularly crucial for a chronic disease like PD. The division runs a clinic for Medicaid patients. The fellows are the primary caregivers and decision makers (with faculty guidance) for their patients, and will follow the same patients for their entire fellowship. Furthermore, fellows can serve as attendings in this clinic beginning in the second half of their second year, affording them the opportunity to begin supervising and teaching more junior fellows and residents. Our center’s combination of referral patterns (tertiary referral center and primary community center of care) provides a rich patient population. In both a published formal assessment and a more recent review of billing codes, we found that approximately half of the patients evaluated had PD, allowing for rigorous training in the diagnosis and management of PD. The other half of patients spanned a wide range of other movement disorders, including atypical parkinsonian syndromes, essential tremor, dystonia, ataxia, myoclonus, chorea, tardive syndromes, and functional disorders.
The program trains fellows in specialized techniques and procedures for movement disorders. The division has an active DBS program, and fellows are intimately involved in all aspects of DBS-related care: evaluation and selection of patients, intraoperative physiological recording, and stimulator programming. Our multidisciplinary DBS team is comprised of movement disorder specialists dedicated to DBS, 2 neurosurgeons, a DBS nurse, and a neurophysiologist. Fellows learn botulinum toxin injections, with and without EMG guidance, for treatment of dystonia and related disorders. The division is closely affiliated with the Clinical Motor Physiology Laboratory (CMPL), under the direction of Seth Pullman. Several past fellows have pursued additional training in motor physiology, including intraoperative monitoring. The CMPL is responsible for performing intraoperative recording during DBS surgery. In addition, the center performs specialized assessment of motor physiology, such as tremor analysis (routinely performed during pre-operative evaluation), back-averaging for myoclonus, and evoked potentials with transcranial magnetic stimulation. Fellows may also choose to do a 6-month elective in the multidisciplinary Huntington disease clinic, located in the adjacent New York Psychiatric Institute.
B. Academic Core:
The division has a robust series of academic lectures and conferences. Fellows play a primary role in these activities, which are scheduled to avoid clinical duties. The core conference is our weekly “video rounds,” where patients’ clinical problems are discussed along with videotaped exams. In conjunction with the New York Brain Bank, we have monthly clinicopathologic conferences (CPCs), which combine clinical histories, presented by fellows, with autopsy findings and a neuropathologic diagnosis. The division also has monthly case conferences, with live presentation of patients. The DBS team conducts monthly “DBS rounds” to review challenging DBS cases. Monthly journal club is organized by fellows to discuss current research articles, emphasizing critical analysis. To start the academic year, formal sessions on fundamental topics in movement disorders are presented by faculty. Two bimonthly research conferences are held, one for the basic laboratory group and one on a translational topic that includes both clinical and basic science groups. Speakers are invited widely within Columbia and from outside. In addition, fellows are expected to present their work in progress at these conferences.
Upon starting the fellowship, fellows are assigned a faculty advisor (based on their preliminary interests) to help guide their research and overall career development. In particular, the advisor ensures that the fellow is formulating their research plans in a timely manner and assists in the selection of scientific and clinical mentors. All fellows are supported for the Aspen course in Movement Disorders, presentation at AAN and MDS meetings, and, if requested, Columbia’s summer course in biostatistics. In addition, Columbia sponsors numerous seminars on relevant topics, such as grant writing and IRB submissions.
C. Research Opportunities:
Our division, and the larger Columbia community, provides an extensive array of potential research training opportunities. This breadth of resources is a unique strength of our program. On the clinical side, we have initiated and participated in several industry- and government-sponsored clinical trials (Fahn, Kang, Levy, Waters), conducted research on biomarkers (Kang, Alcalay) and genetic contributions to PD (Alcalay), explored tractographic predictors of DBS response (Vanegas) and participated in WHO-sponsored public health efforts to improve global dementia care (Shah). On the basic science side, our faculty has explored several facets of autophagy in the pathogenesis of PD (Sulzer, Kuo, Yamamoto, Tang), used single unit recording to assess cognitive effects of subcortical circuit activity (Pullman, McKhann), studied the neural circuit mechanisms underlying levodopa-induced dyskinesias (Kang, Borgkvist, Santini) and investigated novel pathways involved in neuroprotection, mitochondrial dynamics, and axonal regeneration (Przedborski, Tang, Yamamoto). Applicants should check individual laboratory websites for more details and updated projects.
Epidemiology training is another unique strength of the program, with two NIH-funded mechanisms for formal training: Patient Oriented Research Program; Neuro-epidemiology Training Program (NETP), one of only two such programs in the country. These programs provide 2 years of training in biostatistics and clinical research methodologies, culminating in a Master’s degree. Acceptance to these programs is competitive, and 5 movement disorders fellows have been accepted (including 3 in the last 3 years). As an alternative, Columbia offers an intensive 5-week summer course in statistics and research design. Other notable resources outside the division include The New York Brain Bank, located on site, which has autopsy material from hundreds of patients with neurodegenerative diseases.
Fellows are free to seek mentors outside the division and outside the department anywhere at Columbia University including Taub Institute, Sergievsky Center, Mailman School of Public Health, New York State Psychiatric Institute, Departments of Pathology & Cell Biology, Neuroscience, and Psychology.
How to Apply for the Fellowship Program:
The subspecialty of movement disorders is not an ACGME accredited program.
Columbia is a member of a consortium with other movement disorder fellowship training programs in which a matching plan is utilized, and all consortium members notify fellowship candidates of acceptance on the same date. Thus, our program participates in the San Francisco Match for Movement Disorders Fellowship Match. In order to apply to our fellowship applicants should submit their application to the San Francisco match website. Please include your career goals, research interests and potential research mentors, if any, at Columbia University. Any additional materials should be sent directly to firstname.lastname@example.org.
In their letter of intent, applicants are required to specify their interests. Applicants who are interested in NETP who are invited for interviews will also be given information about applying to the Mailman School of Public Health for the Master’s Degree in Epidemiology Program. Note that application to the NETP is a separate process that typically takes place early in the applicant’s first year of fellowship. NETP is funded in collaboration with the NIH, and only open to US citizens or those holding a green card. Candidates are strongly encouraged to contact potential research mentors directly and indicate them in their letter of interest so that interviews are arranged with appropriate faculty members.
Applications should be submitted during PGY3 and must have successfully completed a neurology residency program before entering this fellowship.
Time Line of Application
March to August of the year before the starting date (usually July 1) of fellowship: Registration and application through SFMatch. Most interview decisions are made by June.
- For fellowship starting in July, 2019: SFMatch begins accepting applications on March 1, 2018. The target date for completion of applications is April 11, 2018; this is not an absolute deadline, but a goal date for having all components of the application submitted.
May to August: Interviews (usually takes place in May-July on select Fridays)
Rank list deadline: Early September.
-For fellowships starting in 2019, deadline is Sept 6, 2018.
Match result announcement: mid-September
-For fellowships starting in 2019, announcement is Sept 13, 2018.
We accept international applicants and support their J1 visa. Applicants, however, should be eligible for a New York State License, which requires an ECFMG certificate from all candidates who graduated medical schools outside the USA or Canada. A New York State medical license is required to see patients.
Oren Levy, MD, PhD
Assistant Professor of Neurology
For general inquiry and application: