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About the Program

fellowship program

The Parkinson’s Disease and Movement Disorders fellowship at the Duke University School of Medicine is designed to produce the next generation of physician-scientists. The two-year fellowship program emphasizes clinical experience in the first year, then transitions to a research focus in the second year. Fellows are involved in all aspects of patient care, including initial diagnosis, ongoing patient management, deep brain stimulation implantation and management, and injection of botulinum toxin. For research training, fellows benefit from active mentoring, opportunities for collaboration with internationally-recognized research scientists, and incredible institutional support for physician-scientist trainees.

Mentoring is provided throughout the fellowship through weekly meetings with the Program Director and quarterly meetings with the Division Chief. Fellows work with their faculty mentors to develop research projects based upon their areas of interest during the first year, and a mentoring team will be formed by year 2. Our mission is to train physician-scientists with the skills necessary to expertly manage patients’ needs, while also advancing the scientific understanding of Parkinson’s disease and other movement disorders.

Clinical Exposure: 

A core strength of the Duke training experience is the depth of mentored clinical care exposure that trainees receive. Fellows will spend approximately four days per week engaged in clinical care during the first year, and will transition to 1-2 days per week in the second year as they increase effort on their research project. Fellows will be trained to perform injections of botulinum toxin (with and without EMG guidance) and will gain comprehensive experience in evaluation and management of patients for deep brain stimulation (including on/off testing, surgical planning, intraoperative electrophysiology, and post-operative DBS programming). Duke’s program is one of the few in which neurologists perform surgical planning including target selection and trajectory planning, ensuring that our fellows have detailed training in all aspects of the procedure.  Fellows benefit from scheduled rotations with all of our clinical faculty to ensure comprehensive exposure to the full range of medical conditions, procedures, and practice styles.

Our commitment to excellent care includes an interdisciplinary care team approach, and fellows benefit from weekly interdisciplinary meetings with PT, OT, speech therapy, pharmacy, and social work. Fellows will also participate in our educational outreach programs for patients and caregivers, and our comprehensive care model has been recognized with Center of Excellence recognition from the Parkinson’s Foundation and the Huntington’s Disease Society of America.

Educational Activities

While the majority of our fellows’ clinical education occurs in the context of mentored patient care, fellows also participate actively in structured educational activities. Besides Neurology Grand Rounds, fellows will attend 1-2 Movement Disorders conferences weekly that include:

  1. Monthly DBS interdisciplinary case conferences
  2. Monthly neuromodulation research conference
  3. “Journal Club” reviews of research advances and clinical care guidelines, led by the fellow
  4. Faculty-led Research in Progress meetings
  5. Dystonia “lunch and learn” series
  6. Huntington’s Disease “lunch and learn” series.

Fellows will attend the Movement Disorder Society’s Aspen course and an international scientific conference such as the Movement Disorder Society or American Academy of Neurology meeting. Assessment of the fellow’s progress occurs through weekly meetings with the fellowship director, and through structured feedback given quarterly.

Research Exposure: 

Fellows will spend 25% of their time on research and 75% on clinical work during the first year, then transition to 75% research and 25% clinical time during the second year. As noted above, fellows will work the Program Director and Division Chief during the first year to identify areas of interest and opportunities for collaboration, and a mentoring team will then be formed by year two. The mentoring team will work with the fellow to establish a time table and goals, and to guide the fellow through the research process.

Collaboration across Duke

Fellowship training at Duke provides opportunities for collaboration with a broad range of internationally-recognized research scientists.  Opportunities exist for basic, translational, and clinical research, and our program has long enjoyed robust working relationships with the Departments of Neurosurgery, Neurobiology, Biomedical Engineering, Psychiatry, Physical Therapy, and Radiology.

Ongoing collaborations with the departments of Neurosurgery (Dennis Turner, MD, Nandan Lad, MD, PhD, and Derek Southwell, MD) and Biomedical Engineering (Warren Grill, PhD) provide unique opportunities for cutting-edge DBS research. Much of our research is performed in conjunction with Dr. Grill, who directs an extensive and internationally-renowned translational laboratory focused on understanding the mechanisms of neuromodulation and developing advanced approaches to deep brain stimulation.

Dennis Turner, MD, Jeffrey Cooney, MD and Kyle Mitchell, MD are also utilizing support from the NIH BRAIN Initiative to evaluate electrophysiology recorded from chronically implanted DBS electrodes in the non-operative setting, with the goal of utilizing both electrophysiology and wearable devices to facilitate “closed loop” adaptive DBS.

Collaboration with Cell Biology (Cagla Eroglu, PhD) provides access to cutting-edge PD disease mechanism research involving glia, and incoming fellows will further benefit from major growth in Parkinson’s disease and neurodegeneration research spearheaded by Duke’s Center for Neurodegeneration and Neurotherapeutics led by Al LaSpada, MD, PhD a world expert in trinucleotide repeat disorder mechanisms. Recent recruits include Andy West, PhD, (PD/LRRK2 mechanisms) and Laurie Sanders, PhD (LRRK2/mitochondrial DNA repair) who are leading highly translational programs that are well-integrated with our divisional activities

In summary, our goal is to train motivated fellows to be expert clinicians and leading scientists, and our interdisciplinary collaborations, extensive clinical training, and outstanding research opportunities ensure that our fellows will be poised to expand the clinical and scientific boundaries of Movement Disorders Neurology in the years to come. We look forward to receiving your application to our program!

Prerequisite: Successful completion of an approved neurology residency.

Salary level: PGY-5

For more information, contact Program Director Jeffrey Cooney at Jeffrey.Cooney@duke.edu.