Core Content of Neuromuscular Fellowship
The University of Florida Neuromuscular division has expanded its neuromuscular expertise and clinic availability to include general neuromuscular, MDA (Muscular Dystrophy Association), ALS, Peripheral neuropathy and Myasthenia Gravis multidisciplinary clinics to provide the best care to our numerous patient population. Across all the training locations, we see more than 1500 neuromuscular patients per year, and perform > 100/year inpatient and > 80/week outpatient EMG procedures. We also have a fully equipped autonomic testing laboratory. Our division has many active projects and clinical trials in different neuromuscular conditions including ALS, myotonic dystrophy, peripheral neuropathy, ataxia, SMA and close collaboration with the UF Myology center and UF Center for Neurogenetics.
Through commitment to high quality patient care, education, scholarship and research we will train neurologists in the evaluation, diagnosis, and management of neuromuscular conditions to improve the health and wellbeing of patients of North Florida and referral areas and produce physicians that continue to excel in the neuromuscular field.
- To provide comprehensive training in the diagnosis and treatment of the different neuromuscular disorders, including motor neuron disease, radiculopathies, plexopathies, neuropathies, neuromuscular junction disorders and myopathies with a 5-year first attempt board pass rate of >95%.
- To make the fellow able to perform independently as a neuromuscular specialist after graduation with >60% employed in academic practice within 5 years of graduation.
- To make the fellow comfortable doing basic and/or clinical research in neuromuscular disease, with 100% of fellows having a publication or poster during their fellowship.
Neuromuscular Fellowship Goals and Objectives
- To provide comprehensive training in the diagnosis and treatment of the different neuromuscular disorders, including motor neuron disease, radiculopathies, plexopathies, neuropathies, neuromuscular junction disorders and myopathies. This training will include patient care, research and education.
- To make the fellow proficient in the use of electrodiagnostic testing, including nerve conduction studies and electromyography for the evaluation and diagnosis of neuromuscular disorders.
- To make the fellow comfortable with ordering and interpreting muscle and nerve biopsies and genetic tests for neuromuscular conditions.
- To make the fellow able to perform independently as a neuromuscular specialist after graduation either in academic or at private practice
- To make the fellow comfortable doing basic and/or clinical research in neuromuscular disease
Areas of coverage for the fellowship will include:
- Patient care/Management- medical treatment, interdisciplinary clinic in muscular dystrophy and ALS, role of rehabilitation in neuromuscular disorders.
- Research – writing case reports/reviews/original papers. Participating in ongoing research projects in the neuromuscular division.
- Education – Providing lectures to the residents, supervising residents/students, participating in MDA or AS support group education
The Neuromuscular Fellowship curriculum is comprehensive and follows the ACGME-guidelines and milestones. The fellow will receive the training necessary to develop the skills essential to the performance of Neuromuscular Medicine. This training includes many opportunities to observe, evaluate, and manage inpatients and outpatients of all ages with a wide variety of disorders of the neuromuscular system and perform numerous electrodiagnostic evaluations. Basic clinical knowledge including genetics, pathophysiology, clinical manifestations, diagnostic tests, differential diagnosis, treatment, prognosis of each of the following disorders will be included as part of the training:
a) Motor neuron disease
b) Myopathy, including genetic and acquired
c) Neuromuscular transmission disorders
d) Cranial/spinal single and multiple mononeuropathies
e) Peripheral neuropathy
f) Polyneuropathy: infectious/inflammatory
g) Inherited neuropathy
h) Polyneuropathy: toxins and others
i) Polyneuropathy/systemic disease
h) Nerve hyperexcitability disorders
Training includes direct patient care at the adult neuromuscular clinic, pediatric neuromuscular clinic, MDA and ALS multidisciplinary clinics or inpatient neuromuscular consults at UF Health Shands Medical Center and at the Randall VA Medical Center. Expertise in the performance of electromyography and nerve conduction studies will be obtained in the neuromuscular electrodiagnostic laboratory. There will also be a formal muscle and nerve pathology review teaching session.
Following one year of training, the fellow will be competent in the diagnosis and treatment of patients with any of the above-mentioned neuromuscular disorders.
Structure of the Fellowship
Fellows meet with the Director individually for one on one evaluation and feedback at least once every 6 months. There is a formal confidential evaluation form that fellows must fill out, as well as a survey to be filled out from each of the faculty on the individual fellow. The surveys and feedback ensure that all aspects of training are being addressed and that fellows obtain a comprehensive experience in which all critical skills and training goals are learned or achieved. Additionally, fellows will meet with their individual mentors at least monthly.
The fellows will have the following rotations:
- Adult and pediatric Neuromuscular clinic and Neuromuscular rehabilitation
- Electrodiagnostic Medicine
- Muscle and Nerve pathology
- Neuromuscular Research/elective
Teaching conferences include:
- Muscle and nerve pathology review sessions
- EMG and NCS lecture series
- Neuromuscular lecture series
- Neuromuscular Journal club
- Neurology Grand rounds
Length of Fellowship
One year. There is the possibility of doing an optional 2nd year of neuromuscular research in collaboration with other UF Institutes including the UF Center for Neurogenetics, UF Myology Institute, UF McKnight Brain Institute, UF Powell Gene Therapy Center and the UF Rehabilitation Department.
Fellow’s Status with Accrediting or Approval Bodies:
Fellows will be at PGY-5 level. Prior residency training in Neurology will be required to enter into the fellowship, and the fellows must be board-eligible for the ABPN Neurology Board. Potential fellows may have either a permanent Florida Medical License or a temporary graduate medical education permit through the University of Florida. The Department of Neurology will provide independent funding for licensure for all potential fellows.
Fellowship Selection Process:
Advertisements will be placed in the American Academy of Neurology (AAN) website fellowship directory, on our website, through emails to all fellowship directors listed on the AAN website, and announcements at national and international meetings.
If you are interested in pursuing a 2nd year of neuromuscular research, please include it in your letter of interest or personal statement.
The UF Neuromuscular Fellowship participates in the AANEM Neuromuscular Fellowship Portal and Matching process. The applications received in the portal will be reviewed and qualified applicants will then be selected for interview. Our program is committed to abiding by the following fellowship application process – interview offers will not be made before March 1 of the year prior to the fellowship start date. Fellowship positions will not be offered before June 1 of the year prior to the fellowship start date. Violations of this process will result in removal of our institution from the AANEM NM Fellowship Portal.
Fellowship Director information:
Miguel Chuquilin, MD
Associate Professor Neurology
Neuromuscular Fellowship Director
Department of Neurology
University of Florida
Fixel Institute for Neurological Diseases
3009 SW Williston Rd.
Gainesville, Florida 32608