The program will enable trainees to become independent investigators in the design and conduct of clinical studies in MS and other autoimmune diseases. The Fellowship will be designed as a two-year program, consisting of the following components:

• Clinical diagnosis and management of MS
• Design and conduct of clinical trials
• MRI-based research opportunities
• Formal course work in epidemiology, biostatistics, and trial design
• Basic research opportunities
• Preceptors
• Eligibility and Application
  

Clinical diagnosis and management of MS: In the first 3-6 months, fellows undergo an initiation period during which their role as a physician in the care of MS patients will be reviewed by mentors. During this period fellows will learn how to introduce patients to the concept of clinical trials and informed consent. Fellows will also be trained in the comprehensive evaluation of patients with multiple sclerosis, including the management of relapses and progressive disease, and the appropriate choice of therapy for each disease stage.

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Design and Conduct of Clinical Trials: The fellow will be expected to participate actively in clinical trials involving all stages of MS as an examining physician. He/she will gain experience in the use and interpretation of clinical outcome measures such as the EDSS, the multiple sclerosis functional composite (MSFC), and MRI-based outcome measures.

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MRI-based Research: Most clinical trials in MS depend heavily on MRI as an outcome measure. Neuro-radiologists with special expertise in MRI are responsible for the acquisition and analysis of imaging studies. A portion of the fellow's training time will be devoted to the review of the MRIs connected with the trials. More advanced MRI research activity may be conducted locally or can be arranged in collaboration with the MRI units at Brigham and Women's Hospital in Boston or the MRI Unit at NINDS, NIH. Two 1.5 T magnets capable of multi-voxel MRS are currently available, and a 3.0 T magnet is on order.

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Formal course work in immunology, epidemiology, biostatistics, and trial design: Understanding statistical principles as applied to biomedical investigation is an important component of the fellowship. Several courses are available through the UVM College of Medicine in the Departments of Microbiology and Molecular Genetics and Epidemiology and Public Health. In addition a course is offered in Clinical trial design entitled Designing Clinical Research that the fellow will be expected to take.

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Basic research opportunities: Fellows interested in basic research will have the opportunity to work in conjunction with one of the faculty members in the Neuroscience program. Areas of training include cellular and molecular immunology, cytokine research, neuropathology, and genetics. Additional research opportunities can be arranged through collaboration with the Center for Neurologic Diseases at Brigham and Women's Hospital, or the Department of Neurology at the University of Maryland.

Fellows will be encouraged to develop independent research projects related to MS in one or more of the areas described above. They will also be expected to participate in seminars to review their research progress, to interact with other research groups in clinical or laboratory Neuroimmunology, to prepare a presentation for Neuroscience Grand Rounds once a year, to present their research findings at local and national meetings, and to publish findings in peer-reviewed medical journals.

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Preceptors
Hillel Panitch, MD will be responsible for development and conduct of the training program. Dr. Panitch is Professor of Neurology at the UVM College of Medicine and Director of the MS Center at Fletcher Allen Health Care. Other faculty members of the Departments of Neurology, Radiology, Pathology, Ophthalmology and the Basic Neurosciences will assist. In addition, the fellow will work closely with Nurse Practitioners and Study Coordinators in the conduct of clinical trials. A reading list of relevant articles and books or book chapters will be supplied and updated on a regular basis. In additon, the fellow will be expected to locate and review publications relevant to MS care and research, and discuss them with the preceptor on a regular basis.

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The program is designed as a post-doctoral fellowship. Individuals with MD or MD/PhD degrees are encouraged to apply. Preference will be given to applicants who have completed an accredited 3-year Neurology residency program. Applicants should be board eligible for certification by the American Board of Psychiatry and Neurology, and qualified for licensure in the State of Vermont. Fellowships in Neuroimmunology or Multiple Sclerosis are not accredited by the ACGME. The following documentation must be provided at the time of application:

• Curriculum Vitae
• Statement of specific interests and career plans
• Three letters of recommendation from previous preceptors, program directors, or research collaborators

The fellowship will be designed as a two-year program, with the possibility of further extension. It will begin on July 1, 2003, though other starting dates may be arranged.

Stipends will be commensurate with level of post-doctoral training, generally at the PGY5 and PGY6 levels in accordance with Fletcher Allen Health Care guidelines.

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For further information potential applicants should contact:

Hillel Panitch MD
Professor of Neurology
University of Vermont College of Medicine
Neurology Service
UHC Campus
1 South Prospect Street
Burlington, VT 05401

Phone: 802-847-5441
Fax: 802-847-9489
E-mail: hillel.panitch@vtmednet.org