The Neuromuscular Diseases Fellowship in the Department of Neurology provides broad-based training in the clinical, electrophysiological, pathological and research aspects of neuromuscular diseases. The Neuromuscular Section is directed by Dr. Rup Tandan, with three additional faculty members (Drs. Eugene Dulaney, Timothy Fries and William Pendlebury) who are actively involved in the training of Fellows.

The major objective of this Fellowship is that Fellows will graduate from the program adequately trained in the clinical, electrophysiological, and pathological investigation and management of patients with all varieties of neuromuscular diseases. The program has ample clinical, electrophysiological, and pathological material, and supervision, available to provide the necessary experience. Training is broad-based, and experience is gained in a diverse variety of muscle, neuromuscular junction, nerve and motor neuron diseases encompassing several disciplines.

Clinical Training
The Fellows take part in two Neuromuscular Diseases Clinics per week, and are also responsible for running the Neuromuscular Consultation Service at Fletcher Allen Health Care (FAHC) under the direction of the Fellowship director along with active participation by the other Neuromuscular Section faculty members. Such clinical training is facilitated through the busy clinical services run under the auspices of the Muscular Dystrophy Association Clinic, the National ALS Clinical & Research Center and the International Postpolio Foundation Clinic, all within the Department of Neurology. Through these sessions the Fellows receive directed training in the in-hospital and outpatient clinical aspects of neuromuscular diseases.

Electrophysiology Training
The Fellows obtain training through the peripheral electrophysiology laboratory under the direction of Dr. Timothy Fries to gain experience in the electrophysiological investigation of patients with neuromuscular diseases. In addition to the emphasis on routine EMG and nerve conduction studies, the laboratory also provides the Fellows experience in single fiber EMG, quantitation of motor units and motor unit number estimates, autonomic testing, and quantitative sensory threshold determination which are all routinely performed in the laboratory. There are opportunities for the Fellows to gain experience in EEG, evoked potentials, and intra-operative monitoring. This 12-month supervised experience allows the Fellows to meet requirements for eligibility for the Added Qualifications in Clinical Neurophysiology examination given by the American Academy of Neurology (AAN).

Neuromuscular Pathology Training
Fellows participate in the bi-weekly Muscle and Nerve Pathology conferences held under the direction of Dr. William Pendlebury, to simultaneously gain experience in the preparation of tissue for histological examination, and interpretation of nerve and muscle pathology. At these sessions ongoing training is provided in the pathological diagnosis and investigation of patients with neuromuscular diseases. This training, with adequate documentation, will allow Fellows to meet the requirements for Post-Residency Neurologic Training in Neuromuscular Pathology by the AAN.

Research and Scholarship Training
Research activities of the fellowship involve participation in ongoing research within the Neuromuscular Diseases Section. This includes treatment trials in several neuromuscular diseases, quantitative studies of the natural history of ALS, and clinical trials in ALS. This research is largely undertaken on the National Institutes of Health-funded General Clinical Research Center (GCRC) at FAHC. Fellows also have an opportunity to pursue research in other areas of neuromuscular diseases, such as in clinical electrophysiology (with Drs. Fries and Dulaney); the neuropathology of nerve and muscle diseases (with Dr. Pendlebury); in the clinical investigational use of stable isotopes to study protein or caloric metabolism (with Dr. Tandan and Dr. Dwight Matthews in the Departments of Medicine & Chemistry); pain and acupuncture (with Dr. Helene Langevin in the Department of Neurology); and in the molecular biological aspects of muscle diseases (with Dr. David Warshaw and other faculty in the Departments of Physiology and Molecular Biophysics).

Fellows are expected to plan, develop, and undertake an independent research project in an area of neuromuscular disease during the term of the training. Data from this project is usually presented at a national meeting, and published.

Teaching Responsibilities
Fellows are expected to be involved in the teaching of Neurology residents, medical students and interns rotating on the Neurology in-patient, consultation, and outpatient services. Fellows organize weekly neuromuscular bedside teaching rounds, and accept responsibility for the bi-weekly seminar series in electrophysiology and neuromuscular diseases.

Applicants must be graduates of an accredited training program in neurology in the U.S. or Canada and must be licensed or eligible for licensure by Vermont and New York State. The program prefers to receive applications by August 15 so that candidates can be reviewed, interviewed and a decision arrived at by October 1 of the year prior to initiation of the fellowship. Applications up to October 1 will be considered on a case by case basis. Further information about the training program and an application can be obtained by contacting:

Maureen Leahy, Residency/Fellowship Coordinator
Department of Neurology
University of Vermont College of Medicine
89 Beaumont Avenue, Given C225
Burlington, VT 05405
(802) 656-4590; fax (802-656-5678)