Movement Disorders Fellowship

Welcome to the Yale Movement Disorders Fellowship website. Yale has had a longstanding Movement Disorders Fellowship, fostering the development of superb clinical and academic skills. The program is quite flexible, and can be tailored to individual needs, although the core features of this two-year program are clinical and research training, either in clinical research or basic research. In their letter of intent, applicants are requested to specify their specific interests. Please click the tabs on the top, where we describe the clinical core, the research core, unique features of the program and the application procedures. 

If you have additional questions, please feel free to contact us directly through email (michelle.buckholz@yale.edu) or telephone (203-785-6599). 

Elan Louis, MD
Fellowship Director

The clinical core is at the heart of the program. Fellows devote at least 40% of their time (i.e., four half-days per week) in outpatient clinics, working side-by-side with our attending movement disorder neurologists. Here the trainees: (1) learn to recognize the range of different involuntary movements, developing their skills of observation and pattern recognition, (2) become facile with the development of appropriate differential diagnoses, (3) develop their skills as expert diagnosticians, (4) learn about the treatment of movement disorders, (5) learn how to follow their patients over time, providing long-term and adaptable treatment plans, (6) develop a clear sense of the evolution and development of symptoms and signs over time, and (7) develop strategies for symptom reduction during the course of long-term follow-up care. 

In addition to these activities in the outpatient setting, fellows also work with the faculty in the inpatient setting, evaluating hospitalized patients who are need of a movement disorders consult as well as patients who are on the in-patient neurological service of Yale-New Haven Hospital who have movement disorder issues. 

Fellows also spend an additional one-half day per week in one of our botulinum toxin injection clinics learning how to administer toxin to treat a range of movements, particularly dystonia. They also spend one-half day per week learning deep brain stimulation programming, working closely with our faculty. 

Aside from their learning through direct patient care and interaction with our faculty, the fellows participate in weekly movement disorder videotape rounds, during which time they are exposed to videotaped neurological examinations of a broad range of different types of patients with a range of involuntary movements. The videotapes provide the centerpiece for clinical and academic discussions during the session, and often provide the seed for clinical research projects.

Fellows have 50% available time (i.e., five half-days per week) to develop their research skills. At the time of entry into the fellowship program, the fellow will likely fit into one of the boxes in the grid below. Our program favors the training of fellows who will go on to academic careers in neurology (see first three columns) although will accept exceptional candidates who are interested in pursuing non-academic careers in clinical neurology as well. Fellows generally enter the program with varying levels of insight into their future interests, ranging from those who have yet to develop a sense of their interests to those who have already formulated a clear path. 

Academic career: 70 - 80% clinical research and 20 - 30% clinical careAcademic career: 70 - 80% basic research and 20 - 30% clinical careAcademic career: 20 - 30% clinical research and 70 - 80% clinical careNon-Academic career: 100% clinical care
Clear sense of future interests/career development at the time of entry into fellowship
Preliminary idea about future interests/career development at the time of entry into fellowship
Still need to develop a clear sense of future interests/career development at the time of entry into fellowship

Regardless, a prime objective of our training program is to foster the career development of our fellows, irrespective of where they fall in this grid. This will be discussed further below. Regardless of which of the four columns they fall into, all fellows are actively mentored by the faculty and are expected during their two year training to write at least one scholarly paper, which might be a case report, a case series, a paper involving the collection of original data, or a review article. 

Through their interaction with our faculty, fellows who are interested in clinical research careers will be exposed to and develop expertise in all aspects of clinical research including (1) posing of research questions, (2) critically evaluating the suitability of the research question as the center piece of a practical research project, (3) developing hypotheses and specific aims, (4) developing an idea for a specific paper prior to the onset of the study, (5) designing research protocols and tools (e.g., designing questionnaires), (6) writing and submitting an IRB proposal, (7) learning how to handle thorny issues that arise during the course of the study, (8) becoming familiar with basic elements of data analysis, (9) learning how to write manuscripts, (10) learning how to submit papers for publication and effectively dealing with reviewer comments. Fellows will also have the opportunity to participate in the design and conduct of clinical trials, working with our faculty. 

Fellows who are interested in clinical research careers that involve 70 – 80% research time will receive additional training in developing ideas for research grants, identifying funding opportunities, and writing research grants (esp. K awards to NIH). These fellows will be expected to write several original research scientific papers during their fellowship training. There are a number of additional training opportunities at Yale, which fellows may avail themselves to (e.g., Master of Health Science [MHS] degree program). 

Fellows who are interested in basic research careers that involve 70 – 80% research time will have the opportunity to interact and work with members of the department as well as allied centers who run basic research labs. Here they will develop experience in research design and laboratory techniques devoted to addressing basic questions in movement disorders. These fellows will receive additional training in developing ideas for research grants, identifying funding opportunities, and writing research grants (esp. K awards to NIH). These fellows will be expected to write several original research papers during their training.

The core features of the Yale Movement Disorders program were described in the previous tabs. A number of special features deserve additional highlighting. 

1. The program director, Dr. Elan Louis, has considerable clinical knowledge of a broad range of tremor disorders, and an added element of the program is intensive training in the expert recognition of tremor phenomenology and the diagnosis of tremor disorders. Working at the Yale Comprehensive Tremor Center, which is currently being established, will provide fellows with exposure to a multi-disciplinary approach to the treatment of a range of tremor disorders, including essential tremor, Parkinson’s disease, dystonic tremor, psychogenic tremor, etc. 

2. The program director has had a longstanding career in clinical research as well as the mentoring of trainees and junior faculty. He is strongly committed to mentoring the fellows in clinical research methodology and career development. 

3. Ties between the Department and the Yale School of Public Health provide fellows with additional avenues to develop clinical and epidemiological research skills. 

4. Strengths in other clinical departments and programs at the medical center (Psychiatry, Internal Medicine) provide fellows with the opportunity for unique exposure to patients with Tourette’s syndrome and Wilson’s disease.

Yale is a member of a consortium of movement disorder fellowship training programs in which a matching plan is utilized. This is the San Francisco Match for Movement Disorders. In order to apply to our fellowship, applicants should register through the San Francisco match website and then submit their application to us directly (michelle.buckholz@yale.edu). The application should include the following documents: 

1. A cover letter that summarizes candidate’s qualifications (completion of neurology residency, ECFGM certificate if applicable).

2. A personal statement explaining the candidate's interest in movement disorders and her/his future career goals, including their research interests. 

3. A curriculum vitae 

4. Three letters of recommendation, addressed to Dr. Elan D. Louis, the Fellowship Director, with one letter being from the candidate's department chairperson. 

Applications should be submitted during the PGY3 year and applicants must have successfully completed their neurology residency program before entering the Yale fellowship program. After the application process, selected candidates will be scheduled for an interview. Interviews take place from May through August of PGY4 (i.e., approximately 9 - 12 months before starting the fellowship). A Connecticut State medical license is required in order to see patients.