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Clinical Fellowship in Dementia

Alzheimer’s disease (AD) and the related dementias are complex neurological disorders that are expected to shift the socio-demographic trends in the U.S. and beyond, with drastic public health consequences for the global community. There is an urgent need for training the next generation of clinician-scientists who are well-versed to work with patients with such diseases and to find effective treatments for them.

Overview

The Massachusetts General Hospital Clinical Fellowship in Dementia was established by the Massachusetts Alzheimer’s Disease Research Center (www.madrc.org) in 1982. Since then, approximately 30 fellows have completed the highly-competitive training program. The fellowship curriculum is based on the six competencies required by the Accreditation Council for Graduate Medical Affairs (ACGME):

  1. Medical Knowledge
  2. Patient Care
  3. Practice-Based Learning and Improvement
  4. Systems-Based Practice
  5. Communications and Interpersonal Skills
  6. Professionalism

Program Certification

The fellowship program is considered a component of the Harvard/Partners Neurology Residency Program, which is accredited by the Accreditation Council for Graduate Medical Education (ACGME program number: 1802431050).

Requirements

Eligibility

The Fellowship is open to U.S. citizens, lawful permanent residents or foreign nationals.

Candidates must possess at least an MD or a foreign-equivalent basic medical degree (e.g., MBBS) and have successfully completed a recognized residency training program in neurology or a related field. They must be eligible to apply for a limited license in the State of Massachusetts and have documentation of the USMLE Step 1, Step 2 CK, and Step 2 CS.

International medical graduates may apply and submit ECFMG certification as well, and are expected to be fluent in English. Individuals who will add diversity to the medical sciences and with foreign language skills are considered a plus.

Goals & Objectives

Goals

Year 1: The main goal of the program is to train clinicians in the diagnosis, evaluation and management of patients with dementing disorders such as Alzheimer’s disease, frontotemporal disorders, vascular dementia, dementia with Lewy bodies, and other related disorders.

Clinical mentors will train fellows to gain expertise in clinical/neurological examinations, and the use of laboratory, imaging, biomarker, genetic and neuropsychological test results to: (i) better understand the underlying causes, clinical progression and pathology of a wide range of complex neurologic disorders, and (ii) the use of safe and efficacious drugs to treat clinical syndromes.

During year 1, each fellow will be expected to directly see approximately 90 - 100 new patients and approximately 50 follow-up patients under the supervision of a clinical mentor.

Year 2: The focus of the 2nd year is to enhance and solidify clinical goals identified above in Year 1 of the program. During year 2, each fellow will be expected to directly see approximately 50 new patients and approximately 120 follow-up patients under the supervision of a clinical mentor.

Objectives

By the end of the program, the fellow is expected to attain the following competencies in clinical care:

Medical Knowledge: The fellow will demonstrate an advanced fund of knowledge and skills in clinical settings, and use best practices in the clinical examination, diagnosis and treatment of complex-care patients typically seen in tertiary clinics.

Patient Care: The fellow will demonstrate effective techniques in interviews, physical, neurologic, psychiatric examinations and technical/procedural skills. He/she will develop comprehensive differential diagnosis and multidisciplinary plan of care for patients.

Practice-Based Learning and Improvement: The fellow will actively seek and respond to formative feedback, educate diverse patients/families and other healthcare professionals, and motivate self to improve skills through review of scientific literature, self-reflection, participation and presentations at conferences (e.g., M & M).

Systems-Based Practice: The fellow will deliver compassionate, cost-effective care (or transition of care) in multi-disciplinary settings, functions as a team player, and provide effective suggestions to improve patient safety and care. He/she will be poised to navigate complexities associated with changing health-care laws.

Communications and Interpersonal Skills: The fellow will communicate effectively with diverse patients, family members, colleagues, media and the public. They will gain skills in providing educational guidance on patient care to families and caregivers.

Professionalism: The fellow will demonstrate compassion and integrity in clinical settings. He/she will evident sensitivity to patients’ and colleagues’ diverse backgrounds and adhere to regulations on privacy and confidentiality. He/she will reliably accept, prioritizes and accomplishes professional responsibilities and serves as a positive role model.

How to Apply

Applicants are required to submit the following documents to the program director for consideration:

Cover Letter

The cover letter should clearly state the applicant’s commitment to a clinical career in the dementias and/or a related neurodegenerative disease, include his/her goals for the fellowship and plans after the program, identify faculty mentors or specific laboratories that they may be interested to work with, and include information on his/her visa status (if applicable).

Research Statement (optional; 2 page maximum)

If an applicant has already identified a proposed independent research project to carry out during the fellowship, the following information should also be included: (i) the nature and scope of the research, (ii) how institutional resources would be utilized, and (iii) how the research will help advance knowledge on dementias and/or related disorders.

Curriculum Vitae (CV)

The CV should also include a list of current or pending funding, if available.

Three Letters of Recommendation

These should be from past or current faculty members or mentors who are familiar with the applicant’s potential and aptitude for pursuing an academic, industry or a related scientific field.

The fellowship is awarded through a competitive-review process led by an ad-hoc fellowship selection committee. Application materials are due approximately 4 months prior to the start of the program.

A limited Massachusetts Physician Medical License is required for accepted fellows. They must be in full residence during the entire duration of the 2-year training program and should document successful completion of USMLE Step III by the end of the program. However, the fellowship program director may grant individual Step III exceptions for 1 year at a time with the approval from the Vice President for Graduate Medical Education at Partners HealthCare. Permanent exemptions may be granted to international medical graduates who plan to return to their home country after the completion of their training.

Note: Canadian physicians and Doctors of Osteopathy who are eligible for licensure may substitute documentation of successful completion of LMCC/MCCQE and COMLEX examinations (respectively), in lieu of USMLE examinations.

Submit Application Doctuments to:

M. Teresa Gomez-Isla, MD, PhD
Clinical Fellowship in Dementia Fellowship Director
MassGeneral Institute for NeuroDegenerative Disease
Massachusetts General Hospital
Building 114, Suite 2008
16th Street
Charlestown, MA 02129
tgomezisla@partners.org

Clinical Experience

The clinical aspects of the program will include comprehensive training in all practical and theoretical aspects of diagnosis, evaluation and clinical management of patients with dementias (e.g., Alzheimer’s disease, frontotemporal disorders, dementia with Lewy bodies, vascular dementia, cerebral amyloid angiopathy). The fellow will deliver care to patients of the MGH’s Memory Disorders Unit (MDU) and/or Frontotemporal Disorders Unit on one half-day per week supervised by an assigned clinical mentor. He/she is expected to see a mix of new patients and follow-up patients; participate and present cases at the weekly MDU conference, attend weekly departmental Grand Rounds, and meet with his/her assigned clinical mentor once a week to review cases. Fellows will not have admitting/billing privileges nor will they be providing any coverage responsibility for attending physicians throughout the program.

Research Experience

The Fellowship will also include a research component that will complement the advanced clinical training aspect of the program. The research aspects of the fellowship will include in-depth training in state-of-the-art inquiries in clinical, translational and/or basic science research, including the following: Biomarker/genetic research; novel drug/vaccine/biologics/medical devices development; interventional trials; observational studies; neuroimaging studies; animal models research. Each fellow will be required to develop and conduct an independent research project or clinical trial under the weekly supervision of an identified mentor. Under the guidance of the mentor, the fellow will be expected to present his research at local, national and/or international conferences approximately 1- 4 times per year, and publish findings in leading journals.

 

Didactic Experience

Other didactics (informal teaching) that fellows may attend include (local, national, international) courses, conferences, symposiums, journal clubs and workshops on patient care quality and safety; pain management; interpersonal and communication skills; professionalism and cultural competency; biostatistics; cost-effective health care management; risk management; pharmacology; biotechnology; health disparities; clinical trials; grant-writing; fund-raising; human subjects protection; ethical animal research; ethics; study recruitment; academic-industry partnerships; leadership development; regulatory compliance; IRB/FDA regulations; Intellectual Property; media relations, etc.. Many of these offerings are routinely sponsored by the Harvard Clinical and Translational Science Center (Harvard CATALYST), the Partners Graduate Medical Education Office, the Partners Office of Continuing Professional Development and other entities.

The fellowship program does not impose a specific schedule or length for these didactics as they contribute to the ongoing professional development of fellows. Fellows are encouraged to attend these didactics to complement their clinical and research requirements.

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