UCSF Movement Disorders Fellowship

Training the next generation of leading academic movement disorders clinicians is the goal of our fellowship program at the UCSF Movement Disorders and Neuromodulation Center (MDNC). Along with providing expert clinical care and innovative research, we view education as central to our mission of advancing the understanding and treatment of Parkinson’s disease (PD) and other movement disorders. A spirit of collaboration is key to achieving these objectives and gives fellows a highly integrated, comprehensive, extraordinarily rich and varied training. From its inception, our program has benefited from partnerships with the San Francisco VA Parkinson’s Disease and Research Education and Clinical Center (PADRECC) and our internationally recognized integrated DBS/neurophysiology program (led by Dr. Jill Ostrem and Dr. Philip Starr). In recent years, this spirit of collaboration has expanded to our projects with the UCSF Memory and Aging Center. Dr. Caroline Tanner and others have built a leading research program in PD epidemiology and clinical trials. Our fellows get comprehensive training in design and conduct of clinical research.

Our faculty’s dedication to medical education is frequently recognized by our department and university. Over the years, our department has recognized the strength of our fellowship by approving the growth of the program to up to three fellows per year, and by providing our fellowship directors with salary-supported protected time to continue to build and improve it into a leading program. Our two-year program has trained over 30 movement disorders neurology fellows (and 14 functional neurosurgeons) in the last 15 years (see Where Are They Now?, below). The most important testament to our successful training of fellows is the success of our graduates. Many are now faculty at leading movement disorders programs, including the University of Florida, Johns Hopkins, Rush, Duke, Emory, Case Western Reserve, Brown, and UCSF.

Fellowship Directors

Rafael Zuzuarregui, M.D.
Associate Professor of Neurology
Director, San Francisco VA Parkinson’s Disease and Research Education and Clinical Center
415-353-2311
[email protected]

Ethan Brown, M.D.
Assistant Professor of Neurology
[email protected] 
415-353-2311

How to Apply

Our fellowship program participates in the national SFMATCH application service for movement disorders fellowships. New application cycles typically begin in March of the PGY-3 year of neurology residency. Applications are due by May, and interviews are conducted for select candidates in May-August, a full year (12-15 months) before the start date of the fellowship. Therefore, interested applicants should apply through new.sfmatch.org in spring of their PGY-3 year, (providing a CV, personal statement and 3 letters of recommendation). Applicants are also welcome to directly contact Dr. Zuzuarregui or Dr. Brown (emails above) with any questions.

The University of California is an AA/EEO employer. All qualified applicants are encouraged to apply, including minorities and women.

Mentorship/Education

Mentoring strong, future faculty members provides some of the greatest joy to the faculty and is of the highest priority at our center. Our program leaders meet with each fellow every 6 months to discuss overall career guidance, progress, and research endeavors. The fellowship directors additionally review formative assessments (milestones-based formal evaluations from all faculty) and perform any necessary coaching/feedback. By mid-year, first-year fellows identify a research mentor who will help with the design and implementation of their own research projects. Monthly meetings with this mentor help guide grant and IRB applications, study conduct, and writing and submission of publications. Finally, each fellow is assigned a “near-peer” junior faculty mentor at the beginning of the fellowship. This mentor serves as an ombudsman and can informally advise them about our program, clinic, center, and institution in general.

Fellows attend and present at a twice monthly video rounds and weekly fellows conference which includes lectures on rare disorders, neuropathology, neuropsychology, and recent scientific advances. Fellows attend and present at four monthly journal clubs, including those on pivotal clinical trials and the biweekly Starr neurophysiology lab journal club. This regular critical evaluation of the research literature adds to training in statistical and clinical trial methodology and neurophysiology study design. Furthermore, fellows are able to individualize their training through several coursework opportunities including biostatistics, research design, and health professional education courses. Our program also supports fellows to attend the Aspen Movement Disorders course and the annual Movement Disorder Society International Congress.

Clinical Care

Our fellows are immersed in a comprehensive and extraordinarily diverse clinical experience. Multidisciplinary collaboration with neurosurgery, behavioral neurology, psychiatry, neuropsychology, and physical therapy is central. The fellows are deeply involved in the entire course of disease management, from early detection of PD through palliative care. Working in one of most experienced Deep Brain Stimulation (DBS) centers in the world, fellows gain expertise in all aspects of DBS management; from pre-operative candidacy evaluation, to intraoperative physiology, to the use of interventional-MRI (iMRI) technique of implanting DBS electrodes (which was developed at our center), to post-operative programming. All fellows observe a number of DBS surgeries, but can greatly expand this clinical neurosurgical exposure if this is a major career interest. From the first week, our fellows get hands-on experience in our dystonia center’s botulinum toxin injection clinic, utilizing EMG and ultrasound guidance. Even before the COVID-19 pandemic, our faculty were international leaders in telemedicine (several are members of the MDS Telemedicine Study Group and have multiple publications on telemedicine clinical, research and educational applications). Movement Disorders fellows develop additional independence by managing their own patients longitudinally for two years in supervised weekly continuity clinics at the San Francisco VA PADRECC.

Research

Our center has a proven track record of contribution to the fields of neurology and neuroscience. The UCSF MDNC is a Parkinson Study Group site and a super-site for the MJFF-sponsored PPMI study. It has a long history of innovation in DBS/neurophysiology research. As of Spring 2021, we are located in the new Weill Neurosciences Institute, a state-of-the-art, 280,000 sq-foot, clinical and research center dedicated to advancing science and comprehensive care for neurodegenerative and behavioral illnesses. The Department of Neurology at UCSF (now over 200 faculty members) is fully committed to providing an outstanding scientific environment for clinical and translational research. It provides individualized support from the central administrative and other research cores of the department and has a superior record of success in research funding and contributions to neuroscience.

Included in the research conferences describe above, fellows receive several didactic sessions per year on epidemiology, clinical trial design, and statistical analysis by several faculty who have training and advanced degrees in these fields. Fellows also attend and present their research ideas and progress at weekly research meetings on physiology/DBS research, epidemiology/clinical research, and clinical trials development and operations.

Fellows have protected time and are expected to substantially participate in research. Fellows are encouraged to present their own research at professional conferences and are assisted in attendance if their work is accepted. We involve fellows in cutting-edge science to have a relevant, impactful foundation from which to build a career. For example, current fellows are involved in PD neuroprotection clinical trials, PD prodromal and biomarker research, closed-loop stimulation paradigms, and analysis of databases such as Fox Insight and PPMI.

Former Fellows: Where are they now?

Current Fellows

Beginning Fellowship July 2024