Curriculum

Clinic service represents >50% of the fellow’s time and effort, up to 70% of weekly time depending on the degree of research involvement. Fellows conduct neuropsychological evaluations 3-4 days per week (less for fellows more heavily involved in research, typically in the second year), including the interview, interpretation of standardized tests, case conceptualization, written reports, and feedback. All clinical work provided by the fellow will be under the direct supervision of clinical faculty with additional dedicated time for case discussion. Efforts are made to provide psychometrist support. Fellows may be expected to administer and score tests on occasion. Fellows gain experience with comprehensive neuropsychological evaluations of a diverse and complex neurological population. Fellows will participate in clinical interviews, test selection based on clinical questions, and case conceptualization. Written neuropsychology reports represent relevant history and test results to support summary statements regarding cognitive and emotional functioning, diagnostic implications, and recommendations. Establishing good rapport and professionalism in the clinical setting is also prioritized.

Clinical Experience

Clinical experience will consist of adult neurological evaluation conducted in an outpatient setting. Issues of return to driving, work, and independent living are paramount. The focus is on case conceptualization, interpretation of test results, providing feedback, and report writing. Fellows participate in interviews of patients and family members, as well as feedback. There are typically one or two neuropsychological evaluations per day. The neuropsychological assessments vary in breadth from two-hour extended screenings to full-day batteries, depending on the case and clinic type.

Continuous training in neurology-neuropsychology outpatient clinics – three days per week for the training year. Minor elective rotations in Functional Neurological Disorder Intervention, Rapid Access Triage Clinic, and elective rotations in Rehabilitation/Psychiatry are available.

Neuropsychology Rotations

We have strong programs in all the major neurology subspecialties, including epilepsy, stroke, movement disorders, neuromuscular disease, MS and neuro-immunology, neuro-oncology, neuro-critical care, and cognitive disorders, with over 50,000 neurological outpatient visits annually. In addition, UAB has more than 2,400 neurology inpatient admissions per year representing the full spectrum of acute and tertiary referral neurological disorders. We have a very close working relationship with our outstanding Neurology faculty, the Department of Neurosurgery, and the Divisions of Neuroradiology and Neuropathology, as well as other closely allied departments such as Medicine, Psychiatry, and Rehabilitation Medicine, to name a few. Cases for neuropsychological evaluation will include referrals from General Neurology as well as these subspecialty clinics at UAB.

Referrals from General Neurology and Subspecialty Clinics

Behavioral Neurology Clinic

UAB Memory Disorders Clinic provides state-of-the-art care for patients with a variety of neurological disorders affecting cognition and behavior, including age-related memory loss, Alzheimer’s disease, frontotemporal dementia, Parkinson’s-related cognitive impairment, vascular dementia, Creutzfeldt-Jakob disease, and other related conditions.

Movement Disorders Clinic

Movement Disorders Clinic specializes in neurological disorders that affect movement, such as Parkinson's disease and other Parkinsonian disorders, essential tremor and other tremor disorders, dystonia, tics and Tourette syndrome, myoclonus, ataxias, and other movement disorders. The clinic offers comprehensive diagnostic services and utilizes a full range of treatment approaches including medications, physical, occupational, and speech therapy, deep brain stimulation surgery, neuropsychological evaluations and treatment, botulinum toxin injection therapy for dystonia, spasticity and other movement disorders, and clinical trials testing new medical and surgical therapies, including "neuroprotective therapies" for Parkinson’s disease.

Neuroimmunology/Multiple Sclerosis Clinic

Patient care services provided in the Adult MS Clinic include evaluation, diagnosis, and comprehensive management of MS and other immune-based disorders of the central nervous system (CNS), such as neuromyelitis optica, optic neuritis, transverse myelitis, CNS vasculitis, and neurological complications of systemic immune-mediated disorders. The Division of Neuroimmunology/Multiple Sclerosis also provides specialized services through the Transverse Myelitis Clinic, Neuro-Rheumatology Clinic, Neuro-Infectious Disease and Neuro-HIV Clinics, Transplant Neurology Clinic, and Pediatric Multiple Sclerosis Clinic.

Epilepsy/EMU

The inpatient epilepsy service includes a 10-bed video EEG monitoring unit. State-of-the-art facilities and equipment are available for diagnostic studies and treatment. Intracranial electrode implantation, cortical stimulation studies, specialized EEG procedures, and a full range of conventional and special tests are available. Common reasons for admission to the EMU include the following:

• Classification of seizure type such as epileptic vs nonepileptic or partial vs generalized
• Significant medication changes
• Pre-surgical evaluation that includes any combination of MRI with 3.0T scanner, MEG scanning, PET or SPECT scanning, epidural/subdural electrode recording, neuropsychological evaluation and WADA testing. This patient cohort is seen in collaboration with neurosurgeons specializing in epilepsy surgery.

Weekly Schedule

Fellows will be expected to see a total of three comprehensive cases a week with one of two supervisors and in two clinics per rotation. If the morning case does not show, there is typically an afternoon case with the faculty supervisor to be seen instead. Otherwise, afternoons will be protected for writing time and supervision. Fridays will include participation in one to three rapid intakes with brief batteries and abbreviated templated reports. In the example below, Memory Disorders and Movement Disorder clinics were selected with supervisors Drs. Del Bene and Celka for the first six-month rotation. Fellows will also meet bi-weekly with the Clinical Training Director.

SAMPLE WEEKLY CLINIC SCHEDULE

MON	TUES	WED	THURS	FRI
AM Research	9 a.m. Movement D/O (Celka)	9 a.m. Movement D/O (Celka)	9 a.m. Memory D/O (Del Bene)	9 a.m. Rapid Access Clinic
PM Didactics	PM Protected writing time	PM Protected writing time	PM Protected writing time	11 a.m. Rapid Access Clinic
	3 p.m. Supervision	3 p.m. Supervision	3 p.m. Supervision	1 p.m. Rapid Access Clinic

6-month rotations: Rotations mark the time for reviews and clinical focus/activities based on fellow need areas or interests. Within Neurology Neuropsychology, patients are seen from all the major neurology subspecialties, including epilepsy, stroke, movement disorders, neuromuscular disease, MS and neuro-immunology, neuro-oncology, neuro-critical care, and memory disorder clinic. Fellows will start in a clinical setting of their choice and rotate through each faculty member over the course of the fellowship, depending on the clinical schedule.

SAMPLE ANNUAL ROTATION

1st	2nd	3rd	4th
Movement D/O (Celka)	Epilepsy (Martin)	Vascular/Stroke (Lazar)	9 a.m. Rapid Access Clinic
Memory Clinic (Del Bene)	Neuromuscular (Gerstenecker)	Neuro-Oncology / MS (Del Bene)	11 a.m. Rapid Access Clinic
Rapid Access Clinic	Neurobehavioral Clinic (Knight)	Neurorehab elective	Psychiatric elective

Research

Fellows are encouraged to learn about the role of research in advancing neurological science and to get involved in research projects.

The Department of Neurology has active research across each of its divisions that spans the bench-to-bedside spectrum. There are many more opportunities for scholarly investigation and fellows are encouraged to engage in scholarly pursuits in ways that are meaningful for them.

Research efforts in the Department of Neurology are supported in the context of multiple, collaborations on campus, including the Center for Neurodegeneration and Experimental Therapeutics, the McKnight Brain Institute, the Comprehensive Neuroscience Center, the Civitan International Research Center, the UAB Nathan Shock Center of Excellence in the Basic Biology of Aging, the Department of Neurosurgery, the Department of Neurobiology, and the NIH-funded CTSA in the Center for Clinical and Translational Science. Also, nearly all laboratories are connected by bridges or are located across the street from the hospital complex.

Residents are encouraged to participate in research activities and present abstracts at one of the professional society annual meeting or other subspecialty meetings. The Department is committed to support fellows’ research efforts, and any fellow who presents an abstract at a major neuropsychology meeting will be reimbursed for travel, registration, and other expenses.

 

Didactics Additional Resources