Le H Hua1, Ahmed Z Obeidat2, Erin E Longbrake3. 1. Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas, NV, USA. 2. Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, USA. 3. Yale School of Medicine, Yale University, New Haven, CT, USA; Center for Neuroepidemiology and Clinical Neurological Research, Yale School of Medicine, Yale University, New Haven, CT, USA. Electronic address: erin.longbrake@yale.edu.
Abstract
BACKGROUND: Neuroimmunology/multiple sclerosis is a rapidly evolving, but still poorly defined subspecialty. Fellowship training is not standardized, and there is substantial variability across sites. Outcomes of fellowship training have not yet been studied. We therefore examined early career choices of neuroimmunology/MS fellowship program graduates and solicited the perspective of current and recent trainees on their fellowship experience as well as opportunities to improve neuroimmunology education. METHODS: We developed a questionnaire to collect information about fellowship training experiences and current medical practice. We identified recent graduates based on records from US training programs and the National MS Society and electronically sent the survey to current trainees and recent graduates (within the last 5 years). RESULTS: We identified 179 current/recent trainees and successfully reached 157 with survey distributions. Ninety-five individuals (60.5%) returned surveys. Most graduates assumed an academic practice (68%) focused mostly or exclusively on MS and other CNS neuroimmune diseases (55%), and practiced in regions where there were ≥5 other neuroimmunology specialists (51%). Graduates felt well-prepared to manage diagnoses of MS and neuromyelitis optica spectrum disorders but their comfort with rarer CNS neuroimmune diseases varied substantially. Basic immunology, neuro-rheumatology, grant writing and neuro-rehabilitation were identified as high impact areas for cross-disciplinary didactic training. The majority of recent trainees (57%) favored standardizing a core neuroimmunology curriculum, and 48% favored developing a subspecialty certification. CONCLUSIONS: This is the first study to examine practice outcomes and trainee experiences for neuroimmunology training programs. We anticipate that these data will help educators define a core curriculum for the subspecialty and identify complementary skill sets that enhance the traditional clinic-based model of teaching.
BACKGROUND: Neuroimmunology/multiple sclerosis is a rapidly evolving, but still poorly defined subspecialty. Fellowship training is not standardized, and there is substantial variability across sites. Outcomes of fellowship training have not yet been studied. We therefore examined early career choices of neuroimmunology/MS fellowship program graduates and solicited the perspective of current and recent trainees on their fellowship experience as well as opportunities to improve neuroimmunology education. METHODS: We developed a questionnaire to collect information about fellowship training experiences and current medical practice. We identified recent graduates based on records from US training programs and the National MS Society and electronically sent the survey to current trainees and recent graduates (within the last 5 years). RESULTS: We identified 179 current/recent trainees and successfully reached 157 with survey distributions. Ninety-five individuals (60.5%) returned surveys. Most graduates assumed an academic practice (68%) focused mostly or exclusively on MS and other CNS neuroimmune diseases (55%), and practiced in regions where there were ≥5 other neuroimmunology specialists (51%). Graduates felt well-prepared to manage diagnoses of MS and neuromyelitis optica spectrum disorders but their comfort with rarer CNS neuroimmune diseases varied substantially. Basic immunology, neuro-rheumatology, grant writing and neuro-rehabilitation were identified as high impact areas for cross-disciplinary didactic training. The majority of recent trainees (57%) favored standardizing a core neuroimmunology curriculum, and 48% favored developing a subspecialty certification. CONCLUSIONS: This is the first study to examine practice outcomes and trainee experiences for neuroimmunology training programs. We anticipate that these data will help educators define a core curriculum for the subspecialty and identify complementary skill sets that enhance the traditional clinic-based model of teaching.
Authors: Sean J Pittock; Achim Berthele; Kazuo Fujihara; Ho Jin Kim; Michael Levy; Jacqueline Palace; Ichiro Nakashima; Murat Terzi; Natalia Totolyan; Shanthi Viswanathan; Kai-Chen Wang; Amy Pace; Kenji P Fujita; Róisín Armstrong; Dean M Wingerchuk Journal: N Engl J Med Date: 2019-05-03 Impact factor: 91.245
Authors: Bruce A C Cree; Jeffrey L Bennett; Ho Jin Kim; Brian G Weinshenker; Sean J Pittock; Dean M Wingerchuk; Kazuo Fujihara; Friedemann Paul; Gary R Cutter; Romain Marignier; Ari J Green; Orhan Aktas; Hans-Peter Hartung; Fred D Lublin; Jorn Drappa; Gerard Barron; Soraya Madani; John N Ratchford; Dewei She; Daniel Cimbora; Eliezer Katz Journal: Lancet Date: 2019-09-05 Impact factor: 79.321
Authors: Ahmed Z Obeidat; Yasir N Jassam; Le H Hua; Gary Cutter; Corey C Ford; June Halper; Robert P Lisak; Nancy L Sicotte; Erin E Longbrake Journal: Neurology Date: 2020-02-27 Impact factor: 11.800
Authors: Le H Hua; Ahmed Z Obeidat; Lilyana Amezcua; Jeffrey A Cohen; Kathleen Costello; Jeffrey Dunn; Jeffrey M Gelfand; Myla D Goldman; Sarah Hopkins; Douglas Jeffery; Stephen Krieger; Scott D Newsome; Suma Shah; Nancy L Sicotte; Vijayshree Yadav; Erin E Longbrake Journal: Neurol Clin Pract Date: 2021-08