Curriculum


Multiple sclerosis has been a central focus in the Department of Neurology at The University of Chicago Medical Center for over 25 years. The clinic is busy with over 3,000 patient visits per year. Most patients come from the Chicago metropolitan region, which has a population of 8 million. A significant number of Neurologist-referrals and self-referrals from the Midwest, continental U.S., and from many foreign countries add to the total patient population. Fellows see these patients and have numerous contacts with local and regional neurologists who refer difficult cases to the MS clinic.

The clinical training program consists of mentored clinical care of 2,000 new and follow-up MS patients, under the supervision of five neurologists specializing in MS, plus the opportunity to see patients with specialists in inflammatory peripheral nerve disease and neurodegenerative disease. Fellows also have the opportunity to spend dedicated time in NeuroRadiology, and NeuroOphthalmology, Neurophsyiology, and Physiatry (lectures and graduate-level courses are discussed below).

The MS clinic has been the site of approximately 40 clinical MS trials. We contributed significantly to the design and execution of the first large multicenter trials of Cyclosporin A and interferon-ß-1b. We are currently involved in our own and multicenter Phase I, II, III, and IV MS trials of interferons, glatiramer, natalizumab, rituximab, PPAR-y agonists, MBP tolerization, and FTY720, plus symptomatic therapies such as Fampridine and novel uses of FDA-approved drugs. In internally designed and executed studies on the course of MS or on MS symptoms, we have demonstrated hypothalamic-pituitary-adrenal axis and sympathetic nervous system abnormalities, and defined the role of retinoids, ß-adrenergic agonists, and prostaglandin analogues. For instance, the prostaglandin analogue, misoprostol, reduced severity of EAE and also abrogated the pain of trigeminal neuralgia in MS patients who had been refractory to all other drug and surgical interventions.

The Clinical Research Training Program at The University of Chicago Medical Center began in 1999, and strengthens the MS fellowship. The Essentials of Patient-Oriented Research is a series of integrated weekly lectures exploring specific topics of patient-oriented research held during the academic year. Lectures focus on methods for planning, funding, conducting, and reporting clinical research. They include "Ethics of Clinical Research and Human Subject Protection," "General Biostatistical Methods," "Evidence-Based Medicine" (clinical epidemiology), and "Design and Analysis of Clinical Investigations." Fellows will enroll in this program. Clinical fellows are intimately involved in design and data analysis of investigator-initiated trials, as well as design, contracts, performance, and examinations in pharmaceutical-sponsored trials. Training information can also be found by visiting the General Clinical Research Center (CRC).

The Department of Neurology also has a series of clinical and basic lectures for residents, fellows, and faculty. Fellows will attend relevant lectures and will present one to two lectures per year. In addition, The University of Chicago Medical Center also has a rich series of lectures in immunology, molecular biology, ethics, genetics, medicine, neurobiology, and neurology.

Fellows are expected to give lectures to residents, present abstracts on their work at national and international meetings, and to write original and review papers during the fellowship.