The Michigan Medicine neuromuscular fellowship is a one-year, ACGME accredited program of advanced training in diagnosis, management and pathology of neuromuscular disorders. Trainees interested in research may elect to remain as research fellows for laboratory or clinical research for one year with a grant. The neuromuscular fellowship is designed to enhance the education of academic neurologists in the field of neuromuscular disorders. At the conclusion of the fellowship, trainees are competent in evaluating and managing a wide breadth of neuromuscular diseases, performing quality EMG and receive education in neuromuscular ultrasound. Upon completion, trainees are eligible to sit for the American Board of Psychiatry and Neurology Neuromuscular Medicine Certification examination and the American Board of Electrodiagnostic Medicine Examination.
The University of Michigan neuromuscular clinic is a tertiary referral center, drawing patients from Ann Arbor and the metro-Detroit area, as well as Indiana, Ohio and throughout the state of Michigan. The neuromuscular clinic sees a variety of referrals for common and uncommon neuromuscular diseases. There are also multi-disciplinary clinics for muscular dystrophy, inherited neuropathy and ALS. There is strong collaboration with PM&R, neuro-pathology, neurosurgery and ancillary services (physical therapy, occupational therapy, social work).
- ~ 100-125 adult patients seen weekly in neuromuscular clinic
- ~ 40-50 EMGs performed weekly in lab
Neuromuscular Clinical Exposure
During each week, fellows spend time in the neuromuscular clinic (three half days) and the EMG laboratory (five half days). Fellows will also complete neuromuscular inpatient consults on a variety of acute conditions. Fellows will rotate through the multi-disciplinary clinics in MDA, CMT and ALS. A muscle and nerve pathology conference held several times per month provides exposure to interpretation of muscle and nerve pathology.
Electrodiagnostics and Procedures
There is an early commitment to mastering routine nerve conduction study technique and needle EMG. Throughout the training year, there are opportunities to perform advanced techniques including single fiber EMG and autonomic studies. Fellows may complete EMGs at the bedside of inpatients who are unable to travel to the lab. There are several opportunities per month to perform skin or muscle biopsy with supervision of a staff neuromuscular physician. The lab has recently incorporated an ultrasound to allow for exposure to neuromuscular ultrasound use.
Neuromuscular fellows gain exposure to nerve and muscle pathology by reviewing biopsies through joint neuromuscular and pathology conferences.
- 200 muscle biopsies reviewed per year
- 50 nerve biopsies reviewed per year
A boot camp of high yield neuromuscular topics is held in early July as an initial introduction to neuromuscular medicine. A series of didactic conferences on EMG and neuromuscular topics are conducted weekly throughout the year, designed to provide high yield education to trainees. There is a monthly journal club and interesting neuromuscular case series intended to stimulate discussion on diagnosis or management of neuromuscular disease. Fellows receive instruction from neuromuscular faculty with a variety of clinical and research interests.