Neuro-Ophthalmology Fellowship

Program Description

The Neuro-Ophthalmology fellowship is a one-year clinical training program that provides a broad clinical and research experience in the care of acute and chronic neuro-ophthalmic disease in both adults and children. Our division sees over 150 patients per week. Fellows are actively involved in all neuro-ophthalmology clinics as well as in care of patients in the emergency department and hospital inpatient services. Many opportunities exist for research and for presentations at local and national meetings.  

We have one funded position per year. Eligible applicants must have completed either neurology or ophthalmology ACGME accredited residency program. International candidates please see below. 

The neuro-ophthalmology fellowship at the University of Michigan is an Association of University Professors of Ophthalmology (AUPO) compliant fellowship.  

Curriculum

The training program provides inpatient and outpatient clinical experience, research, and teaching opportunities.  

Clinical Experience

Outpatient Experience

Fellows are assigned to outpatient clinics under the supervision of one of four neuro-ophthalmology faculty. Clinics are located at the Kellogg Eye Center or at the main hospital (a short 10-minute walk or 5-minute bus ride from the eye center). Fellows will initially examine patients, present findings to the attending and then have an opportunity to jointly see the patient with the attending. The fellow will primarily evaluate approximately 40 patients each week. The case mix includes patients with disorders of the visual and ocular motor pathways, changes in higher cortical function, and pupil abnormalities. We collaborate closely with many other specialties including neurosurgery, neuroimmunology, and neuro-oncology. We evaluate both adult and pediatric neuro-ophthalmology patients. Fellows develop more sophisticated decision-making as training proceeds, but they are always supervised by attending physicians in clinics.  

Our faculty perform botulinum toxin injections for a variety of conditions, including hemifacial spasm, blepharospasm, migraine, and trigeminal neuralgia. Fellows will have an opportunity to learn how to evaluate and treat these disorders.  

Temporal artery biopsies are performed by Otolaryngology. Fellows will have an opportunity to observe this procedure.  

Fellows will have a half day of independent clinic in general neurology or comprehensive ophthalmology every week. This clinic provides an opportunity to longitudinally follow a cohort of patients throughout the year in your respective specialty. 

For interested ophthalmology-trained fellows, there is the possibility of performing cataract surgery.  

Inpatient Experience

The inpatient and emergency department ophthalmology consult service is primarily run by neuro-ophthalmology faculty. Fellows will participate in inpatient rounds at the hospital and have an opportunity to examine acute neuro-ophthalmic patients at bedside. Rounds are held once a week on Friday afternoons.  

Neuro-Radiology Conference

Fellows are actively involved in a 2-hour weekly (Friday afternoon) neuroradiology conference directed by one of the University of Michigan attending neuro-radiologists. Imaging from cases seen in clinic and the hospital setting are reviewed and discussed.  

Research

Fellows are given one half day a week for dedicated research time. Fellows are expected to join ongoing projects or develop new research projects, either clinical or in the basic sciences, under faculty supervision.  Each fellow has in the past produced at least one publication in a peer-reviewed journal. Fellows will attend the annual North American Neuro-Ophthalmology Society (NANOS) meeting and are expected to submit an abstract (research and/or Walsh case). There are also opportunities to attend and present at regional meetings, such as the Upper Midwest Neuro-Ophthalmology Society (UMNOG) annual meeting. Fellows also participate in the Department of Ophthalmology Annual Research Day.  

Teaching

Didactic Teaching

Fellows meet with Dr. Jonathan Trobe weekly for didactic clinical teaching. Fellows also have access to the formal NANOS neuro-ophthalmology fellowship curriculum. All clinics end with a formal wrap-up to review cases seen that day and provide additional teaching.  

Residents and Medical Students

The fellow is actively involved in teaching medical students and residents. Trainees from ophthalmology, neurology, and neurosurgery rotate through the neuro-ophthalmology clinics.  

Other Learning Opportunities

Our division includes faculty with core training in ophthalmology and neurology. Our fellowship will provide background knowledge for residents coming from either specialty.   

Ophthalmology trained fellows will have an opportunity to acquire additional neurology training by spending time with the neurology consult and inpatient teams.  

Neurology trained fellows will have time designated initially in dedicated ophthalmology clinics (comprehensive ophthalmology/optometry) to acquire ophthalmology examination skills. They also attend introductory ophthalmology resident lectures during this time period.  

Our fellows are exposed to related specialties to broaden their training, including pediatric ophthalmology, orthoptists, ophthalmic genetics, retinal dystrophy and electroretinogram testing, vestibular disorders, general neurology, neurosurgery, neuroradiology, and neuropathology. Fellows may elect to spend additional time acquiring skills and knowledge in any of these disciplines. 

Call

Ophthalmology residents/ophthalmology faculty provide primary call coverage for patients in the emergency room and inpatient units of the University of Michigan Hospitals and Ann Arbor VA. The neuro-ophthalmology fellow is available for consultation as needed. There is always a neuro-ophthalmology attending back-up readily available for case discussion.  

Ophthalmology trained fellows will take two weeks of primary ophthalmology trauma call over the course of a year, staffing general ophthalmology consults and surgical cases (ex: open globes).  

Benefits

Fellows receive health insurance coverage through the University of Michigan Health System. They are treated as junior faculty members and given 4 weeks of vacation. 

International Fellows

We welcome international fellows. Fellowship positions for international medical school graduates or physicians are generally non-funded positions. Interested applicants are encouraged to obtain a funding (e.g., grant) from their respective ministry of health, institution, or organization or use personal funds to support their participation in the neuro-ophthalmology fellowship position.  

On occasion, we may have funding available for international fellows. Interested applicants are encouraged to contact us since this varies from year to year. 

Of note, this program offers only J1 visas. 

The qualifications needed for international medical graduates to be accepted in our fellowship include graduation from Graduate Medical Education (GME) approved medical school, USMLEs, and ECFMG certification. If you are interested in the international fellowship position, please contact the program director (see below).