Houston Methodist. Leading Medicine.
Houston Methodist. Leading Medicine

Department of Neurology

Program Description

Rotations

Fellows are assigned to 12 months of neuromuscular medicine as follows:

JULY
AUGUST
SEPTEMBER
OCTOBER
NOVEMBER
DECEMBER
NM
Rotation
NM
Rotation
NM
Rotation
NM
Rotation

NM
Rotation

ALS/NM

JANUARY
FEBRUARY
MARCH
APRIL
MAY
JUNE

ALS/NM

 

EMG/NCV

 

EMG/NCV

 

EMG/NCV

Elect

 

Elect

 

The NM (Neuromuscular) Rotation (5 mos.) experience is 70% outpatient and 30% inpatient (admits, consults) with weekly ½ day clinics in EMG/NCV, Muscle/Nerve biopsy reading, Pediatric Neuromuscular clinic, and Muscular Dystrophy Association (MDA) fellow’s clinic.

The outpatient experience occurs at the Houston Methodist Hospital Scurlock Towers, suite 802, a 36 examination room clinic with separate nurse and physician work spaces, internet and computer services and resources, and clerical and medical support. Fellow will rotate with Drs. Ericka Simpson and Milvia Pleitez in morning clinics Monday through Thursday which includes both new and follow up patients with a variety of neuromuscular disorders.

The inpatient experience includes the evaluation and treatment of the acute and critical neuromuscular patient under the supervision of Drs. Ericka Simpson and Milvia Pleitez. One fellow is assigned to one attending a month. The inpatient service is made up of a variety of cases including AIDP, Myasthenia gravis exacerbation/crisis, critical illness neuropathy and myopathy, rhabdomyolysis, acute respiratory failure associated with other neuromuscular disorders (dystrophy, ALS, inflammatory myopathies).

The  ALS/Neuromuscular (NM) Rotation (2 mos.) experience is also 70% outpatient and 30% inpatient (admits, consults) with weekly half day clinics in EMG/NCV, Muscle/Nerve biopsy reading, Pediatric Neuromucular clinic, and Muscular Dystrophy Association (MDA) fellow’s clinic.

The outpatient experience occurs on the outpatient workup unit located on the 11th floor of the West Pavilion of the Houston Methodist Hospital. The unit has 24 beds,  six chair infusion suite, a 4 bed EMG/NCV unit. Patients are referred for a 2-3 day outpatient evaluation, treatment plan or treatment predominantly under the supervision of Dr. Stanley H. Appel and a smaller proportion under Drs. Simpson and Pleitez. The patient population evaluated on the unit is made of a large number of ALS patient and other neuromuscular disorders including CIDP, diabetic neuropathy, myasthenia gravis, and dystrophies.

The inpatient experience also includes the evaluation and treatment of the acute and critical neuromuscular patient under the supervision of Drs. Ericka Simpson and Milvia Pleitez. One fellow is assigned to one attending a month. The inpatient service is made up of a variety of cases including AIDP, Myasthenia gravis exacerbation/crisis, critical illness neuropathy and myopathy, rhabdomyolysis, acute respiratory failure associate with other neuromuscular disorders (dystrophy, ALS, inflammatory myopathies).

The EMG/NCV Rotation is a three month outpatient experience (including inpatient consults for EMG/NCV). It is located on the outpatient workup unit located on the 11th floor of the West Pavilion of the Houston Methodist Hospital. Fellows will be taught the basics of electrodiagnostic testing including safety, NCV, EMG, and RNS and its application in the diagnosis of motor neuron disorders, disorders of neuromuscular junction, myopathies, myotonic syndromes and disorders of muscle hyperexcitability, peripheral neuropathies, radiculopathies, and  plexopathies under the guidance and supervision of David Rosenfield, MD (Director), Milvia Pleitez, MD, and Ron Tintner, MD.

Fellows are provided two months for elective rotations whichinclude PMR, Research, Muscle and Nerve Histopathology, or EMG/NC. The electives allow the resident to gain additional exposure and training to these subspecialties based upon their interests and future career/academic goals. These rotation experiences are all located at the Houston Methodist Hospital under the guidance of the respective program faculty.