Neuroimmunology - Cleveland
The Clinical Neuroimmunology Fellowship is designed to prepare academically oriented neurologists and physiatrists for a career in patient care and clinical research in multiple sclerosis (MS) and autoimmune neurologic disorders. The training program is flexible; the specific curriculum and duration are tailored to the Fellow’s background, interests, and career goals.
Overview
The Mellen Center Clinical Neuroimmunology Fellowship offers combined training in MS and autoimmune neurology with the options of focusing on clinical care, adult or pediatric disorders, rehabilitation, or clinical research. The proportions of time spent on the various activities described above and the duration of the program vary. Fellows interested in focusing on clinical training typically spend most of their time seeing patients and complete the Fellowship in 1 year. Fellows interested in combining clinical training with training in clinical research typically spend 1-2 days per week seeing patients and typically need 2 years to complete the requirements for the Master’s Degree. Both tracks can be extended by mutual agreement of the Fellow and Program.
We usually have 4-6 Fellows at a given time and offer 2-4 new positions per year, which typically start training in July. Applications are accepted beginning 24 months prior to the planned start date.
Applications to the Fellowship will be accepted through SF Match (sfmatch.org). Required supporting documents include curriculum vitae, personal statement, 3 letters of recommendation, USMLE scores (or equivalent), and documentation of ECFMG certification (if applicable). Interviews will be arranged by invitation. Offers will be made through the SF Match system.
The Mellen Center is a comprehensive MS and autoimmune neurology program providing clinical care and conducting research at the Cleveland Clinic Neurological Institute. The Mellen Center is among the largest clinical neuroimmunology programs worldwide, with 1000-2000 new patients and more than 25,000 total visits annually. The total currently active patient base is approximately 14,000. Mellen Center physician staff includes 13 neurologists who specialize in MS and other autoimmune neurologic disorders, including 3 staff neurologists with fellowship training in autoimmune neurological disorders, plus 4 physiatrists. Non-physician staff includes advanced practice clinicians, nurse care coordinators, infusion nurses, medical assistants, social workers, clinical psychologists, cognitive psychologist, psychology fellows, neuropsychology technicians, physical/occupational/speech therapists, and administrative support staff.
Clinical visits cover diagnostic questions, confirmation of the diagnosis of MS and other autoimmune neurologic disorders, disease management recommendations and implementation, symptom management recommendations and implementation, and evaluation for potential participation in experimental therapy protocols. Clinical visits are supplemented by quantitative neuroperformance, patient reported outcomes, and biospecimen collection for all visits. Specialized programs include outpatient parenteral drug administration, multidisciplinary symptom management programs (e.g. bladder, bowel, spasticity, tremor, pain, and fatigue), a comprehensive Mellen rehabilitation program (physical therapy, occupational therapy, speech therapy, cognitive rehabilitation, power mobility assessment, virtual reality rehabilitation), health psychology, neuropsychology, a pediatric MS and white matter disorders program, and autoimmune neurology program (NMOSD, MOGAD, autoimmune/paraneoplastic encephalitis, neurosarcoidosis, CNS vasculitis, CNS inflammatory disorders complicating TNF blockade and immune checkpoint inhibition).
The Mellen Center is fully accessible to individuals with disabilities and has areas for appointment scheduling, financial counseling, patient education, rehabilitation therapies, individual and group health psychology visits, neuropsychological testing, 16 medical exam rooms, 2 procedures rooms, 15-chair infusion center, work area for specimen preparation and storage, conference rooms, and office space. There is a unique clinical intake space for 9 patients to perform technology-enabled neuroperformance testing and complete patient-reported outcome questionnaires on computer tablets with the results uploaded immediately to the electronic medical record for patient care and registry for research. This testing has been fully integrated into routine visit flow. The Mellen Center is located in close proximity to Adult and Pediatric Neurology, the main Cleveland Clinic, and the Lerner Research Institute (which houses collaborators in Quantitative Health Sciences, Neuroscience, Immunology, and Biomedical Engineering). Case Western Reserve University and Medical Center (collaborators and graduate courses) is 5 minutes away by car.
Technical resources within the Mellen Center include a dedicated imaging center with 3 tesla clinical scanner (Siemens Skyra®), 3 tesla research scanner (Siemens Prisma Fit®), 7 tesla clinical/research scanner (Siemens Terra®), high-resolution monitors for viewing images, and workstations for quantitative image processing. The Mellen Center Optical Coherence Tomography laboratory houses Zeiss Cirrus and Heidelberg Spectralis spectral domain OCT machines. The Mellen Gait and Balance Laboratory is equipped with a GAITRite gait analysis system, Tetrax computerized balance-testing platform, exoskeleton walking device (EksoGTTM), and CAREN system (a state-of-the-art virtual reality and motion analysis system).
The Mellen Center Experimental Therapeutics Program infrastructure includes research nurses, data coordinators, and administrative support personnel. All of the Mellen Center professional staff participate in clinical research projects (as Principal Investigator or a co-investigator). The Cleveland Clinic MS Academic Coordinating Center (an academic research organization comprising personnel in the Mellen Center Experimental Therapeutics Program, Biomedical Engineering, Neuroradiology, and Quantitative Health Sciences) provides academically-oriented management of multicenter clinical trials (protocol development, site recruitment and management, investigator training, data management, quantitative MR image analysis, statistical analysis and interpretation, and publication).
Components of the Training Program
Patient Care
One aspect of the fellowship is supervised patient care to develop specialized expertise in the diagnosis and management of MS and other autoimmune neurological disorders. The Mellen Center has emphasized multidisciplinary care since the program was founded in the 1980s. Fellows participate as a member of a multi-disciplinary team that evaluates and treats a large number of patients (we are among the largest MS programs in the U.S.). Medical neurology visits cover a wide spectrum of issues, including diagnosis, disease management, management of symptoms and psychosocial issues, and evaluation for potential participation in experimental therapy protocols. Fellows also have the opportunity to get hands-on experience with spasticity treatment (botulinum toxin injection and intrathecal baclofen pump management) and performing and interpreting OCT. We predominantly see patients with MS and autoimmune neurological disorders. It is possible to arrange time in other areas, such as the Neuromuscular Section of Neurology, Neuro-Ophthalmology, or Rheumatology, to gain expertise in other immune-mediated disorders of the nervous system. Also, it is possible to pursue a training program with greater emphasis on pediatric MS and other white matter disorders in children or rehabilitative aspects of MS.
The relative proportions of time spent seeing MS versus autoimmune neurology can be tailored to the fellow’s interests. It also is possible to pursue a training program with greater emphasis on pediatric or rehabilitative aspects of MS and other autoimmune neurologic disorders.
Experience in Clinical Trials
The other potential focus of the fellowship is training in clinical research, most often experimental therapeutics. In addition to clinical training, Fellows pursuing clinical research training divide their time between participation as a co-investigator in ongoing trials, formal training as a "trialist" through coursework, and conducting independent research. We participate in a large number of clinical trials, and Mellen Center staff members often fill leadership positions in those trials. In some trials, Fellows serve as an Examining Physician to develop expertise in a standardized neurologic examination, calculating rating scales such as the Kurtzke EDSS, and performing the MS Functional Composite. In other trials, Fellows serve as Treating Physician to become familiar with issues involved in patient management within the constraints of a protocol. Fellows gain experience in trial management and implementation by serving as the de facto Site Principal Investigator for a clinical trial under staff supervision. Responsibilities include composing the consent form, preparing IRB correspondences, reviewing the budget, coordinating contract negotiation, managing other regulatory documents, supervising patient recruitment, planning study visits, developing source documents, and working with data coordinators and study monitors to resolve queries.
Some fellows have focused on areas other than experimental therapeutics, for example, rehabilitation, epidemiology, or cognitive aspects of MS and other autoimmune neurologic disorders.
Graduate Coursework
We encourage and help arrange coursework in, for example, statistics, epidemiology, and trial design. Most Fellows in the 2-3-year track combining clinical and clinical research training complete the requirements for a Master’s Degree in Clinical Research through the Clinical Research Scholars Program at Case Western Reserve University (for information see http://casemed.case.edu/crsp/).
Clinical Research
All fellows pursue academic activities. Although research is not an emphasis of the one-year clinical program, those Fellows prepare at least one manuscript for publication, participate as a co-investigator in a few clinical trials to gain some exposure to clinical trial conduct, and carry out a focused research project. Fellows pursuing clinical research training and a Master’s Degree design, carry out, analyze, and report a formal independent research project to fulfill the requirements. For this, graduate school faculty and members of the Mellen Center staff mentor them. The project is designed during the first year and carried out during Years 2-3. This experience familiarizes the Fellow with formulating a research question, designing and carrying out a clinical experiment, and analyzing and interpreting the results. There are opportunities to collaborate in basic research or translational projects, although this program is not a laboratory research fellowship.
Training in Imaging
Training in MRI is obtained through reading studies as part routine patient care and the twice-monthly Mellen MRI conference (managed by the fellows) in which studies are reviewed with Neuroradiology. Fellows also are trained to perform and interpret OCT. Research projects utilizing MRI or OCT are possible.
Didactic and Scholarly Activities
To supplement the clinical and research activities described above, there is a weekly lecture series, monthly journal club, weekly Mellen Center case conference, every other month multi-institutional case conference, plus a variety of other clinical and research conferences. Fellows are encouraged to prepare abstracts and present at meetings. They have the opportunity to author or contribute to review articles, chapters, and primary publications.
In Conclusion
This is a time of rapid advances in the basic understanding of neuroinflammatory disorders, resulting in the emergence of an increasing number of treatment options. Our goal is to train clinicians who provide expert patient care and clinical investigators who further advance the field. Many institutions are trying to recruit someone with this sort of training.
We look forward to hearing from you.
Application Process
Beginning with the 2023-2024 application cycle, the application and selection process for the Clinical Neuroimmunology Fellowship will occur by the match administered by SF Match and coordinated by Americas Committee and Treatment and Research in MS (ACTRIMS).
Interested candidates will be requested to submit:
- Curriculum vitae.
- Personal Statement.
- Three letters of recommendation.
- USMLE/COMLEX Score Reports.
- Currently valid ECFMG certificate (applicable for International Medical Graduates only).
Interviews are arranged by invitation.
Contact
Fellowship Director
Jeffrey A. Cohen, MD
216.445.8110
cohenj@ccf.org
Fellowship Associate Director
Daniel Ontaneda, MD PhD
216.444.0151
ontaned@ccf.org
Fellowship Program Coordinator
Sarah Planchon Pope, PhD
216.636.1232
planchs@ccf.org
Neurologic Institute Education Office
nieducation@ccf.org
Clinical Fellows
Outstanding patient care, education of those who serve and research are the three goals the Department of Neurology strives to achieve. As a part of that overall commitment to education, below are the recognized current neurology fellows who value the importance of providing the highest quality of medical care.
2023-2024 Clinical Fellows
Year Three
Jameson Holloman, MD
Medical School: Georgetown University School of Medicine
Residency: Barnes-Jewish Hospital
Year Two
Moein Amin, MD
Medical School: Griffith University Gold Coast, Queensland, Australia
Residency: Cleveland Clinic – Neurology
Year One
Kimberly DiMauro, DO
Medical School: Ohio University, College of Osteopathic Medicine
Residency -: Cleveland Clinic - Neurology
Carol Swetlik, MD
Medical School: Cleveland Clinic Lerner College of Medicine Case Western Reserve University
Residency -: Cleveland Clinic – Neurology
Karlo Toljan, MD
Medical School: Croatia – University of Zagreb
Residency -: Cleveland Clinic - Neurology
Living in Cleveland
Cleveland, an ethnically diverse, mid-sized city located on Lake Erie, features a host of cultural attractions, recreational activities, major sporting events and an exploding culinary scene. Cleveland is home to the second largest theater district in the U.S., The world famous Cleveland Orchestra, a park system featuring 23,700 acres in 18 reservations, and is the birthplace of rock ’n’ roll, home to the Rock ‘n’ Roll Hall of Fame and Museum. Cleveland Clinic is located near the University Circle area, which is the cultural epicenter of Cleveland. This area features Severance Hall and the world-renowned Cleveland Orchestra, the Cleveland Museum of Art, several other museums, and Case Western Reserve University. Downtown Cleveland, home to all major sports venues and an exploding culinary scene, is approximately two miles from Cleveland Clinic’s main campus.
Clinical Neuroimmunology & Multiple Sclerosis Fellowship - Las Vegas
The Clinical Neuroimmunology and Multiple Sclerosis Fellowship is designed to prepare academically oriented neurologists and physiatrists for a career in patient care and clinical research in multiple sclerosis. The training program is flexible; the specific curriculum and duration are tailored to the Fellow’s background, interests, and career goals.
Potential components of training include:
Patient Care
One aspect of the fellowship is supervised patient care to develop specialized expertise in the diagnosis and management of MS and related disorders. Fellows participate as a member of a multi-disciplinary team that evaluates and treats a large number of patients. Medical neurology visits cover a wide spectrum of issues, including diagnosis, disease management, management of symptoms and psychosocial issues, and evaluation for potential participation in experimental therapy protocols. We predominantly see patients with MS and related CNS disorders. It is possible to arrange time in other areas, such as the Neuroradiology or Neuro-Ophthalmology, to gain expertise in other immune-mediated disorders of the nervous system.
The Lou Ruvo Center for Brain Health is a tertiary care center that provides consultation to health care professionals worldwide, and principal continuing care for patients in Nevada and surrounding states, focusing on neurodegenerative disorders of Dementia, Movement Disorders and Neuroimmunology/Multiple Sclerosis. The Neuroimmunology and Multiple Sclerosis Program cares for approximately 1500 patients annually. The clinical team is comprised of 2 Neuroimmunology and Multiple Sclerosis Fellowship Trained Neurologists and an Advance Care Provider, dedicated MS nursing team, Social Workers for counseling and support services, physical/occupational/speech therapists who have obtained certified MS specialty training, neuropsychiatry, health psychology and neuropsychology staff, and botulinum toxin specialists for spasticity. External rotations include neuro-ophthalmology, rheumatology and physical medicine and rehabilitation. Our center provides comprehensive care for patients with Multiple Sclerosis and Related Disorders in a community based academic setting.
Resources include a dedicated imaging center with on-site 3T MRI, high-resolution monitors for viewing images obtained on any CCF scanner, and workstations for quantitative image processing. We also have a dedicated optical coherence tomography unit.
Experience in Clinical Trials
The other potential focus of the fellowship is training in clinical research, most often experimental therapeutics. In addition to clinical training, Fellows pursuing clinical research training divide their time between participation as a sub-investigator in ongoing trials and conducting independent research. We participate in a large number of Multiple Sclerosis and Neuroimmunology clinical trials. In some trials, Fellows serve as an Examining Physician to develop expertise in a standardized neurologic examination, calculating rating scales such as the Kurtzke EDSS, and performing the MS Functional Composite. In other trials, Fellows serve as Treating Physician to become familiar with issues involved in patient management within the constraints of a protocol. Fellows gain experience in trial management and implementation by serving as the de facto Site Principal Investigator for a clinical trial under staff supervision. Responsibilities may include reviewing the consent form, preparing IRB correspondences, reviewing the budget, coordinating contract negotiation, managing other regulatory documents, supervising patient recruitment, planning study visits, developing source documents, and working with data coordinators and study monitors to resolve queries.
The Lou Ruvo Center for Brain Health Multiple Sclerosis Program infrastructure includes research nurses, data coordinators, and administrative support personnel. All of the Lou Ruvo Center for Brain Health professional staff members participate in clinical research projects (as Principal Investigator or a co-investigator).
Clinical Research
All fellows pursue some academic activities. Although research is not an emphasis of the one-year clinical program, those Fellows prepare at least one manuscript for publication, participate as a sub-investigator in a few clinical trials to gain some exposure to clinical trial conduct, and carry out a focused research project. There are also opportunities to collaborate with Main Campus in Cleveland on research projects.
Training in Imaging Related to MS
Training in MRI is obtained through reading studies as part routine patient care and the twice-monthly Mellen MRI conference (managed by the fellows) in which studies are reviewed with Neuroradiology. Fellows also are trained to perform and interpret OCT. Research projects utilizing MRI or OCT are possible.
The one-year clinical fellowship focuses on clinical training, and fellows typically spend most of their time seeing patients.
Application Process
One position per year is available, typically starting in July. Applications are accepted beginning 24 months prior to the planned start date, and Fellows are selected on a rolling basis. We have a position available for the 2024-2025 academic year. Interviews are arranged by invitation.
Please submit the following in order for us to process your application:
Please email the following documents to Susan Farris at farriss@ccf.org. If you experience technical difficulties completing the application or have any questions, please contact Susan at 702.279.5542:
- Your updated CV.
- Three letters of recommendation (one from your residency or hospital director).
- Personal statement.
- USMLE/COMLEX Score Reports.
- Medical School Diploma.
- All International Medical Graduates must submit a copy of their current ECFMG certificate and qualifying exam results.
Beginning with the 2025-2026 academic year, Cleveland Clinic Nevada’s Clinical Neuroimmunology and Multiple Sclerosis Fellowship will be using the SF Match Central Application Service (CAS). Applicants for our July 1 start should submit all materials via CAS.
This fellowship name and identification through SF Match is: #9119
Cleveland Clinic Nevada, Adult Neurology and PM&R, Clinical
Neuroimmunology & Multiple Sclerosis Fellowship
The following materials will be requested of you, by CAS:
- CAS Distribution List (Online Submission).
- Completed CAS application form (Online Submission).
- USMLE Scores or equivalent score reports.
- ECFMG Certificate (applicable to International Graduates).
- Three (3) letters of reference.
- Curriculum Vitae (CV).
The SF Match CAS instruction manual, available through your SF Match online profile, will provide additional information regarding application requirements and the submission of application documents. Each fellowship's application instructions and requirements differ.
This is a time of rapid advances in the basic understanding of the MS disease process leading to the emergence of an increasing number of treatment options. Many institutions are trying to recruit someone with this sort of training.
We look forward to hearing from you.
Living in Las Vegas
While many Las Vegas newcomers are awed by the nightlife and world of entertainment options, they are even more delighted with the myriad of housing options available citywide. Whether you are looking for rural seclusion, a lush, private master-planned community or high-rise living on the Las Vegas Strip, you will find the options endless.
Clark County contains Las Vegas, Henderson and North Las Vegas the three biggest cities in Southern Nevada. Clark County's population based on the most recent U.S. Census figures indicates we have reached nearly two million residents. Las Vegas is known as the entertainment capital of the world and over the last couple of decades has garnered accolades for its fast-growing population, entrepreneurial atmosphere, unlimited housing and vast employment options. Las Vegas continues to expand its non-gaming industry base and is becoming a notable education and research community. Henderson has been consistently measured as one of the fastest growing communities in the nation. Las Vegas' little sister, Henderson has a population of just over 250,000.
Just south of Las Vegas, Henderson is a vibrant suburb. Created for Basic Magnesium, Inc. defense plants during World War II, Henderson continues to evolve with the addition of its own entertainment and recreation. Henderson's main attraction is Lake Mead, the world's largest man-made lake and home to Hoover Dam.
North Las Vegas is the third fastest-growing city in the nation with a population exceeding 200,000, and it is vibrant and independent city. A proactive city government has led the way in creating a technology hub in the area. The city is home to the bulk of Southern Nevada's manufacturing facilities.
Located in the southeastern part of the valley, 25 miles from downtown Las Vegas and 10 miles outside of Henderson lies Boulder City, home of the Hoover Dam and Lake Mead National Recreation Area. This small community preserves the charm of "small" town U.S.A. just minutes from the one of the most exciting cities in the world. Controlled growth and thoughtful planning make Boulder City an ideal choice for those seeking a hometown free from gaming.
Planned Communities you might choose the mountain communities located in west and southwest Las Vegas. Mountain's Edge, Summerlin and Centennial Hills are all neighborhood communities that offer amazing vistas and landscapes. Southern Highlands in southwest Las Vegas is one of the newest areas near the airport and the trendy "south" Strip. You might prefer more established communities in the heart of the city near the Strip and resort corridor in Paradise Valley. There are also beautiful communities in Henderson just south of Las Vegas featuring championship golf courses and country clubs such as Green Valley Ranch, MacDonald's Highlands and Seven Hills.
