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Department of Neurology

 


 

Research and the CWRU Neurology Residency

Research Tract


Our program emphasizes developing each resident’s clinical skills, and the majority of our residents go on to careers centered on clinical care, balanced between private and academic settings. The term “clinical skills” encompasses clinical and translational research, and all of our residents gain exposure to faculty engaged in major multicenter clinical trials. We also have a long tradition of fostering the development of neurologists who ultimately focus heavily on research. Many of our trainees have entered the program with prior research experience, and over the past twenty years, approximately 10% of our graduated residents have made neurological research a centerpiece of their careers, demonstrated by their federal research funding and senior authorship on multiple papers describing original, investigator-initiated research.

Residents benefit from the presence of physician-scientists on the attending staff who provide mentorship, role models, and access to ongoing research projects. Further benefits stem from the medical center’s close proximity to its parent university, which makes it feasible for residents to develop relationships with basic science faculty. Case Western Reserve University ranks among the country's leading research institutions (see CWRU rankings). The 2008 NSF Survey of Research and Development Expenditures rated Case Western Reserve 13th among private institutions and 26th among all in federal expenditures for science and engineering research and development. Particularly relevant to neurologists is CWRU’s Department of Neurosciences (founded by Story Landis, now Director of NINDS) and the Department of Biomedical Engineering. The CWRU Department of Biomedical Engineering was ranked nationwide as the #10 graduate training program in 2012 by US News and World Report, and has numerous faculty members engaged in studies of neural engineering and rehabilitation (see CWRU Neural Engineering). CWRU is recognized as a leader in the field of neuromodulation, including the sub-disciplines of functional electrical stimulation (FES) and brain computer interface, technologies variously aimed at restoring function in victims of spinal cord injury, stroke , epilepsy and Parkinson's disease. Both the Cleveland Functional Electrical Stimulation Center (Cleveland FES Center) and the Advanced Platform Technologies (APT) Center are based at CWRU and the Cleveland Dept. of Veterans Affairs Medical Center. All residents receive exposure to this research during their neuro-rehabilitation rotation in the PGY2 year.

The neurology program allows between 3 - 6 months of elective across the three years of training. Many past residents with prior research training have successfully used this time to develop applications to fund further research training under the NIH “K” program (NIH K awards) or the Department of Veterans Affairs Career Development Program (see VA CDA). Some graduates have initiated their research during residency and then remained at CWRU for a research-oriented fellowship, during which they developed their applications for funding. Funding research and fellowship training are in a period of historical instability, but the CWRU Neurology faculty and department leadership are committed to working with residents to identify mechanisms to support their development as research neurologists.


What Our Graduates Have to Say About Their Experience

Aasef G. Shaikh, MD, PhD
Graduated: 2013
Current Position: Movement disorders fellow, Emory University
Research Interests: Vestibular and ocular motor neurophysiology, Disorders of eye movements and vestibular function, neurophysiology of head movements, cervical dystonia and head tremor.

“Before my residency I completed a doctorate focused on brainstem neurophysiology, and an NIH post-doctoral fellowship in neurophysiology of primate cerebellum, vestibular, and ocular motor systems. In addition to this basic science training, I had training in translational neuroscience. At CWRU I found excellent faculty, a friendly environment, and strong neuroscience research. The world-famous Daroff-Dell'Osso Ocular Motility Laboratory at the VA was another big reason I chose CWRU for my neurology residency. During residency, while receiving a well-rounded training in clinical neurology, I always found it possible to make time for basic and clinical research. Faculty at Case are very supportive of resident research; they would do everything possible to help residents get projects completed and published. I think excellent clinical training and guidance on how to combine the clinical work with basic science have made me what I wanted to be - a physician-scientist.”


Alessandro Serra, MD, PhD
Graduated: 2012
Current Position: Clinical Neuroimmunology Fellow, Mellen Center for Multiple Sclerosis, Cleveland Clinic Foundation
Future Position: Assistant Professor of Neurology, CWRU
Research Interests: control of eye movements, eye movements in neurological disease

"After completing a neurology residency and a neuroscience PhD in Italy, I was attracted by the opportunity of pursuing research in the United States and CWRU stood out for its collegial and stimulating environment, ideal for young clinicians with a passion for research. The presence of R. John Leigh on the faculty was particularly important. My research mentor for more than 10 years, he kept me motivated throughout my CWRU neurology residency and supported my studies of fast eye movement disorders in diseases such as multiple sclerosis and myasthenia gravis. The experience at CWRU has definitely put me on the launch pad for a future career of independent clinical research and cutting-edge patient care."


Christian Grommes, MD
Graduated: 2009
Current Position: Instructor, Memorial Sloan-Kettering Cancer Center
Research interests: genetic abnormalities in primary central nervous system lymphoma (PCNSL), treatment of PCNSL, targeted therapy of high grade gliomas

“My research focused on the anti-tumor effects of PPARgamma agonists on high grade gliomas. I was interested in the CWRU neurology program because I was able to be trained as a clinical neurologist and in parallel could pursue my basic science interests. I worked in the laboratory of Gary E. Landreth in the CWRU Neuroscience Department during my time as a neurology resident, resulting in peer-reviewed publications. My neurology training at CWRU and my research background allowed me to move on to a neuro-oncology fellowship at Memorial Sloan-Kettering Cancer Center (MSKCC). I am now a faculty member at MSKCC and I am pursuing a career as a physician scientist with the goal of translating basic “bench” research into clinical trials and finally to new treatment regimens. The experience and training I received during my time at the CWRU Neurology Department built the foundation of my successful transition into a physician-scientist.”


Araya Puwanant, MD
Graduated: 2009
Current Position: Instructor of Neurology, University of Rochester Medical Center
Future Position: Assistant Professor of Neurology, University of Pittsburgh Medical Center
Research Interests: Outcome measures in myotonic disorders, experimental therapeutics in neurologic channelopathies and inherited myopathies

“My work is focused on autosomal dominant forms of muscular dystrophy and neurologic channelopathies. The genetics, pathophysiology, and developing new approaches to treatment of these disorders are my primary area of interest. I was originally attracted to the CWRU Neurology Program because of the strong reputation of their neuromuscular faculty and by the presence on the faculty of Dr. Robert Daroff, the editor of Bradley’s Neurology in Clinical Practice. During my PGY3 and PGY4 years, I had the unique opportunity to work closely with Dr. Robert Ruff on the periodic paralysis research. Drs. Daroff and Ruff continue to provide me the guidance and resources to develop a successful academic career at the University of Rochester. Their sponsorship supported me obtain the Muscular Dystrophy Association Clinical Research Training Grant and secure my future academic career.”


Eric Bershad, MD
Graduated: 2006
Current Position: Assistant Professor of Neurology, Baylor College of Medicine
Research Interests: Brain physiology monitoring, Intracranial pressure, intracerebral hemorrhage, space medicine

“I was originally attracted to CWRU Neurology residency program due to the excellent diversity and high quality reputation of the faculty members. During my residency I learned from many world renowned neurological experts in their fields which gave me a solid clinical, educational and research foundation. I then pursued my interest of neurocritical care and subsequently helped develop the program at the Baylor College of Medicine, where I am currently on faculty. Using the foundations that I learned at CWRU, I then built my research area in intracranial pressure monitoring assessment, and have received funding from the Center for Space Medicine, and the National Space Biomedical Research Institute for projects related to the visual impairment intracranial hypertension syndrome in the long duration astronauts.”


William Stacey, MD, PhD
Graduated: 2006
Current Position: Assistant Professor of Neurology, University of Michigan
Research Interests: iEngineering and epilepsy: Computational modeling and analysis of epileptic waveforms



"I stayed at University Hospitals for Neurology residency after completing my MD PhD at Case Western in Biomedical Engineering with Dominique Durand. I was attracted to the strong neural engineering group at Case, which has continued to develop translational research projects with the Department of Neurology. During residency, I was able to spend some elective time working on a small research project based upon my PhD work, and afterwards moved to an epilepsy fellowship at the University of Pennsylvania. I believe the most important part of my residency was strong clinical training that allows me to combine patient care with my current research interests."


Stephen Selkirk, MD, PhD
Graduated: 2006
Current Position: Assistant Professor of Neurology, Case Western Reserve University
Research Interests: immunology of demyelinating disease, mechanisms of myelin repair


“My PhD focused on the neuroinflammatory response against aberrant myelin proteins. I was originally attracted to the Neurology residency at CWRU by the work of Robert H. Miller in myelin repair. During my residency I was able to initiate bench research in Dr. Miller’s laboratory. This work formed the preliminary data that was used for my Career Development Award application. This award allowed me to develop a novel model of oligodendrocyte cell death and better study the process of myelin repair. ”


Svetlana Pundik, MD
Graduated: 2003
Current Position: Assistant Professor of Neurology, Case Western Reserve University
Research Interests: Neural plasticity during stroke rehabilitation



“CWRU is the institution where I developed my interest in neuroscience and where I had an opportunity to develop and conduct my own research. My involvement in translational cerebrovascular neurological sciences began during my undergraduate years, in the CWRU School of Medicine (SOM) neurosurgery and neurology laboratories of Drs. Warren Selman, W. David Lust and Joe LaManna. We were working on metabolic and biochemical consequences of adult and neonatal rodent models of cerebral ischemia and hypoxia. This fascinating line of research formed my interest in neurology and cerebrovascular disease. Throughout my medical training at CWRU SOM and in Neurology at University Hospitals of Cleveland I was able to remain involved in the ongoing research in these laboratories. The opportunities provided by this rich basic and clinical neuroscience environment at Case inspired me to continue pursuing a research career.

During stroke fellowship at UH, with the guidance of Drs. Dennis Landis and Jose Suarez, I advanced my clinical research skill by completing CWRU’s Clinical Research Scholar graduate training program. Also, during my stroke fellowship, I realized the gaps in our understanding of brain plasticity following stroke and during rehabilitation and this sparked my interest in neurorehabilitation science. Neuroplasticity after stroke and during rehabilitation has been the focus of my current research. Through the outstanding mentorship Drs. Janis Daly and Robert Ruff and the funding from the Department of Veterans Affairs CDA-1 and CDA-2 awards, I have been conducting clinical research studies that would further explain the mechanisms of neuroplasticity after stroke and to enhance methods to improve post-stroke recovery.”


Eroboghene Ubogu, MD
Graduated: 2003
Current Position: Professor of Neurology, University of Alabama at Birmingham; Director, Division of Neuromuscular Disorders, the Electromyography Laboratory, and the Muscle and Nerve Histopathology Laboratory
Research Interests: neuromuscular inflammation, mechanisms of leukocyte entry into peripheral nerve and muscle in autoimmune disease and during immune surveillance, biology of the human blood-nerve barrier

“During my CWRU residency I was inspired by physician-scientists on the faculty, including Bob Ruff, Henry Kaminski and John Leigh. Further exposure to neuromuscular medicine during my clinical fellowship contributed to my developing a burning desire to understand how the internal microenvironment of peripheral nerves is regulated in health and disease. I particularly wanted to understand how the systemic immune system interacts with peripheral nerves during immunosurveillance and how this interaction is altered during immune-mediated inflammatory disorders such as Guillain-Barré syndrome (GBS). The ultimate goal of my work is to improve outcomes and reduce the burden of neurological disease. My exposure to internationally recognized clinician researchers and physician scientists on the cutting edge of their respective disciplines, and seeing their genuine desire to translate their discoveries to the care of patients inspired my research career.”


Jiong Shi, MD, PhD
Graduated: 2004
Current Position: Associate Professor
Director, Center for Alzheimer's Disease and Cognitive Disorders, Barrow Neurological Institute
St. Joseph's Hospital and Medical Center
Research Interests: Alzheimer’s disease and other memory disorders, biomarkers and pharmacological treatment of dementia.

"My PhD research focused on the neuroscience and pharmacology of stroke and dementia. I continued post-doc training under Dr. Robert Friedland at CWRU, who is well known for his work on genetic risk factors in AD. He is my mentor and a good friend as well. With his help, I was able to continue my research in biomarkers for AD during my PGY4 year. This has helped me to develop a career as a physician scientist."


John Stahl, MD, PhD
Graduated: 1996
Current Position: Professor of Neurology, CWRU
Research Interests: Neurophysiology of vestibular system, treatment of disorders of cerebellum and eye movements



“My PhD research focused on the neurophysiology of the vestibulocerebellum, and I was originally attracted to the CWRU Neurology program by the presence on the faculty of R. John Leigh, the co-author of Leigh and Zee’s Neurology of Eye Movements. During my PGY3 and PGY4 years Dr. Leigh provided the guidance and resources for me to develop a successful NIH K08 application to study coordination of head and eye movements. The experience he made possible allowed me negotiate the often awkward jump from a PhD and a neurology residency to a career combining patient care and basic neuroscience research.”


Jose I Suarez, MD
Graduated: 1996
Current Position: Professor of Neurology, Baylor College of Medicine (BCM)
Research Interests: Neurocritical care outcomes, subarachnoid hemorrhage and neuroprotection.

 

“My main areas of interest are neurocritical care and stroke and I joined the neurology residency program at CWRU in 1993. I was fortunate to join a training program with excellent mentorship for neurology residents. Drs. Dennis Landis, John Leigh, and Robert Ruff provided the support and guidance for me to network with key academic neurocritical care practitioners and helped me schedule elective rotations with them since there was no such program at CWRU at the time. After my fellowship training in neurocritical care and stroke at the Johns Hopkins University, Drs. Landis, Leigh, and Ruff were instrumental in securing my return to CWRU to establish a successful academic program in neurocritical care and stroke, which has been running since 1998. The nurturing I received at CWRU helped me secure R01 funding from NINDS to become one of the few neurointensivists with such funding in the US. I was able to combine a busy neuroICU practice with an academic career dedicated to the investigation of newer therapies for neurocritically-ill patients. Even though I am not at CWRU at the moment I truly believe that the mentoring I received there during my residency and my first 9 years of academic life paved the way for my very satisfactory career.”


Alan J. Lerner, MD
Graduated: 1991
Current Position: Professor of Neurology, Neurological Institute Chair for Memory and Cognition
Research Interests: Alzheimer's Disease, Dementia, Behavioral Neurology

“The CWRU Neurology residency and fellowship has had a profound impact on my life. I was originally drawn to Cleveland because of Dr. Daroff, then the Neurology chair. He was a tremendous inspiration for me, both in terms of how to be a caring and insightful physician as well as how to blend a academic, research and clinical pursuits. Coming out of residency, I found that this caring humanistic approach to patients has carried me through time and again and helped make my practice a tremendous success. During residency and fellowship my main research mentor was Rob Friedland, with other faculty contributors being Sami Harik, Dennis Landis and Peter Whitehouse. Through them I learned the importance of networking and meeting the leaders in the field, and was very fortunate to have made many connections through my mentors. I learned the importance of "actually knowing something about something," how to acquire specialized knowledge in my field, the importance of reading and reviewing papers, and the importance of being supportive of younger colleagues (students, residents, fellows and faculty). Some other things I learned (and the people I learned them from) included: Always look at every neuroimaging exam personally (Rob Friedland); reassess patients thoroughly and understand them as living human beings (Joe Foley); try to understand things from a physiological perspective (Sami Harik).”


David Geldmacher, MD
Graduated: 1990
Current Position: Charles and Patsy Collat Scholar of Neuroscience and Director of the Division of Behavioral Neurology and Memory Disorders at the University of Alabama at Birmingham.
Interests: drug development for dementia, disorders of complex visual processing

“I was strongly influenced by the eye-movement research labs during my time in residency at CWRU. I adapted my knowledge from exposure to those activities to my interests in visuospatial cognition. The research I conducted during the early years of my academic career was focused on the interface of eye-movements and cognition in studies of visuospatial exploration. Unfortunately, the technologies available in the 1990s made study of cognitive eye-movements very difficult in older adults with cognitive impairment. I retain a strong clinical interest in eye-movements, and dizziness as a direct consequence of my time as a resident at CWRU.”


Henry Kaminski, MD
Graduated: 1989
Current Position: Professor and Chairman, Dept. of Neurology, George Washington University
Interests: Biological basis for differential sensitivity of limb and extraocular muscles to neuromuscular disorders

“CWRU was the birthplace of my research career and the residency, with its numerous role models (John Leigh, Robert Ruff, Sami Harik, Dennis Landis, Robert Daroff), allowed me to see how a career in science and medicine was possible.”


Myrna R. Rosenfeld, MD, PhD
Graduated: 1989
Current Position: Adjunct Professor of Neurology, University of Pennsylvania and Senior Scientist, Institute for Biomedical Research, Hospital Clínic, Barcelona, Spain
Interests: Autoimmune encephalitis and paraneoplastic neurologic disorders 

““When I arrived at CWRU I had already completed by PhD studies in Neuroscience and was set on a career in Neuro-oncology. My residency training at Case taught me the power of the clinical examination and the process by which clinical observations are translated into research questions. This became the foundation for my own translational research into the mechanisms that underlie autoimmune and paraneoplastic neurologic disorders and allowed my colleagues and I to identify novel immune-mediated syndromes. At CWRU there was a mentor in every corner and each had an infectious passion for Clinical and Academic Neurology. A non-inclusive list of those that to this day, I carry their lessons with me every day include Drs. Robert Daroff, Joseph Foley, Sami Harik, Robert Ruff, James Schmidley, Susan Chester, Dennis Landis, and John Leigh.”


Stephen G. Reich, M.D.
Graduated: 1987
Current Position: The Frederick Henry Prince Distinguished Professor in Neurology, Co-Director Maryland Parkinson's Disease and Movement Disorders Center, University of Maryland School of Medicine.
Interests: experimental therapeutics of movement disorders; phenomenology and natural history of movement disorders; progressive supranuclear palsy

“What was most important to me when searching for a residency, as a senior medical student in 1982, was finding a mentor. It was quickly apparent during my interview day at CWRU that Dr. Daroff was it. During my internship at Mt. Sinai (Drs. Michael Devereaux and Krishan Chandar were the neurologists there at that time), I began to appreciate that the success of the training program was that Dr. Daroff was surrounded by other outstanding faculty who also became important mentors and role models. There was, and continues to be, a great spirit of scholarship and inquiry throughout CWRU that stimulated me to pursue an academic career. It was under the mentorship of Dr. Robert Ruff that I published my first paper as a resident. It was largely through my experiences at the VA clinic that I became interested in movement disorders—I was (and remain even more so) fascinated by the phenomenology. Furthermore, some of the most rewarding long-term patient relationships I had as a resident were with people with Parkinsons’ disease and their families. Dr. Daroff nurtured this interest and helped me arrange an elective with Dr. David Marsden in London during the second year of my residency—another key influence on my specialty choice. One could not graduate from the program then without becoming interested in eye movements and I was cast under the spell by not just Dr. Daroff but also Dr. John Leigh. Even though I specialize in movement disorders, a number of my presentations and publications have been on ocular motor findings in Parkinson’s disease and PSP and I am an amateur “dizzy doctor”. I have always considered myself a clinician first; I started my residency largely “undifferentiated” but the positive academic experiences and role models I had as a resident at CWRU influenced me to stay in academic neurology and combine clinical care with clinical research and I remain grateful for their mentoring, continued support, and friendship.”