The Vanderbilt Autonomic Dysfunction Center (ADC) was established in 1978 as the first international center for patient care, research, and training with a focus on the autonomic nervous system. The staff of the ADC continue to research autonomic dysfunction and work to discover the most evidence-based therapies to treat those symptoms. Our Clinical Research Infrastructure has an operating budget of 3 million dollars per year and we have had continuous NIH funding for the past 30 years. Our breakthrough discoveries are listed on our home page under "Our History".

The clinical fellow will be engaged in education, clinical and laboratory practice, as well as research. We have a large, diverse spectrum of patients with autonomic disorders, ranging from the most common and mild to the rarest and most disabling one.

We have a dynamic and multidisciplinary team of faculties from different specialties (neurology, autonomic disorders, cardiology, and geriatrics) dedicated to the care of patients with Autonomic Disorders. The fellow will rotate with all the faculty members in clinic and in the laboratory in order to have the broadest exposure. They will have the opportunity to interact with other neurological subspecialties (such as neuromuscular, movement disorders, and autoimmune neurology) with whom we often share complex cases. They will also interact with all the other medical specialties (cardiology, geriatrics) that refer patients to us.

Our clinic has the largest volume of patients than any other center, guaranteeing a very extensive experience. Fellows will have the opportunity to participate in research projects and they will be encouraged to do so and present their results at national and/or international meetings.

Educational Program

The Clinical Autonomic Disorder Program (CADP) Fellowship prepares the trainee for practice in the care of a broad variety of autonomic disorders that affect cardiovascular autonomic regulation. At the end of the fellowship program, trainees are prepared for the Board of United Council for Neurological Subspeciality (UCNS) Exam in Autonomic Disorders. Graduates will be ready for the independent practice of clinical autonomic disorders, including use of techniques such as head-up-tilt-testing, interpretation of neuro-hormonal assessment (norepinephrine and its metabolites), and autonomic function testing (AFT).

As stated in the UNCS Autonomic Disorder subspecialty, the Autonomic Disorders is a medical subspeciality defined by competency in:

1. Understanding the health and disease of the autonomic nervous system.
2. Performance and interpretation of clinical and laboratory evaluation of the autonomic nervous system.

3. Diagnosis and care of those who suffer from autonomic dysfunction syndromes.

    

What is unique about our fellowship program?

1. Strong clinical and research mentorship program from leaders in the field of Autonomic Disorders.
2. Multidisciplinary team of clinical educators and physician-scientists dedicated to the care of patients with autonomic disorder.
3. Exposure to broad range of pathologies that affect the autonomic nervous system in the outpatient and inpatient setting.
4. Support to pursue scholarly activities such as conference and meeting attendance.
5. Possible pathway to faculty at one of the top academic medical institutions in the country.

Goals and Objectives:

The goal of this program is to prepare the physician for independent practice in Autonomic Disorders. The training is based on supervised clinical work with increasing patient responsibilities and transition to independent practice over the course of the training program.

Based on the ACGME Six Competencies, fellows in both training programs are expected to reach the level of an independent practitioner in the following areas:

1. Patient care that is compassionate, appropriate, and effective for the treatment of autonomic dysfunction problems and the promotion of health in autonomic cardiovascular regulation.
2. Medical knowledge about established and evolving clinical autonomic science and tools, and the appropriate application of this knowledge to patient care.
3. Practice-based learning and improvement that involves investigation and evaluation of their own patient care, appraisal and assimilation of scientific evidence, and improvements in patient care.
4. Interpersonal and communication skills that result in effective information exchange and teaming with patients, their families, and other health professionals from different specialties (neurology, cardiology, clinical pharmacology and geriatrics.
5. Professionalism, as manifested through a commitment to carrying out professional responsibilities, adherence to ethical principles, and sensitivity to a diverse patient population.

During your fellowship, you will:

1. Participate in the clinical assessment and management of patients with a wide variety of autonomic disorders.
2. Participate in the assessment and interpretation of the studies performed in the Autonomic Function Testing Laboratory and Neuro-hormonal assessment.
3. Have the opportunity to engage in Clinical Research in Autonomic Disorders under a structured mentorship program.
4. Elective rotation in Hypertension, Cardiology, and Neurology (Movement Disorder and Neuromuscular Disorder Clinic).
5. Attend weekly departmental conferences and scheduled didactic activities.