Our section actively cares for over 2,500 patients with multiple sclerosis or related diseases, including NMOSD, MOGAD, recurrent optic neuritis, transverse myelitis, CNS sarcoidosis and CNS vasculitis. The John L. Trotter MS Center, the patient care arm of our section, employs an advanced nurse practitioner, two clinical RN coordinators, a medical assistant, an administrative assistant and nine clinical study coordinators.

The MS Center provides multidisciplinary comprehensive care and routinely collaborates with neuro-ophthalmology, urology, physical medicine and rehabilitation, neuroradiology, pain medicine, psychiatry, neuropsychology, occupational therapy, physical therapy and speech therapy. The MS pediatric neurology faculty at St. Louis Children’s Hospital (SLCH) led by Soe Mar, MD, frequently interacts with the adult MS group.

In clinic, fellows will follow their own patient cohort under direct faculty supervision. They will have ample time (typically ~90 minutes for each new patient and ~45 minutes for each returning patient) to gather history, perform an examination and discuss the patient with the MS clinical faculty supervision. Fellows will see patients with relapsing and progressive forms of MS and other related demyelinating diseases. They will gain experience in the differential diagnosis for MS and related disorders, learn how to order and interpret appropriate diagnostic studies, learn how to tailor treatments for individual patients and apply the latest risk mitigation strategies for each therapy. Fellows perform the initial evaluation on inpatient consultations (one to two per month, on average) and discuss these with an MS faculty member. These inpatient cases often have different and more complex presentations and are good learning experiences for trainees.

In addition to regular meetings with mentors to discuss patients, fellows have several opportunities to present interesting and complex patients to a wider audience at case conferences.  They also have opportunities to teach by occasionally having residents or medical students with them in the clinic.

Additional clinical rotations

To ensure a broad clinical experience, fellows will augment their clinical time by rotating with other faculty members in MS-related disciplines through a tailored schedule (varies depending on fellowship type, duration and fellow goals) that guarantees access to the many different rotations. Sub-specialty rotations include pediatric MS, physical medicine and rehabilitation, neuro-ophthalmology, neuro-infectious diseases (and other neuroinflammatory conditions), urology, neuroradiology, physical and occupational therapy, and neuropsychology.