Neuromuscular Specialist, University of Alabama at Birmingham
- Neuromuscular Specialist
- Neurology - Clinical Neurophysiology, Neurology - Neuromuscular Medicine, Neurology - Research
- Birmingham, Alabama
The Department of Neurology at the University of Alabama at Birmingham (UAB) School of Medicine is seeking two neuromuscular specialists or clinical neurophysiologists to join the Division of Neuromuscular Disease. This is a unique opportunity to practice the full breadth of neuromuscular medicine – including single-fiber EMG; muscle, nerve, and skin biopsy; autonomic testing; and mitochondrial neuromuscular disease – at the only Level 1 Trauma Center and tertiary referral center within a 50,000 square mile catchment area.
Founded by renowned neuromuscular expert Dr. Shin J. Oh, the UAB Division of Neuromuscular Disease is rapidly expanding to meet the increasing demands of a population home to a host of rare and complex pathologies. The division is led by Dr. Eroboghene Ubogu - a quadruple-boarded neuromuscular specialist and recent recipient of three National Institutes of Health (NIH) Independent Investigator Awards - and it is his goal to more than double the size of the division’s faculty and make UAB a premier neuromuscular program. The division currently houses a large neuromuscular clinic, a Muscular Dystrophy Association (MDA) clinic which includes an ALS clinic, an electrodiagnostic and evoked potentials laboratory, and an active muscle/nerve/skin biopsy program. An autonomic laboratory is under construction, and come 2017 UAB will be just the 8th program nation-wide to have a sweat chamber. Plans are also in motion to launch a mitochondrial neuromuscular clinic, which will be the first of its kind in the Southeast. In terms of research, UAB’s affiliation with NIH NeuroNext provides access to a wealth of clinical trials. Dr. Oh’s muscle and nerve histopathology laboratory also presents a distinct research opportunity, given that it houses fixed archived tissue, patient data, and case reports dating back to 1970. Formal and informal teaching opportunities exist in terms of involvement with UAB’s ACGME-accredited clinical neurophysiology fellowship, neuromuscular medicine fellowship, and neurology residency.
The UAB Division of Neuromuscular Disease is based at the UAB Medical Center, the nation’s fourth largest academic medical center. UAB President Dr. Ray Watts, former Dean of Medicine and Chairman of Neurology at UAB, has deemed Neurology to be a strategic pillar of growth for the institution as a whole. Under the leadership of Dr. David Standaert, Neurology Department Chair, the number of Neurology faculty members has more than tripled from 22 in 2009 to nearly 70 in 2016. The new faculty are making their presence felt, with Neurology outpatient visits increasing 24% from fiscal year 2014 to fiscal year 2015; inpatient admissions rose 12% in the same timeframe. The Neurology Department has also experienced a 17% increase in NIH funding from 2014 to 2015, placing the department in the top 25 nationwide.
Division of Neuromuscular Disease
UAB's neuromuscular specialists are highly-trained neurologists with fellowship training, board certification, and subspecialty expertise in clinical neurophysiology and neuromuscular medicine. The team of six neuromuscular attendings, four EMG lab technicians, and two muscle and nerve histopathology lab technicians provides expert care for patients with a wide variety of neuromuscular diseases such as inflammatory myopathies, muscular dystrophies, neuromuscular junction transmission disorders such as myasthenia gravis (MG) and Lambert-Eaton Myasthenic syndrome (LEMS), inherited and acquired peripheral neuropathies (which affects more than 20 million individuals in the United States), including small fiber neuropathies, plexopathies, radiculopathies as well as disorders affecting motor and sensory neurons. As the only dedicated tertiary care neuromuscular center in the state, the UAB neuromuscular program has the capabilities to diagnose and treat peripheral nervous system disorders using the most current medical techniques.
At UAB, state-of-the-art facilities and equipment are available for diagnostic studies including routine and specialized motor and sensory nerve conduction studies, electromyography, single fiber electromyography, somatosensory, visual and brainstem evoked potentials, surgical procurement of muscle, peripheral nerve and skin punch biopsies, and a full range of histopathological techniques to diagnose neuromuscular disorders.
Left to right: Dr. Peter King, Dr. Kenkichi Nozaki, Dr. Shin Oh (Emeritus), Dr. Mohammad Alsharabati, Dr. Eroboghene Ubogu. Not pictured: Dr. Mohamed Kazamel
UAB is also home to the Muscular Dystrophy Association (MDA) Clinic, a dedicated clinic for the initial evaluation, diagnosis and treatment of rarely acquired and inherited disorders affecting peripheral nerves, the neuromuscular junction, and muscles. As the only MDA clinic available in Alabama, the clinic serves patients from across the southeast.
Eroboghene Ubogu, M.D.
Director, Division of Neuromucular Disease
Director, EMG and Evoked Potential Laboratory
Director, Shin J. Oh Muscle and Nerve Hisopathology Laboratory
Director, Clinical Neurophysiology Fellowship Program
Director, Neuromuscular Immnuopathology Research Laboratory
Dr. Ubogu is a renowned physician-scientist and a board certified neurologist with additional certifications in clinical neurophysiology, electrodiagnostic medicine, and neuromuscular medicine. He is a recent recipient of three National Institutes of Health (NIH) Independent Investigator Awards, a Creative and Novel Ideas in HIV Research grant, and a collaborative Department of Defense award. His laboratory was the first in the world to isolate and characterize human peripheral nerve endoneurial endothelial cells that form the restrictive blood-brain barrier. Dr. Ubogu serves as Director of the Division of Neuromuscular Disease amongst several other clinical, research, and educational leadership positions.
Associate Professor, Neurology
Dr. Kazamel is a board certified neurologist with additional certification in clinical neuromuscular pathology, currently serving as an Assistant Professor. A recent graduate of the UAB neurology residency program, Dr. Kazamel completed a neuromuscular medicine fellowship at the Mayo Clinic prior to rejoining UAB as a faculty member.
Dr. Alsharbati is a board certified neurologist with additional certification in neuromuscular and electrodiagnostic medicine. Dr. Alsharabati sees patients at the Kirklin Clinic and he also performs Nerve Conduction Studies (NCS), Electromyography (EMG), single fiber EMG, muscle and nerve biopsies at the UAB clinical neurophysiology lab.
Assistant Professor, Neurology
The monthly single fiber EMG Clinic provides an avenue to diagnose patients with myasthenia gravis in addition to routinely performed repetitive nerve stimulation (Jolly) studies. The electromyography and evoked potentials laboratory at UAB sees approximately 3,000 studies performed annually, including routine nerve conduction studies, needle EMG tests, repetitive nerve stimulation tests, single-fiber EMG, and other sophisticated studies. A dedicated biopsy suite is located within the EMG laboratory for deep muscle, peripheral nerve, and skin punch biopsies to aid in the histopathological diagnosis of neuromuscular disorders. Muscles commonly biopsied under local anesthetic in sterile conditions include the anterior tibialis, vastus lateralis, biceps, and deltoid muscles. These biopsies aid diagnose inflammatory, metabolic, and mitochondrial myopathies and muscular dystrophies. Skin punch biopsies are also performed from a distal and proximal site for epidermal nerve fiber density analyses to diagnose small fiber neuropathies.
Plans are underway at UAB to build the first dedicated autonomic nervous system laboratory in the state of Alabama, with clinical operations on track to begin early 2017. Conservative estimates based on emergency room, inpatient and outpatient visits suggest that roughly 2000 patients can be investigated per year. The autonomic laboratory will provide the full spectrum of autonomic testing, tilt table, cardiac response to deep breathing, cardiac response to Valsalva, Quantitative Sudomotor Axon Reflex Test, and Thermoregulatory Sweat Test, to aid in the diagnosis of peripheral and central dysautonomias as a service to the UAB community and broader catchment area. The Thermoregulatory Sweat Test will be especially unique, as there are under 10 Themoregulatory Sweat Chambers in the nation.
Mitochondrial Neuromuscular Medicine Clinic
A combined adult and pediatric multidisciplinary clinic in mitochondrial neuromuscular disease sponsored by the Foundation for Mitochondrial Medicine and Seahorse Biosciences is also planned for the near future. This will serve as the clinical arm of the recently developed comprehensive mitochondrial disease program at UAB geared to better understand the bioenergetic dysfunction in individual patients and devise personalized therapies for mitochondrial disease. This will be the first clinic of its kind in the South East and one of few dedicated clinics nationally.
The shared academic, philanthropic and medical mission of the clinic is to revolutionize the treatment and diagnosis of mitochondrial diseases by establishing and integrating state-of-the-art techniques in bioenergetics and therapeutics using a precision medicine approach. The clinic will achieve this vision by developing two parallel components: 1) a monthly multidisciplinary clinic to evaluate and care for adults and pediatric patients with mitochondrial disease and 2) a reference laboratory for metabolic bioenergetics focused on establishing mitochondrial-targeted clinical, noninvasive laboratory measurements and instruments.
VA Neuromuscular Program
For individuals interested in working at the VA, opportunities for general neuromuscular and electrodiagnostic medicine exist, as well as neuromuscular biopsy procurement (sent to the UAB muscle and nerve laboratory for processing and interpretation). The VA Neuromuscular Program has 3 clinic rooms with brand new equipment – including Caldwell machines. Candidates with interest in providing some service at the VA will be strongly considered.
Clinical Trial Research
As the only tertiary care facility in Alabama, there is steady access to industry and National Institutes of Heathy (NIH)-funded clinical trials. The neuromuscular disease program is part of the NIH NeuroNext network. Currently there are ongoing clinical trials in myasthenia gravis, Lambert Eaton myasthenic syndrome, CIDP and ALS. Investigator-initiated clinical studies are also quite encouraged, especially those aimed to better understand pathogenesis or investigate novel treatment approaches in neuromuscular medicine.
Patient-Based Clinical Outcomes Research
Due to the large patient load and access to longitudinal medical records (including Electrodiagnostic and histopathology study reports), opportunities exist to study the natural history of a broad spectrum of neuromuscular disorders and describe the effects of specific interventions.
Collaborative Laboratory-Based Research
The Shin J Oh Muscle and Nerve histopathology laboratory has nearly 50 years of fixed archived tissue samples, patient data, and case reports dating back to 1970, with frozen muscles and nerves stored for at least 7 years. Another freezer was recently purchased to increase storage capacity of these precious specimens. Access to these tissues through an IRB exemption provide faculty with opportunities to study the biology of common and rare neuromuscular disorders utilizing core laboratory resources at UAB or in collaboration with basic or translational basic scientists with specific research questions locally, nationally and internationally.
For individuals dedicated to developing careers as physician scientists in laboratory-based neuromuscular research, opportunities may exist following discussion with the Chair. Current areas of active translational basic science research include motor neuron disease, and immune-mediated neuropathies/ vascular biology of the blood-nerve barrier. Areas of potential research focus include myopathies (particularly inflammatory myopathies) and muscular dystrophies, vasculitic neuropathies and myasthenia gravis.
The division has trained more than 200 residents and more than 70 fellows, including many from Korea, Turkey, Japan, Poland, Colombia, and Brazil. Opportunities exist to:
- Participate in undergraduate medical student teaching as part of the UAB school of medicine neuroscience course or Medical Student Neurology Clerkship
- Participate in internal medicine and neurology residency teaching, as well as clinical neurophysiology and neuromuscular medicine fellows (formal and informal)
- Give lectures locally, nationally and internationally in an area of subspecialist interest at meetings or CME conferences
Clinical Neurophysiology Fellowship Program, EMG/Neuromuscular Track
The Clinical Neurophysiology Fellowship, directed by Dr. Ubogu, offers active participation in a program that encompasses evaluating and diagnosing patients with neuromuscular disorders as well as performing and interpreting advanced techniques in electrodiagnostic medicine under faculty supervision. Such techniques include routine nerve conduction studies, blink responses, repetitive nerve stimulation (Jolly test), needle electromyography, single fiber EMG, and evoked potential studies (visual, brainstem auditory, and somatosensory). This work will take place at the EMG Laboratory located in Sparks Center at UAB Hospital. Evaluation of inpatients with neuromuscular disease is also provided through bedside studies in the hospital or assessment in the EMG Laboratory. Fellows will also have the opportunity to participate in one or more research projects under the mentorship and guidance of Neuromuscular Disease division faculty. Click here for additional information.
The Neuromuscular Medicine Fellowship, directed by Dr. Kenkichi Nozaki, offers active participation in a program that combines comprehensive training in clinical neuromuscular disease, electrodiagnostic medicine (including evoked potentials), and muscle and nerve histopathology. UAB’s faculty expertise and institutional resources cover all aspects of adult and pediatric neuromuscular disease with additional exposure to rehabilitation medicine. Opportunities exist to participate in intramural or extramurally funded basic, translational, and clinical research projects. This program can be tailored toward individuals interested in academic or private practice careers. Click here for additional information.
Department of Neurology
David G. Standaert, MD, PhD – Professor & Chair of the Department of Neurology
The US News & World Report nationally-ranked UAB Department of Neurology is led by David G. Standaert MD, PhD, Professor and John N. Whitaker Chair of Neurology. It is home to eight comprehensive divisions and seven centers offering an array of clinical activities. More than 27,000 patients are cared for annually through state-of-the-art subspecialty care and innovative treatments. The Neurology Department faculty has experienced rapid growth under the leadership of Dr. Standaert, expanding from 22 faculty members to 63 faculty members in 2015.
The Neurology faculty spans all the major subspecialties of the field. Major clinical programs include stroke and cerebrovascular disease, epilepsy, memory disorders and neuropsychology, movement disorders, multiple sclerosis, neuromuscular disease, neuro-oncology, and headache and pain. As the Neurology faculty has dramatically expanded, so has the clinical volume of the program:
- Outpatient visits increased 24% from Fiscal Year 2014 to Fiscal Year 2015
- Inpatient admissions increased 12% from Fiscal Year 2014 to Fiscal Year 2015
UAB’s Department of Neurology Faculty
Level IV Comprehensive Epilepsy Center
Under the leadership of Dr. Jerzy Szaflarski, Division Chief of Epilepsy, the UAB Comprehensive Epilepsy Center has become one of the busiest centers in the country. As a Level IV Center, the highest level recognized by the National Association of Epilepsy Centers, UAB has the capability to diagnose and treat epilepsy using the latest and most current medical and surgical techniques available anywhere in the world.
State-of-the-art facilities and equipment are available for diagnostic studies and treatment. Intracranial electrode implantation, cortical stimulation studies, specialized EEG procedures, and a full range of conventional and special tests are available. The only magnetoencephalography (MEG) laboratory in the Southeast, the UAB-HSF MEG Laboratory, is part of the Epilepsy Center. MEG provides a more accurate way of locating the origin of seizures and is also used to locate brain areas responsible for speech, sensation, and vision. See below for elaboration on the clinical volume of the Comprehensive Epilepsy Center:
- 2,500 routine EEG’s/year
- 10-bed Epilepsy Monitoring Unit (EMU)
- Plans underway to expand to a 16-bed unit
- 50 surgical resections for epilepsy/year
- Long-Term EEG monitoring has increased from 200/month in 2013 to 550/month in 2015
Neurology Department Research Overview
The Neurology Department’s clinical care is provided in the context of a vibrant neuroscience research community which has expanded rapidly in the last five years. In recent years, the UAB administration has placed a high priority on the Neurosciences as a strategic pillar to the Medical School’s growth and infrastructure moving forward. Much of this growth can be traced to new leadership: Dr. Kevin Roth, recruited as Division Director for Neuropathology and now Chair of Pathology; Dr. Ray Watts, recruited as Chair of Neurology who later served as Dean of the School of Medicine and now is President of UAB; Dr. David Sweatt, Chair of Neurobiology; Dr. Jim Meador-Woodruff, Chair of Psychiatry, and Dr. David Standaert, recruited as Chair of Neurology by Dr. Watts in 2006. The result of this new leadership has been a substantial increase in both numbers of faculty and extramural support.
The Shelby Interdisciplinary Biomedical Research Building, home to many of the Neurology program’s basic science labs
Within the Department of Neurology, clinical research is a major focus. Regulatory and financial management of Neurology clinical trials is managed by a central administrative group. The Department of Neurology offers research opportunities in various fields at both the basic science and clinical levels; currently, the department has more than 120 clinical trials ongoing, amounting to more than $3 million in cash receipts annually. Clinical trials of new agents for epilepsy, multiple sclerosis, motor neuron disease, and brain tumors enroll large numbers of patients.
NIH Funding & Infrastructure
The infrastructure for research is substantial: UAB has an NIH Clinical Translational Science Award (CTSA) which supports a range of translational activities, and was named as one of the 25 sites which form the NIH funded NeuroNEXT Program (Network for Excellence in Neuroscience Clinical Trials). This network hosts a wide range of Phase II trials in neurology, providing a robust, standardized, and accessible infrastructure and funding to facilitate rapid development and implementation of protocols in neurological disorders affecting adult and/or pediatric populations. All told, Neurology research expenditures have tripled since 2006, and for the 2015 year UAB will rank in the top 25 with $6.3 million.
There is also an NIH R25 program for training of residents in neurology, neurosurgery and neuropathology in research methodology. Qualified candidates will have 80% protected across two full years of support, with the goal of an increase in the number of residents who subsequently obtain K08/K23 funding.
Neuro-Imaging Research Infrastructure
In 2013, UAB opened the Advanced Imaging Facility, featuring one of the largest cyclotrons at an academic medical center in the US, and new PET/CT and PET/MRI facilities. There is also extensive infrastructure for research MRI imaging, including a recently commissioned Siemens Prizma scanner, representing the latest generation of technology for fMRI and other advanced imaging techniques. UAB is also the only institution in the Southeast with a MEG laboratory. Neurosurgeons utilize the MEG on a daily basis for both brain tumor and epilepsy surgery cases.
UAB Neurovascular Conference (including attendings, residents, and students)
UAB’s Neurology Residency Programs
The incoming vascular neurologist will have the opportunity to teach and mentor residents and fellows through the Department of Neurology’s various training programs. The 4-year, ACGME accredited Neurology Residency program has 6 Residents per year, 24 total, plus 4 additional positions in clinical neurophysiology. The UAB Neurology residents, as a whole, have scored above the 90th percentile on the RITE exam for the past 5 years.
UAB’s Fellowship Programs
There are 10 clinical fellowship programs offered within the UAB Department of Neurology, including the ACGME accredited Vascular Neurology fellowship and the UCNS accredited Neurocritical Care fellowship. Additionally, the department has or will have postdoctoral fellowships in all subspecialties that, where applicable, will lead to board certification. Clinical fellowships are available in the following subspecialties:
- Memory Disorders/Behavioral Neurology
- Movement Disorders
- Neuroimmunology/Multiple Sclerosis
- Neuromuscular Medicine
- Vascular Neurology
- Neurocritical Care
UAB School of Medicine
The UAB School of Medicine is a nationally ranked, world-class setting where cutting edge research meets boundless collaboration to produce one of the most unique medical educations in the country. The UAB School of Medicine was established over 60 years ago and has a long tradition of interdisciplinary research, which has played a large part in enabling UAB to consistently rank among the leading recipients of the NIH funding. Total research funding exceeds $450 million annually; $250 million in NIH funds can be attributed to the School of Medicine alone. UAB ranks 27th among academic institutions in federal research funding and 20th in funding from NIH.
In the past few years, the School of Medicine has added more than half a million square feet of space for clinical facilities, research laboratories, classrooms, surgical suites, and administrative space. The medical center, now at 1,150 beds, is also undergoing substantial upgrades including new OR suites, ICU’s, catheterization/imaging/interventional suites and an ER department covering almost a full square block. A recently completed expansion project is the 430,000 square feet Women’s and Infant Center and Hazelrig-Salter Radiation Oncology Center. In late 2012, UAB celebrated the grand opening of the Alabama Children’s Hospital occupying more than 700,000 square feet. Together with existing facilities, the net square footage at the UAB School of Medicine exceeds 12 million square feet and nearly 100 city blocks. For more than 20 years, the UAB Hospital has been ranked by US News & World Report as one of “America’s Best Hospitals”.
UAB President & Dean of Medical School
Dr. Ray Watts, President of UAB
UAB’s former Chairman of Neurology, Dr. Ray Watts was recently appointed as the President of the University of Alabama Birmingham, after serving as the Sr. VP and Dean of the School of Medicine. In August 2013, Dr. Selwyn Vickers was selected as the new Sr. Vice President and Dean of the School of Medicine. Dr. Vickers, a member of the prestigious Institute of Medicine of the National Academy of Sciences, is a world-renowned surgeon, pancreatic cancer researcher, pioneer in health disparities research and a native of Alabama. Dr. Vickers returns to UAB after serving as the Professor and Chair of the Department of Surgery at the University of Minnesota.
$1 Billion Campaign for UAB
In October 2013, it was announced that UAB would begin the school’s largest-ever fundraising campaign titled “The Campaign for UAB: Give Something, Change Everything.” The campaign will run through 2018, with the plans to raise $1 billion. “We are working hard to strengthen our position as one of the nation’s most productive and dynamic universities,” said University President Ray Watts.
Location Specifics – Birmingham, Alabama
The Vulcan Statue – The Largest Cast Iron Statue in the World, reflecting Birmingham’s Steel and Iron roots
The rolling countryside of the greater Birmingham area provides a beautiful metropolitan city with an excellent quality of life. Birmingham is the largest city in Alabama with a population of approximately 1.3 million people. It is a culturally diverse city that ranks as one of the most important business centers in the Southeastern United States. The Birmingham metropolitan area has consistently been rated as one of America’s best places to work and earn a living based on the area’s competitive salary rates and relatively low living expenses. Birmingham is perfectly suited to young families with superior public and private schools and a low cost of living. It is one of the few places in the United States where a 4-hour drive affords one the access to mountains, beaches or a major metropolitan area. For your convenience we have provided some facts about Birmingham that may pleasantly surprise you:
Region’s Field, located within walking distance of the Children’s Hospital
Culture & Arts
- Birmingham is the cultural and entertainment capital of Alabama with numerous art galleries in the area including the Birmingham Museum of Art, the largest art museum in the Southeast.
- Birmingham’s vibrant downtown area features the Birmingham Museum of Art, Birmingham Civil Rights Institute, Alabama Sports Hall of Fame, McWane Science Center, Alabama Theatre and Alabama Jazz Hall of Fame.
- Other Birmingham attractions include Vulcan Park & Museum, Birmingham Botanical Gardens, Birmingham Zoo and Barber Motorsports Park.
- The Riverchase Galleria in Birmingham is one of the largest malls in the entire Southeast US
World Class Cuisine
- On December 2013, The Highlands Bar and Grill (which is located within a 5 minute walk of the Medical Campus) was recognized by Open Table on the list of the 100 Best Restaurants in the America. The Open Table recognition was based on 5 million restaurant reviews for more than 19,000 restaurants in all 50 states.
- Frank Stitt III, the owner and executive chef of Birmingham’s Highlands Bar and Grill, Bottega Restaurant, and Chez Fon Fon was named as the “Best Chef in Southeast” in 2001.
- Chris Hastings, an understudy of Frank Stitt III’s and the owner and executive chef of Birmingham’s award winning restaurant Hot & Hot Fish Club, was recognized as the “Best Chef in the South” by the James Beard Foundation in 2012.
Largest Business Centers in Southeastern US
- The Birmingham area serves as headquarters to one Fortune 500 company: Regions Financial, along with five other Fortune 1000 companies.
- Birmingham area also serves as the headquarters to a large number of Health care services providers HealthSouth, Surgical Care Affiliates and Diagnostic Health Corporation. Caremark Rx was also founded in the city.
- Birmingham is home to three of the state’s five law schools: Cumberland School of Law, Birmingham School of Law, and Miles Law School.
- Birmingham is also the headquarters of the Southeastern Conference, one of the major U.S. collegiate athletic conferences.
- The Birmingham area has major colleges of medicine, dentistry, optometry, pharmacy, law, engineering, and nursing.
- Birmingham is home to two major banks: Regions Financial Corporation and BBVA Compass.
- SouthTrust, another large bank headquartered in Birmingham, was acquired by Wachovia in 2004. The city still has major operations as one of the regional headquarters of Wachovia, which itself is now part of Wells Fargo Bank