Publication

Abstract : There is a demand for quality Parkinson's Disease (PD) care globally and competent movement disorders specialists are needed.1-3 Fellowship training provides neurologists (residency graduates) education in the diagnosis and management of movement disorders. Graduates may provide improved care for patients with movement disorders, serve as a referral for colleagues, become educators or leaders in the field, and may have scholarly experience during training that prepares them to contribute to the understanding of movement disorders. In North America, there are at least 88 fellowship positions in 2022, compared to 43 positions in 2012.4, 5 Detailed data outlining the landscape of movement disorders training across global regions is unavailable, but training programs exist in countries across all populated continents. Most programs offer clinical training, research, and didactic conferences, but there is curricular variability.5, 6 Data suggests improvement in training is needed.1 A curriculum developed by the American Academy of Neurology (AAN) Movement Disorders section and the Movement Disorder Society's Pan American Section (MDS-PAS) outlines content, but provides little methodological guidance for evaluating trainees (Supplementary S1). Other international neurological societies (ie, the MDS, the European Academy of Neurology) financially support clinical or research fellowships in movement disorders ranging from 3 to 12 months at selected centers. There is no established common curriculum for these fellowships. Firmer assessment guidance will improve trainees' clinical competency development. Milestones are used in medical education internationally, although the definition of “milestone,” differs between regions.7, 8 Our use of “milestones” adheres to the United States (US)-based definition, in which milestones are “behaviors associated with a specific level of achievement for [a] competency.”7 American physician training programs accredited by the Accreditation Council for Graduate Medical Education (ACGME) use milestones to address inter-program variability and as a tool to evaluate trainees' growth.9 These milestones are not requirements, but provide discrete levels of growing competence trainees can demonstrate via observable behaviors