Program Overview

The Spinal Cord Injury (SCI) Program of the Department of Rehabilitation Medicine is a nationally recognized and core component of our Department. The SCI Program is the only such service in New York City accredited by the Commission on the Accreditation of Rehabilitation Facilities (CARF) The Fellowship Training Program is fully accredited by the Accreditation Council for the Graduate Medical Education. The program is under the direction of Thomas N. Bryce, MD, a faculty member at Mount Sinai.

Spinal Cord Injury Medicine (SCIM) is a medical subspecialty with board certification that incorporates all knowledge required to diagnose and treat persons with traumatic and non-traumatic SCI. Completion of a one-year fellowship program is a requirement for admission to the subspecialty examination that leads to certification. Admission to a fellowship requires satisfactory completion of a residency training program in physical medicine and rehabilitation, neurology, internal medicine or psychiatry. The training program in SCI Medicine at Mount Sinai has been accredited by the Accreditation Council for Graduate Medical Education since July, 2000.

Fellows receive training by rotating through inpatient and outpatient programs at The Mount Sinai Hospital and affiliated institutions, including the James Peters VA Medical Center, and The Rusk Institute for Rehabilitation Medicine at New York University Medical Center. At each facility, the fellow works with experienced clinical staff including physiatrists, neurourologists, neurosurgeons, orthopedic spine surgeons, and many rehabilitation professionals. The fellow has a continuity outpatient experience, building a panel of outpatients throughout the year for whom they serve as the primary medical contact. Additionally, the fellow is expected to complete a scholarly project related to SCI. Practical experience, didactic training and scholarly work prepare the fellow to sit for the subspecialty examination in SCIM, which is administered annually in the fall by The American Board of Physical Medicine and Rehabilitation.  

Teaching Facilities

Fellows in SCI Medicine benefit from access to the patient populations at diverse institutions. The three hospitals participating in the training program are The Mount Sinai Hospital (MSMC), the James J. Peters Veterans Affairs Medical Center (VAMC), and New York University Medical Center. All of the affiliated hospitals are within 30 minutes drive of the main campus, which is located at MSMC. Inter-hospital transportation is facilitated by the availability of a regularly scheduled shuttle bus service that operates between MSMC and the VAMC.

The Mount Sinai Hospital is a 1,170 bed tertiary care hospital fully accredited by the Joint Commission on the Accreditation of Healthcare Organizations (JCAHO). The Department of Rehabilitation Medicine at Mount Sinai has been chaired since 1986 by Kristjan T. Ragnarsson, one of the world's leaders in SCI Medicine. The Rehabilitation Center at the Mount Sinai Hospital houses an 50 bed acute inpatient facility with a 25 bed inpatient SCI Unit that provides acute rehabilitation services to persons with SCI, including those with ventilator dependent tetraplegia. The SCI Unit is staffed by physiatrists with substantial expertise in SCI Medicine: Thomas Bryce, Miguel Escalon, and Avniel Shetreat-Klein. In addition to acute inpatient SCI rehabilitation, the Mount Sinai experience will also include inpatient consults, continuity clinic, private outpatient SCI care, neuro-urology conferences, and biweekly neuro ICU acute care rounds. Other rotations throughout the medical center may be arranged based on the fellow's interest.  

The James Peters Veterans Affairs Medical Center (JPVAMC) provides comprehensive care for veterans with SCI, both on an acute and chronic basis. The 80 bed SCI Unit is directed by Arthur Cytryn, MD. Dr. Cytryn is board certified in SCI Medicine. At the JPVAMC, fellows are exposed to inpatient SCI Medicine and additional specialty areas, including a wound care clinic, telemedicine, and urologic testing. Fellows also participate in a home visit program for veterans with SCI who are living in the community.

The Rusk Institute for Rehabilitation Medicine of New York University School of Medicine is the site of the fellows' experience in Pediatric SCI. This experience is a wholly outpatient. Pediatric rehabilitation services are directed by Joan Gold, MD, who has been in her position for nearly 20 years and is known for her outstanding teaching and her encyclopedic knowledge of pediatric rehabilitation. In addition, during the rotation, the fellows participate in neuroradiology image interpretation and the adult clinics for multiple sclerosis, wound care, and fertility.

Educational Program

The SCIM Fellowship educational program includes a weekly journal club, weekly formal SCIM didactics, and weekly formal training on research methodology. The SCIM Specialty Board exam pass rate for the the past five years has been 100%. Fellows have the opportunity to participate in all aspects of intrathecal pump management for spasticity from screening trials, to ongoing refilling procedures, to troubleshooting. Other procedures performed include urodynamics, nerve and muscle blocks with neurotoxins, and diaphragm pacer programming and management. Fellows have the opportunity to participate in the community outreach program which includes a swimming program, and life challenge activities for persons with SCI. Fellows are expected to participate in the education of residents and staff members through formal lectures and informal teaching as well as to develop a quality improvement project. Fellows are also expected to participate in research and to prepare a scholarly work. There is protected educational and research time.

Benefits

Each resident presently has four weeks of paid vacation annually and receives an extensive benefits package. Benefits include: major medical insurance, free hepatitis B vaccine, prescription plan, dental insurance, life insurance, malpractice insurance, disability insurance, discounts for recreational activities in New York City, including Broadway shows, concerts, etc.

Interested Applicants should contact:

Thomas Bryce, MD
SCIM Fellowship Program Director
Department of Rehabilitation Medicine
The Mount Sinai Medical Center
5 East 98th Street, Box 1240B
New York, NY 10029-6574
E-mail: thomas.bryce@mountsinai.org