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Physical Medicine & Rehabilitation - Education

Houston, Texas

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PM&R Alliance Education Office
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Clinical Fellowship in Brain Injury Rehabilitation

Location: Brain Injury Program, The Institute for Rehabilitation and Research


  • Gerard Francisco, M.D., Associate Director, Clinical Research, Brain Injury and Stroke Program, TIRR; Chairman and Clinical Professor, Department of PM&R, UT
  • Sunil Kothari, M.D., Associate Director, Clinical Services, Brain Injury and Stroke Program, TIRR; Assistant Professor, PM&R, BCM
  • Monika Shah, D.O., Program Director of Brain Injury and Stroke Program, TIRR; Assistant Professor, PM&R, BCM
  • Cindy B. Ivanhoe, M.D., Brain Injury and Stroke Program, TIRR; Assistant Professor, PM&R, BCM

Funding: Generated Income, Industry Support

Number of Fellows: One or two

Certificate: BCM and/or UT


  • Completion of an accredited residency program in PM&R;
  • Valid Texas medical license by February of year starting;
  • Citizenship or permanent residency status in the U.S. or its possessions or territories.

Stipend: PGY V

Training Period: 12 months

Start Date: July

Goals of Program:

Fellows will:

  • Train on a brain injury unit and learn effective team leadership and medical management of persons with brain injury, including consultation-liaison, admission screening, acute and post-acute care, vocational and educational rehabilitation, and work with families;
  • Develop skills to manage spasticity through serial and inhibitive casting, medications, motor point and nerve blocks, botulinum toxin injections and intrathecal Baclofen pump;
  • Understand the mechanisms of action and side-effects of pharmacologic agents used for neurobehavioral and cognitive and affective dysfunctions after brain injury;
  • Develop expertise to perform mental status and neuro-functional examinations; to interpret neuroimaging studies, EEG, evoked potentials and neuropsychological testing; and to relate these findings clinically;
  • Understand the pathophysiology of coma and learn appropriate assessment techniques and management skills;
  • Learn to assess and treat cranial nerve, musculoskeletal, and other dysfunctions caused by brain injury;
  • Learn to develop and implement behavioral modification programs for persons with brain injury;
  • Develop an awareness of medico-legal issues pertinent to brain injury, including competence, guardianship, and expert witness testimony;
  • Learn administrative skills in program development and evaluation, team leadership, and quality improvement.


The Fellow will:

  • Perform acute care consults;
  • Perform history and physical examinations;
  • Participate in daily bed service rounds and outpatient clinics;
  • Supervise medical students and residents who rotate in the program;
  • Participate in ongoing research programs, including preparing at least one paper for submission for publication, preparing submissions to national meetings, and collaborating in the preparation of grant proposals;
  • Participate in PM&R didactic teaching including one Grand Rounds and one Research Conference presentation;
  • Participate in PM&R resident clinical education including monthly clinical teaching rounds;
  • Attend program development meetings.

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