Autonomic Disorders Fellowship Program

The clinical Autonomic Disorders Fellowship Program at Vanderbilt University Medical Center (VUMC) is one of the few accredited programs of its kind in the country. Training for this program is provided through the internationally recognized Vanderbilt Autonomic Dysfunction Center, and specializes in the clinical treatment and research of orthostatic hypotension and other debilitating neurological and neurodegenerative conditions that disrupt vital autonomic functions. The program is in the process of adding an additional training spot so that two fellows can rotate through the program each year.

Fellows engage in education, clinical and laboratory practice, and research under the mentorship of a multidisciplinary team of clinical educators and physician-scientists who are dedicated to the care of patients with autonomic disorders. Comprised of a dynamic team of faculty from different specialties such as neurology, autonomic disorders, cardiology and geriatrics, the Autonomic Dysfunction Center has the largest volume of patients than any other center. As a result, fellows are guaranteed to have exposure to a broad range of pathologies that affect the autonomic nervous system in the outpatient and inpatient setting, while also collaborating with other neurological and medical specialties on complex cases. Fellows are encouraged to pursue scholarly activities such as conference and meeting attendance, and have the opportunity to participate in research projects that may be presented at national and/or international meetings.

During the Autonomic Dysfunction Fellowship, trainees will:

  • Participate in the clinical assessment and management of patients with a wide variety of autonomic disorders
  • Participate in the assessment and interpretation of studies performed in the Autonomic Function Testing Laboratory Neuro-hormonal assessment
  • Engage in clinical research in autonomic disorders under a structured mentorship program
  • Complete an elective rotation in Hypertension, Cardiology or Neurology (Movement Disorder, Neuromuscular Disorder Clinic)
  • Attend weekly departmental conferences and scheduled didactic activities

Autonomic clinic: Fellows will be asked to attend a minimum of two afternoon clinics at the Vanderbilt Heart and Vascular Institute Autonomic Clinic each week. Activities will be supervised by one of the dedicated faculty members. Clinic may be moved or canceled during vacation or national meeting times.

Autonomic function testing: Testing occurs five mornings per week in the Autonomic Dysfunction Clinic and at least three times a week in the Autonomic Dysfunction Lab, located close to the Clinical Research Center. The fellow is expected to review and interpret all testing results with supervision of the clinical staff.

Consult service: Fellows will be required to participate in the autonomic inpatient consult service. On average, the consult service has one to two consults per day. Fellows will be asked to rotate for a minimum of four weeks per year. They will evaluate the patient and formulate a treatment plan under the supervision of the attending autonomic physician.

Elective rotation: Movement Disorder Clinic/Cognitive Disorder Clinic and Hypertension clinic due to the frequency of coexistent autonomic failure.

Specialized testing such as microneurography recordings, spectranalysis of blood pressure and heart rate, analysis of cardiac output by impedance and acetylene re-breathing technique, and pharmacological testing is available to fellows during their research rotation. Adequate training in these techniques is available through our dedicated research faculty.

We are now accepting applicants for the 2024-2025 academic year. Requirements for traditional, licensed applicants include:

  • Medical degree from an institution registered in the World Directory of Medical Schools
  • Residency training in Internal Medicine or equivalent
  • Hold a current, active, valid, unrestricted and unqualified license to practice medicine in at least one jurisdiction in the United States, its territories or Canada, and in each jurisdiction in which they practice. If license is restricted, applicant must provide explanation to the Program Director.
  • Board Certification. Faculty Diplomate applicants may include an American Board of Medical Specialties (ABMS) member board or the Royal College of Physicians and Surgeons of Canada (RCPSC); a specialty certification board of the American Osteopathic Association; an appropriate board of the European Union of Medical Specialists; or the medical board of the applicant's country of origin, such board to be approved by the Certification Council.

Requirements for non-traditional, non-licensed applicants include:

  • Medical degree from an institution registered in the World Directory of Medical Schools
  • Residency training in Internal Medicine or equivalent
  • Since non-licensed, must provide explanation to Program Director
  • ECFMG-certified If this applicant is looking at applying for the UNCS certification examination, they would need to have completed the residency and fellowship, have an unrestricted license to practice medicine in the state in which they practice, and met the required 36 months of practice time, excluding residency time, in autonomic disorders.

For additional information, please email Jill Martin, Program Coordinator.

Fellow Testimonial

Vanderbilt's Autonomic group is a leader in autonomic care across the US, and to be part of that is a privilege and prepares me well going forward.

I had the opportunity to work closely with several MDs, researchers, coordinators, and nursing staff who were nothing less than exemplary. There is a sense of a family vibe here, with everyone being very approachable. The department's multidisciplinary team of clinical pharmacologists, cardiologists, neurologists, and geriatricians gives me a uniquely different perspective on managing our patient cohort - something that is not present in similar fellowship programs across the country.

Fellows get stellar clinical opportunities with a busy patient-volume load in outpatient and inpatient services.

The chance to be involved in research and academics is also wide open, with several research mentors available to provide feedback. Personally, the most critical strength I value is the continued presence of the support and mentorship needed to advance my career further.

Amr Wahba, MD

Autonomic Disorders Fellows, 2020-2021

Program Leadership

Cyndya A. Shibao, MD, MSCI

Professor of Medicine
Director, Autonomic Disorders Fellowship Program 

Italo Biaggioni, MD

Professor of Medicine
Director, Vanderbilt Autonomic Dysfunction Center