Focus on Multiple Sclerosis

An MS Fellow explains how she benefited as a physiatrist from a program sponsored by United Spinal Association.

By Seema R. Khurana, DO

While trying to determine what my next step in life would be after residency, Dr. George Kraft was invited to speak at the University of Michigan. During his lecture he discussed multiple sclerosis (MS) and the important role rehabilitation plays in its treatment. As I listened to him, I began to see the significance of that area of rehabilitation medicine. It was at that time that I decided to pursue it further. Soon after his talk, I interviewed at the University of Washington and was offered a position in the Multiple Sclerosis Fellowship Program.

The Multiple Sclerosis Fellowship Program provided me with an invaluable learning experience. Nurtured by its environment, I feel that I grew both professionally and personally during the year.

This program provided me with great mentors, including both a physiatrist and neurologist. Dr. Kraft and Dr. James Bowen taught me about MS on a daily basis and the important role a physiatrist plays in treating a patient with MS. I now understand that since these patients are losing function continuously, as a physiatrist, I can address their changing needs through examination of their cognitive, psychological, physical and vocational status. In addition, I have learned to treat their medical needs, including providing appropriate disease modifying medications, interpreting MRI’s and addressing urological needs.

In my year as MS Fellow, not only did I spend time in clinic, but I was also focused on research. During my clinics, I was able to see patients with MS in a variety of settings including the MS clinic for general visits, the spasticity clinic where patients were evaluated for and given botulinum toxin (Botox®) and phenol injections, and in the electrodiagnostic lab where patients were evaluated for carpal tunnel, radiculopathies, and other neurological problems. Also, I was able to see patients in three different hospitals including the University of Washington Medical Center, the Veterans Hospital of Seattle, and Overlake Hospital (private community). I was able to start two independent research projects, one examining the cognitive demands on functional mobility and the other examining the prevalence of obesity in veterans with MS.

These research projects have provided me with an additional learning experience that I could not have gained in a clinic setting alone. I was awarded the National MS Society Pilot Grant for “The Effects of Cognitive Demand on Functional Mobility in Persons with Multiple Sclerosis.” I had the opportunity to present the preliminary results of both projects at the Consortium of Multiple Sclerosis Centers Annual Meeting, the American Paraplegic Society Annual Meeting and the 22nd Congress of the European Committee for Treatment and Research in Multiple Sclerosis. I also gave a presentation on Cognitive Dysfunction in Multiple Sclerosis at the American Academy of Physical Medicine and Rehabilitation Annual Meeting. Currently, I am working on submitting two papers based on our research findings. In addition to my own research, I was able to participate in clinical trials for new MS medications. These experiences have given me the foundation to build my clinical and research career.

In order to build camaraderie in the Seattle area for physicians that treat patients with MS, I started a journal club for physicians to discuss new articles and difficult cases. This was a great experience because not only did everyone learn about different aspects of MS, but we were able to meet our colleagues in this area on bi-monthly basis.

During my fellowship, I was able to accomplish more than I could have ever imagined. This program exceeded my expectations and gave me a strong base on which to build from for the future. I was able to interview at several programs, and was offered multiple job opportunities in the area of MS.

In October 2006, I began a position in at the University Of Miami School Of Medicine in the PMR department. I am confident that I will be able to contribute to the field of multiple sclerosis through both research and patient care.

The 2006 MS Fellow at the University of Washington Medical School, Seema Khuran, DO, is now a physiatrist and assistant professor of rehabilitation medicine at the University of Miami School of Medicine. The MS Fellowship Program is sponsored by a grant from United Spinal Association.