History and Background

The Professional Master’s Degree Program in Neurology and Clinical Neurosciences (PMDPNCN) at the Ribeirão Preto Medical School, USP (FMRP-USP) was proposed in 2013 as part of the CAPES initiative to encourage the training of professional masters qualified to develop activities and technical-scientific works on topics of public interest in the health area (Ordinance No. 17 of 28/12/2009 and Notice No. 02 DAV/CAPES-2009-Professional Master’s Degree Associated with Residency Programs in Health).

 

The program was developed based on an extensive history of training qualified human resources in our institution and due to the high demand for specific professional training in our society.

The General Hospital of the Ribeirão Preto Medical School-USP (HCFMRP-USP) is a national reference in the qualification and training of health professionals. The Department of Neurosciences and Behavioral Sciences at the FMRP-USP coordinates the Medical Residencies in Neurology and Neuropediatrics at the HCFMRP-USP. The Neurology and Neurosciences program received grade 7 by CAPES in the last five assessments.

The Medical Residency Program in Neurology at HCFMRP-USP, linked to the Department of Neurosciences and Behavioral Sciences initiated the activities in February 1961. It trains physicians who are specialists in Neurology, preparing them for the clinical practice considering the technical and ethical aspects. The residents are supervised by professors and assistant physicians of the Neurology Discipline of the Department of Neurosciences and Behavioral Sciences at FMRP-USP. The Medical Residency Program in Neurology is approved by the National Committee for Medical Residency and the Brazilian Academy of Neurology and consists of three years in the specialty of Neurology and an optional 4th year in Clinical Neurophysiology. The course offers 56 vacancies for the Medical Residency in Neurology (14 for R1, 14 for R2, 14 for R3, and 14 for R4), making the HCFMRP Medical Residency Program one of the largest in the country. The Foundation for Administrative Development of the State of São Paulo (FUNDAP) and the Ministry of Health have been awarding grants for the first three years and for the Clinical Neurophysiology (R4). The Residency Program in Pediatric Neurology consists of two years and has three vacancies each year, one for the 3rd year (R3) and one for the 4th (R4). The vacancies can be for graduates from either the Neurology or Pediatrics Program. Both Neurology and Neuropediatrics Residency programs are open to physicians from all over the country, selected through public notice.

Despite the proven success of the medical residency programs in training specialists in Neurology and Neuropediatrics, specific training in some sub-specialties of these areas (such as cerebrovascular diseases, dementias, extra-pyramidal diseases) is essential for the leadership in specialized units (stroke units, specialized outpatient clinics, botulinum toxin services, etc.). Also, specific training is not covered in medical residency programs. The motivation for this professional master’s program was the frequent search of neurologists for additional specialized training in specific areas to meet the demand of public and private health services. Therefore, training leaders in these subspecialties requires additional training that is not covered in medical residency programs in neurology and child neurology. In this sense, a professional master’s program is a prominent solution to provide professional training in the sub-specialties of Neurology, combined with a solid academic background in applied clinical research.

Among some reasons that stimulated the establishment of the MPNNC, we highlight:

1. The importance of subspecialties as areas of the medical practice in Neurology.

2. Several diseases, which comprise these subspecialties, are serious public health problems in the country, such as neurodegenerative diseases (dementias) and neurovascular diseases (CVA).

3. The lack of public policies to encourage the qualification of these professionals who are subspecialized in Medical Residency Programs. Specific training in some subspecialties of Neurology, such as neurovascular diseases and dementias, are not covered by medical residency programs.

4. The high local demand for medical training in neurological subspecialties, which does not have a specific course.

Historically, the graduate program in Neurology was launched on June 15, 1971 and it was approved by the Federal Council of Education in 1975 and 1985. In its more than 40 years of existence, it has graduated more than 200 masters and more than 120 Ph.D. who currently work mainly in Public Universities in the country. The Program initially aimed at neurologists, included in 2001, two areas of concentration: 1) Neurology, for neurologists (who have already had at least two years of medical residency in Neurology); 2) Neurosciences, for physicians not specialized in Neurology and non-medical professionals in biological areas, or whose investigative interest involves neurosciences.

The development of diagnostic and therapeutic techniques and methods in the last decades has demanded more qualified neurologists. Despite the high prevalence and socioeconomic impact of some conditions such as stroke, dementia, and other neurodegenerative diseases, the country requires professionals specialized.

Therefore, we aimed to create a continuing education center at the HCFMRP-USP to train professionals and human resources in neurology with social responsibility to disseminate knowledge. This initiative reinforces the University of São Paulo’s commitment to the community in training professionals in the field of Neurology. This proposal was a pioneer in neurology in the country among the programs in Medicine II. The demand to be met comprises neurologists and neuropediatricians in programs approved by the CNRM in the various states of Brazil. All of these factors evidence the importance of creating a formal graduate course such as the MPNNC. This course meets the demand for professional qualifications necessary for health services, allowing the training of medical professionals to act critically and innovatively in their area of expertise.

The program is organized into two major areas of concentration:

1. Developmental Neurology and Clinical Neurophysiology,

2. Chronic-Degenerative and Immune-Mediated Nervous System Diseases.

The lines of research are:

1. Vascular neurology,

2. Movement disorders and behavioral neurology,

3. Pediatric neurology,

4. Neuromuscular diseases and neuroimmunology,

5. Video/EEG-Invasive Electrophysiology,

6. Electroneuromyography.

 

By 2019, 42 students have already defended their professional master’s degree in the program (ANNEX 8):

2015 – 1 defense

2016 – 13 defenses

2017 – 10 defenses

2018 – 6 defenses

2019 – 12 defenses

2020 – 7 defenses

2021 – 1 defense so far

 

As we will illustrate in the following sessions, the program graduates have assumed a prominent role in the care practice, many of them are leaders and coordinate services in their sub-specialty in the country.

Prof. Carolina Araújo Rodrigues Funayama, pediatric neurologist and senior professor at the Department of Neurosciences and Behavioral Sciences, retired since 2013, supervised her last student in 2017, and requested her dismissal from the program.

Unfortunately, Prof. Amilton Antunes Barreira, who was the first coordinator of our program and played a significant role in consolidating the professional master’s degree in neurology at USP, passed away in 2018. His students completed their defenses in 2019 under the supervision of Prof. Vanessa Daccach Marques, a neurologist and professor at the FMRP. She joined the program and also works with lines of research in neuroimmunology.

Also, Prof. Marcelo Riberto, from the physiatrics area, requested his dismissal from the program in 2019 to manage the Lucy Montoro Rehabilitation Center in Ribeirão Preto.

In 2021, three new advisors were admitted: Prof. Millene Rodrigues Camilo (permanent advisor) is currently a postdoctoral fellow in our department and professor of the PART program at USP, which came to strengthen the research line of Vascular Neurology; Prof. Patrícia Aparecida Zuanetti (specific advisor) speech therapist, who came to strengthen the line of research in pediatric neurology with her expertise in language development disorders; and Prof. Marcelo Volpon Santos (specific advisor), pediatric neurosurgeon, directly involved in the successful separation surgeries for the Siamese twins from Ceará, which brought international visibility to HCFMRP-USP. He also came to strengthen the line of research in Pediatric Neurology.

Finally, the COVID-19 pandemic brought new challenges to the program, especially regarding online distance learning platforms, social distancing, and mandatory personal protective equipment in practical activities. Measures for rescheduling outpatient appointments for stable patients were taken by the administration of HCFMRP-USP, as well as the implementation of telemedicine for outpatient appointments for neurological patients. In this way, the faculty and students have been adapting to ensure the quality of professional training and minimize the impacts of the pandemic.

List of dissertation defenses carried out in the quadrennium:

2020

1. Title: “Avaliação de pacientes submetidos à trombectomia mecânica com janela estendida para o tratamento de acidente vascular cerebral isquêmico por oclusão arterial proximal de circulação anterior em um hospital público brasileiro”

Student: Mayara Thays Beckhauser

Advisor: Octávio Marques Pontes Neto

Defense: 04/11/2020

 

2. Title: “O eletrodo de forame oval pode identificar a zona epileptogênica na epilepsia do lobo temporal mesial quando o EEG de superfície é inconclusivo?”

Student: Izabela Dayany França Feitosa

Advisor: Tonicarlo Rodrigues Velasco

Defense: 19/10/2020

 

3. Title: “Avaliação de qualidade de vida e sobrecarga do cuidador em crianças e adolescentes submetidos à cirurgia para tratamento da epilepsia farmacorresistente”

Student: Suenia Timotheo Figueiredo Leal

Advisor: Ana Paula Andrade Hamad

Defense: 25/08/2020

 

4. Title: “Dispersão temporal na análise eletrofisiológica dos pacientes com Doença de Charcot-Marie-Tooth ligada ao X”

Student: Rodrigo Assad Diniz da Gama

Advisor: Wilson Marques Júnior

Defense: 11/05/2020

 

5. Title: “Caracterização clínico-radiológica da apatia pós-acidente vascular cerebral”

Student: Rodrigo de Souza Castro

Advisor: Octávio Marques Pontes Neto

Defense: 06/05/2020

 

6. Title: “O impacto de uma unidade de acidente vascular cerebral em um hospital universitário brasileiro”

Student: Luisa Franciscatto

Advisor: Octávio Marques Pontes Neto

Defense: 11/02/2020

 

7. Title: “Preditores de desfecho em pacientes com infarto maligno do território da artéria cerebral média submetidos à craniectomia descompressiva”

Student: Luiz Fernando Rodrigues de Oliveira

Advisor: Octávio Marques Pontes Neto

Defense: 11/02/2020

 

 2019

 

1. Title: “Caracterização do diagnóstico e tratamento do transtorno de déficit de atenção e hiperatividade (TDAH) realizada por uma amostra de neurologistas infantis brasileiros”

Student: Marina Estima Neiva Nunes

Advisor: Ana Paula Andrade Hamad

Defense: 06/12/2019

 

2. Title: “Doença de Parkinson prodrômica em pacientes com Tremor Essencial de início tardio e precoce em um ambulatório especializado”

Student: Winnie Perissini Blasque

Advisor: Vitor Tumas

Defense: 05/12/2019

 

3. Title: “Avaliação da qualidade de vida de pacientes com tremor essencial e tremor essencial plus atendidos no Hospital das Clínicas de Ribeirão Preto”

Student: Marília Pereira Graner

Advisor: Vitor Tumas

Defense: 14/11/2019

 

4. Title: “Caracterização clínica da mialgia, fadiga e cãibra nos pacientes com intolerância ao exercício e deleções múltiplas do DNA mitocondrial”

Student: Lucas Ravagnani Silva

Advisor: Claudia Ferreira da Rosa Sobreira

Defense: 04/11/2019

 

5. Title: “Prevalência das ‘síndromes de tremor’ em um ambulatório especializado”

Student: Nayara dos Santos Reimer

 

Advisor: Vitor Tumas

Defense: 17/10/2019

 

6. Title: “Prevalência de transtornos psiquiátricos e alcoolismo em uma amostra de pacientes com tremor essencial”

Student: Drielle Nogueira Sales

Advisor: Vitor Tumas

Defense: 10/10/2019

 

7. Title: “Operacionalização e resultados da aplicação do Core set resumido de 6 a 14 anos da Classificação Internacional de Funcionalidade, Incapacidade e Saúde para crianças e jovens com paralisia cerebral”

Student: André Luiz da Silva Manganelli

Advisor: Marcelo Riberto

Defense: 24/07/2019

 

8. Title: “Distribuição da fraqueza na Distrofia Muscular de Cinturas 2B com ênfase nos membros superiores”

Student: Emília Caram Bordini

Advisor: Claudia Ferreira da Rosa Sobreira

Defense: 25/04/2019

 

9. Title: “Avaliação neurológica de recém-nascidos com microcefalia secundária à infecção congênita pelo vírus Zika”

Student: Marili André Coelho

Advisor: Ana Paula Andrade Hamad

Defense: 22/03/2019

 

10. Title: “Alterações na sensibilidade superficial no eixo corporal nas polineuropatias desmielinizantes adquiridas”

Student: João Paulo Elias Alves

Advisor: Amilton Antunes Barreira

Defense: 15/03/2019

 

11. Title: “Tradução, adaptação transcultural e validação da escala global de avaliação das incapacidades na neuropatia motora multifocal”

Student: Paulo Sérgio Rosa Moreira

Advisor: Amilton Antunes Barreira

Defense: 15/03/2019

 

12. Title: “Capacidade de reconhecimento facial de emoções em pacientes com espasmo hemifacial”

Student: José Guilherme Schwam Junior

Advisor: Vitor Tumas

Defense: 01/03/2019

 

2018

 

1. Title: “Situações de ansiedade aumentam a frequência e a gravidade do espasmo hemifacial?”

Student: Herculano Roberto Ricordi Barbosa

 

Advisor: Vitor Tumas

Defense: 08/11/2018

 

2. Title: “Aspectos clínicos, demográficos e neurocomportamentais em pacientes com espasmo hemifacial”

Student: João Alves Cardoso Júnior

Advisor: Vitor Tumas

Defense: 06/09/2018

 

3. Title: “Associação entre hemimegalencefalia e esclerose tuberosa em pacientes com epilepsia”

Student: Larissa Cristina de Queiroga Mendonça Coutinho

Advisor: Ana Paula Andrade Hamad

Defense: 20/06/2018

 

4. Title: “Manejo de fármacos antiepilépticos após hemisferotomia: implicações em recorrência de crises, aspectos práticos, neuropsicológicos e do desenvolvimento”

Student: Larissa Aparecida Batista

Advisor: Ana Paula Andrade Hamad

Defense: 29/05/2018

 

5. Title: “Análise do fluxo sanguíneo colateral em pacientes com AVC isquêmico por oclusão proximal da artéria cerebral média”

Student: Daniel Escobar Bueno Peixoto

Advisor: Octávio Marques Pontes Neto

Defense: 09/05/2018

 

6. Title: “Associação entre características tomográficas do osso temporal e a qualidade da janela transtemporal com o ultrassom transcraniano colorido em pacientes com AVC e AIT: estudo observacional analítico”

Student: Rodrigo Tavares Brisson

Advisor: Octávio Marques Pontes Neto

Defense: 09/05/2018

 

2017

 

1. Title: “Fatores preditivos de quedas em pacientes com acidente vascular cerebral”

Student: Luiz Henrique Soares Santos Stefano

Advisor: Taiza Elaine Grespan dos Santos

Defense: 23/11/2017

 

2. Title: “Mortalidade dos pacientes do espectro de neuromielite óptica”

Student: Alexandre Marreco de Oliveira

Advisor: Amilton Antunes Barreira

Defense: 12/09/2017

 

3. Title: “Epilepsia reflexa evacuatória: revisão de literatura e descrição de caso clínico com registro de crise ao vídeo-eletroencefalograma”

Student: Renata Pina Rocha

Advisor: Ana Paula Andrade Hamad

Defense: 14/06/2017

 

4. Title: “Triagem e diagnóstico de dificuldades de aprendizagem – Aplicação e desfecho de avaliações interdisciplinares de uma série de casos”

Student: Larissa Solange Moreira Paterlini

Advisor: Ana Paula Andrade Hamad

Defense: 12/06/2017

 

5. Title: “Assimetrias no exame neurológico de crianças com síndrome de Guillain-Barré”

Student: Pedro Henrique Marte de Arruda Sampaio

Advisor: Amilton Antunes Barreira

Defense: 12/06/2017

 

6. Title: “Doença de Charcot-Marie-Tooth ligado ao X em crianças: série de casos tipo 1 de pacientes do HC-FMRP”

Student: Mariana Neiva Cruz

Advisor: Carolina Araujo Rodrigues Funayama

Defense: 30/05/2017

 

7. Title: “Avaliação de processos motores e cognitivos em pacientes com cãibra do escrivão”

Student: Ana Luiza Nunes Cunha

Advisor: Vitor Tumas

Defense: 29/05/2017

 

8. Title: “Caracterização da dor em pacientes com distrofia facioescapuloumeral”

Student: Camila de Aquino Cruz

Advisor: Claudia Ferreira da Rosa Sobreira

Defense: 29/05/2017

 

9. Title: “Operacionalização e resultados da aplicação do core set resumido de 0 a 18 anos da Classificação Internacional de Funcionalidade, Incapacidade e Saúde para crianças e jovens com paralisia cerebral”

Student: Rafaela Pichini de Oliveira

Advisor: Marcelo Riberto

Defense: 11/04/2017

 

10. Title: “Avaliação da prevalência de sintomas não motores em pacientes com distonias focais e segmentares idiopáticas”

Student: Nathália Novaretti

Advisor: Vitor Tumas

Defense: 07/03/2017

 

2. Title: “Pesquisa da mutação C9ORF72 e de suas características clínicas nos pacientes portadores de esclerose lateral amiotrófica, demência frontotemporal e parkinsonismo atípico”

Student: Daniel Sabino de Oliveira

Advisor: Vitor Tumas

Defense: 17/10/2016

 

3. Title: “Qualidade da janela transtemporal definida pelo ultrassom transcraniano colorido”

Student: Renata da Silva Almeida Santos

Advisor: Octávio Marques Pontes Neto

Defense: 17/10/2016

 

4. Title: “Aspectos clínico-neurológicos da neuropatia motora multifocal”

Student: Paula Marques Lourenço

Advisor: Amilton Antunes Barreira

Defense: 11/07/2016

 

5. Title: “Caracterização clínica, laboratorial e de neuroimagem de pacientes com doença mitocondrial associada à mutação m.3243A>G”

Student: Margleice Marinho Vieira Rocha

Advisor: Claudia Ferreira da Rosa Sobreira

Defense: 01/07/2016

 

6. Title: “Aspectos da assistência ambulatorial na área de neurologia infantil na rede regional de atenção à saúde 13 (Araraquara – Barretos – Franca – Ribeirão Preto)”

Student: Nelson Macedo Liporaci

Advisor: Carolina Araujo Rodrigues Funayama

Defense: 28/06/2016

 

7. Title: “Análise genética em uma amostra de pacientes brasileiros portadores de doença de Parkinson: estudo de mutações no gene LRRK2”

Student: Raquel Silveira Jesuino e Silva

Advisor: Vitor Tumas

Defense: 28/06/2016

 

8. Title: “Genótipos da Apolipoproteína E em pacientes brasileiros com doença de Parkinson e sua correlação com desempenho cognitivo avaliado pelo MoCA”

Student: Manuelina Mariana Capellari Macruz Brito

Advisor: Vitor Tumas

Defense: 14/06/2016

 

9. Title: “Proposta para o registro de acidente vascular encefálico em crianças”

Student: Reinaldo Regis Silva

Advisor: Carolina Araujo Rodrigues Funayama

Defense: 10/06/2016

 

10. Title: “Avaliação clínica de pacientes com distonia idiopática”

Student: Torben Cavalcante Bezerra

Advisor: Vitor Tumas

Defense: 03/05/2016

 

11. Title: “Avaliação da frequência e gravidade da estenose intracraniana nos pacientes com AVCI e AIT através da ultrassonografia transcraniana colorida e angiotomografia de crânio”

Student: Letícia Januzi de Almeida Rocha

Advisor: Octávio Marques Pontes Neto

Defense: 03/02/2016

 

12. Title: “Preditores de oclusão arterial proximal em pacientes com acidente vascular cerebral de circulação anterior, baseados na avaliação clínica e na tomografia de crânio não-contrastada”

Student: Rui Kleber do Vale Martins Filho

Advisor: Octávio Marques Pontes Neto

Defense: 02/02/2016

 

13. Title: “Acurácia da ultrassonografia transcraniana colorida no diagnóstico de forame oval patente”

Student: Milena Carvalho Libardi

Advisor: Octávio Marques Pontes Neto

Defense: 26/01/2016