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International Parkinson and Movement Disorder Society
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        VOLUME 29, ISSUE 1 • MARCH 2025.  Full issue »

Knowledge without borders in South America: An MDS Center-to-Center Program experience 


The growing global demand for better care for people with movement disorders underscores the unequal availability of high-quality local training opportunities. Skilled neurologists enhance patient care, deepen our understanding of movement disorders, and take on inspiring roles as educators and leaders.  

Latin America and the Caribbean exceed 630 million people. Marked by ethnic diversity, cultural hybridization, and economic and social inequality, the region suffers educational gaps and unequal access to healthcare and specialists. This underrepresented region faces considerable challenges in movement disorders, struggling with the lack of local training opportunities. To illustrate, North America has at least 88 fellowship positions available1, whereas Latin America has only a handful of programs in very few countries.  

The International Parkinson and Movement Disorder Society (MDS) offers innovative solutions to address these disparities and elevate global management and understanding of movement disorders. The MDS Center to Center Program is a powerful opportunity to make dreams a reality through dedicated implementation. This program fostered an inspiring collaboration between the Hospital de Clínicas Universitario in La Paz, Bolivia, and the Center for Movement Disorders CETRAM in Santiago, Chile, embodying the encouraging power of unity and a shared vision. 

Bolivia has about 12 million people, many living in poverty, with over 40% identifying as indigenous. In 2017, the Bolivian Society of Neurology registered 70 neurologists and three neurology residency programs. Their needs and disadvantages are palpable, yet individual efforts, such as those of Dr. Erik Gonzalez in Santa Cruz, stand out as beacons of hope. On the other hand, Chile has fostered a remarkable network of movement disorders neurologists, locally driven by the pioneering work at CETRAM, an established center in South America. 

The MDS allocated an online platform to create a comprehensive curriculum for Drs. Rosario Jauregui and Sergio Silva from La Paz, using resources from the MDS website. At CETRAM, all academic activities transitioned to a hybrid format, allowing mentees to participate online in CETRAM educational meetings. This setup enabled them to take on the responsibilities of regular fellows, deliver presentations, and complete assessments. A clinic equipped with audiovisual technology was established, allowing them to join remotely. 

When mentees visited CETRAM, they completed ultrasound-guided botulinum toxin injections and deep brain stimulation (DBS) programming workshops and attended DBS surgeries. 

When mentors visited La Paz, they attended patients with movement disorders, delivered lectures for residents and neurologists, and conducted hands-on workshops on botulinum toxin injections. They also gave talks to the community and launched awareness initiatives through local radio interviews. 

During their training period, Dr. Jauregui and Dr. Silva volunteered at their hospital, providing care for patients with Parkinson's disease and other movement disorders. This two-year invaluable experience has led to the establishment of the first movement disorders unit in a public hospital in Bolivia and motivated us to continue with a two-year hybrid fellowship program for colleagues lacking local training opportunities in Latin America. 

We envision this initiative as a catalyst for greater collaboration among specialized centers in Latin America, empowering the future of regional education in movement disorders. 

 

References

  1. Ratliff JB, Schaefer SM, Chitnis S, Cooney JW, Hess CW, Okubadejo N, Shalash A, Moro E, Sue C, Pandey S, Pal PK, Yang L. Viewpoint on Milestones for Fellowship Training in Movement Disorders. Mov Disord. 2022 Aug;37(8):1605-1609. doi: 10.1002/mds.29146. Epub 2022 Jul 11. PMID: 35816077; PMCID: PMC9543200. 

 

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