Department of Neurology History
For over 50 years, Neurology at the University of Miami, Miller School of Medicine, has been a renowned leader, in treating patients from all over the world, in cutting edge research and in training and attracting esteemed faculty. The department’s reputation has been built on the dedication of its chairmen and faculty.
THE BEGINNING, THE MIAMI VA MEDICAL CENTER AT THE BILTMORE HOTEL – 1950 TO 1955
Neurology had a presence in the University of Miami even prior to the opening of the Medical School in 1952. When Dr. Peritz Scheinberg came to Miami from Duke in 1950, he was in part-time private practice and obtained an NIH grant to support studies in human cerebral blood flow and metabolism. His laboratories were in the old ballroom of the original Coral Gables Biltmore Hotel, which had been converted to a Veterans’ Administration Hospital. This was also the site of what was then known as the University of Miami Medical Research Unit, a group of medical investigators located in that same building. Dr. Scheinberg was appointed Assistant Professor of Physiology in that Unit, and his laboratory was active and productive for the next three years, publishing 16 major articles on cerebral circulatory and metabolic functions in various physiologic states and diseases in peer review journals. One of these was the first article to be published under the by-line of the new University of Miami School of Medicine which began its first classes in the fall of 1952. That research was conducted with the assistance of several local practicing physicians whose only motivation was scientific curiosity.
THE EARLY YEARS
Peritz Scheinberg, M.D. – Chairman
In February 1955, the Division of Neurology in the Department of Psychiatry was created with Dr. Scheinberg as Director of that Program with the title of Associate Professor of Neurology. He was the director and only faculty member in that division, which had no established Neurology Service at Jackson Memorial Hospital. Prior toxx this, all Neurology Post-Doctoral teaching and all Neurology consults at Jackson Hospital had been handled by four neurosurgeons, who rotated that responsibility. The first step was to establish a presence for the new Division of Neurology by opening a Neurological Out-Patient Clinic at Jackson, and to begin to provide some teaching in Neurology for the medical house staff at Jackson, as well as the medical students whose clinical years were spent at Jackson. The Division also provided Neurological consultations for private physicians.
The Department of Psychiatry, underwent a series of leadership changes beginning in 1955 and continuing for the next three to four years. Thus, because both Dr. Reinmuth and Scheinberg were trained in and board certified in Internal Medicine as well as Neurology, the Neurology Division sought and achieved a transfer to the Department of Medicine.
Neurology Becomes a Department
By 1961, it became evident that Neurology needed its own representation on the Executive Committee of the Faculty in order to grow and prosper, especially since there were serious internal problems in the Department of Medicine. After prolonged and difficult negotiations, in early 1962, Neurology was granted Department status and could compete for the very limited resources available to the Medical School on a more equitable basis.
By the end of 1962 the Department of Neurology had recruited an outstanding cadre of house officers and had a large and thriving staff and private inpatient services on 4 Woodard and Skaggs. It was providing consultative Neurologic Services for most of South Florida, the Caribbean area, and Central and South America. The cerebral blood flow laboratories competed successfully for research grants, and the laboratory began to attract fellows from other parts of the U.S., South America, Europe, and Japan.
The 1960’s and 1970s – A Period of Expansion
The 1960’s and 1970’s saw the expansion of the clinical programs with the arrival of chiefs and heads for every major neurological specialty. The residency-training program was considered to be of high quality, and was competitive for high quality house officers with the upper echelon of training programs in the U.S. The program accepted six Adult Neurology Residents and one Pediatric Neurology Fellow each year, along with several clinical and research fellows, so that there were 26 to 28 trainees in the Department at any given time.
The Neurology Service at the V.A. Hospital, which moved from the old Biltmore Hotel in Coral Gables to the new facility directly across 12th Avenue from Jackson Memorial Hospital, became an integral part of the Residency Training Program
Following completion of the Rosenstiel Medical Sciences Building in 1969, the face of the campus began to change, and the Department was able to move a considerable portion of its research laboratories out of the crowded, make-shift wooden cottages to the new building. By this time, the University of Miami Cerebral Vascular Research Laboratories had achieved international recognition and scientists from Europe, Israel, South America, and Japan took training fellowships and sabbaticals in the laboratory.
In 1978, the Department of Neurology re-located most of the clinical, administrative, and research activities to the National Parkinson Foundation Building (NPF). This was the result of an agreement between the University and the NPF in agreement which was felicitous for both parties. The University gained much needed space and the NPF as afforded, for the first time, a true clinical and scientific presence.
Continuing Growth in the 1980’s
The 1980’s saw additional specialty expansion and growth in NIH funding.
School. The addition of Neuro-Rehabilitation, Neuro-Oncology, and the Sleep Center increased the breadth of the Department. Dr. Peritz Scheinberg was elected President of the American Neurological Association and the Association of University Professors of Neurology in 1981.
In 1995 the Peritz Scheinberg Chair in Neurology was endowed from gifts from faculty, former residents, patients, friends, and family.
Dr. Scheinberg retired as Chairman in 1989 and, following an interim acting Chairmanship by Dr. Noble David, Dr. Walter Bradley formerly Chairman of the Department of Neurology at the University of Vermont was appointed to the Chair. Dr. Bradley received his neurological training in Great Britain (Oxford and Newcastle upon Tyne) and has had a distinguished career as a clinician and scientist, particularly in neuro-muscular disorders.
THE 1990’S ONWARDS
Walter G. Bradley, D.M., F.R.C.P. – Chairman
The 1990’s, under Dr. Bradley, the full-time faculty of the Department had expanded to 45, a third of whom were basic neuro-science researchers. All were involved in teaching to a greater or lesser extent. In addition, 50 voluntary faculty assisted the full-time faculty in teaching and indigent patient care.
The clinical services covered the whole range of neurological diseases. The department sees patients in the Professional Art Center Clinic, the National Parkinson’s Foundation Clinic, Veterans Administration clinic and the Jackson Memorial Hospital Clinic. the The Department had 40 beds for acute neurological problems in Jackson Memorial Hospital, 35 adult neuro-rehabilitation beds in the Ryder Trauma Center, and 5 – 10 acute and rehabilitation Pediatric Neurology beds. The Neurology Service at the Veterans Administration Hospital has 10 allocated beds. The areas of clinical specialization of the faculty include Stroke, Epilepsy, Movement Disorders, Neuromuscular Disease, Neuropsychology, Multiple Sclerosis, Behavioral Neurology and Dementia; Headaches, Pediatric Neurology, Neuro-Opthalmology, Neurorehabilitation including Brain and Spinal Cord Injury, Neurovirology and AIDS, Neuro-Oncology and Sleep Disorders.
Research extended over virtually the whole range of neurological diseases as well. The Department was one of the largest in the country. Research grants totaled about $3 million per year in direct costs, and about $1.5 million per year in indirect costs. The faculty clinical practice earnings amounted to about $4 million per year, and the total annual budget of the Department was approximately $11 million. There were 21 residents and nearly a dozen fellows in the program.
A major research area of the Department is Cerebral Vascular Disease, the long-term interest of Dr. Peritz Scheinberg. Another is Parkinson’s disease in collaboration with the National Parkinson Foundation. The Cerebral Vascular Disease Research Center, started by Dr. Peritz Scheinberg, is now in its 41st year of NIH funding, and it is the longest continuously funded center in the USA. The very long standing clinical and research effort in Parkinson’s disease continues a long tradition of collaboration with the National Parkinson Foundation, which started and remains based in Miami.
Additional major research groups include those in Neurotransmitters, including Alzheimer’s disease, Neurovirology, and Neurological Complications of AIDS, Spinal Cord Physiology, Neuronal Metabolism, Molecular Genetics, Neuromuscular Diseases, Physiology of Aging of the Nervous System, Epilepsy, and Trauma of the Nervous System. The underlying principle of all of these research groups is that basic research is of crucial importance to advance our understanding of clinical diseases, and that from the collaboration of basic research workers and clinicians comes an improvement in the understanding and treatment of those human diseases. Each of these research groups is responsible for continuing advances in our understanding of the cause and cure of human neurological diseases, and for teaching clinicians and research workers from all over the world who return to their own cities and countries to continue this work.
Dr. Bradley retired in 2006. In April of 2007, Dr. Ralph Sacco became the third Chairman in the department’s history. He was recruited from Columbia Presbyterian and is a world-renowned neurologist specializing in Stroke. In 2010, he became the first neurologist to become President of the American Heart Association.
THE CONTINUING SUCCESS STORY
Ralph L Sacco M.D., M.S. – Chairman
Today, under Dr. Ralph L. Sacco, the Department of Neurology is one of the premier Departments in the country with more than 70 renowned research and clinical faculty in most of the neurological sub-specialties. Together with Neurosurgery, US News and World Report ranked us in the top 50 among departments in the country and our department ranked in the top 16 in NIH funding.
The mission of the Department has grown to fourfold—to expand the knowledge of the causes, treatments, and cures for neurological disease; to conduct cutting-edge research; to provide unparalleled care to patients and to train the next generation of practitioners and neuroscientists.
Widely recognized as an international referral center, neurologists from Latin America and all over the United States turn to UM faculty for expertise in solving complex neurological problems. The department has grown to fourteen clinical divisions and programs that offer patient care. They are:
Memory Disorders and Alzheimer’s
Movement Disorders (including Parkinson’s)
Neuromuscular Disorders (including ALS)
The number of patients cared for by the Department is impressive; as an example, there are about 2,500 patients with movement disorders, 2000 patients with multiple sclerosis, 1000 patients with cognitive impairment, 1500 with stroke and about 300 patents with ALS.
The physicians and scientists within the Department also conduct cutting-edge clinical and basic science laboratory research in a variety of program areas including Cerebrovascular Disease; ALS and other neuromuscular diseases; Epilepsy; genetic and mitochondrial diseases of the nervous system; movement disorders and degenerative diseases; neuro-pharmacology; and neurophysiology. The Department has achieved particular distinction for research in Cerebral Vascular disease. Also, Centers of Excellence with clinical and research focus on Parkinson’s disease and Multiple Sclerosis have been fostered by long term collaborations with the National Parkinson Foundation and the National MS Society.
The Department of Neurology is home to the McKnight Brain Institute which conducts clinical and basic research in the area of age related memory loss and the Brain Endowment Bank, which banks and studies the human brain affected by Parkinson’s disease and other movement disorders, drug addiction, and aging.
With offices in Palm Beach, Miami, Plantation, Kendall and Hialeah; major scientific advances to its credit and vast expertise, the Department of Neurology is committed to solving the puzzle and finding a cure for neurological diseases in this generation.