����һ������

Fifty years ago, neurologists were able to diagnose devastating brain diseases but had little to offer patients beyond information. Today, many of those same conditions can be treated, slowed or even prevented through advances once thought impossible.

This transformation over time mirrors the progressive evolution of the at The University of Texas at San Antonio (UT San Antonio). 

Established in 1975 as a division within the Department of Medicine at the Joe R. and Teresa Lozano Long School of Medicine, the program began with a small group of physician-scientists committed to understanding the brain and training future neurologists for a rapidly changing field. That same year, the institution launched its neurology residency program — a decision that would shape brain healthcare across South Texas for decades to come.

What followed was strategic growth over the next five decades driven by collaboration, mentorship and scientific curiosity. These qualities continue to define the department today as it celebrates its 50th anniversary.

Building from the ground up 

When J. Donald Easton, MD, arrived in San Antonio in 1982 at the invitation of Jay Stein, MD, then-chair of the Department of Medicine in the Long School of Medicine, neurology was still a small division, but it had ambitious plans. Leaders anticipated expanding faculty and residency training with the long-term goal of becoming an independent department.

“The opportunity was clearly there. They saw the original opportunity for what could grow,” Easton said. Resources were limited, but momentum was strong. With only a handful of faculty members, Easton helped recruit additional specialists and strengthened residency education.“Getting good residents is not a simple matter. But in San Antonio there was, in a sense, no competition,” he said. 

Among the early faculty hires was John Carter, MD, who joined Easton along with David Sherman, MD, and Robert Hart, MD, who helped build the clinical and academic framework nearly from scratch. 

Six faculty members initially covered inpatient services across two hospitals while simultaneously developing programs for patient care and resident training. Stroke research quickly emerged as a defining strength, supported by National Institutes of Health-funded studies that helped establish San Antonio as a leader in vascular neurology.

Faculty expanded electroencephalography, or EEG, services; laid groundwork for epilepsy monitoring; and introduced neuro-ophthalmology care to the South Texas area. Faculty often balanced weighty clinical responsibilities with research and academic development. “There was a lot of need,” Carter said. “It was an undeveloped division that needed the essentials.”

From division to department

Over the years, several key milestones marked the department’s transformation.

•  A clinical neurophysiology fellowship program launched in 1996, expanding subspecialty training and research capacity. 
• Growth accelerated in 2007, when neurology officially became an independent department.
• When Robin Brey, MD, was appointed founding chair of the Department of Neurology in 2009, it marked a pivotal moment in the program’s evolution. Becoming a department created new opportunities to recruit faculty and expand clinical and research programs across major areas of neuroscience. 

“It was an incredible honor to be appointed the founding chair. Moving from a division to a department meant there was already an extraordinary group of faculty in place and tremendous opportunity to grow in all our missions,” said Brey.

During her tenure, neurology also became part of the core curriculum for medical students. This introduced students to the field earlier in their training. At the same time, residency and fellowship programs expanded significantly. Brey credits the institution’s collaborative culture for enabling that progress. “The environment of mentorship and support here allows people to grow and succeed. It also creates opportunities for multidisciplinary collaboration that help research, education and clinical care thrive,” she said.

Among the developments she finds especially meaningful was the launch of the Glenn Biggs Institute for Alzheimer’s and Neurodegenerative Diseases in 2017, which established the institution as a leader in neurodegenerative disease research, patient care and caregiver support.

Training future neurologists

Throughout the years, a commitment to education has remained a core mission of the department. In 2010, the number of resident positions increased to nine and then to 12 by 2016. In 2017, the residency program transitioned to a categorical program and doubled in size to 24 positions. The program continued to grow, increasing to 28 positions in 2020 and to 36 positions in 2022 — a remarkable leap from the program’s earliest years.

To meet the growing demand for neurology subspecialists, fellowship training programs expanded. In 2011, the addition of the vascular neurology fellowship program reinforced the department’s longstanding leadership in stroke care. An epilepsy fellowship program was established in 2015, followed by a movement disorders fellowship program in 2019, a neuropsychology postdoctoral fellowship program in 2020 and a neuroimmunology fellowship program in 2022. The behavioral neurology fellowship program, a partnership with the Biggs Institute, was also added in 2022.

In 2014, neurology became a core clerkship that introduced medical students to the specialty earlier.

A field transformed

The department’s growth paralleled dramatic scientific revolutions in brain imaging and other neurological diagnostic tools. When Carter began practicing medicine, diagnostic tools were limited. CT imaging was still emerging, MRI technology was unavailable at some local hospitals and evaluating neurological disease sometimes required invasive procedures.

“We had plain skull X-rays or radioisotope brain scans that only gave a vague picture showing a bit more activity in a region, but there are 20 different things it could be. CT scans and MRIs changed that tremendously,” Carter said.

Stroke care, however, most vividly illustrates the remarkable strides in the field. “Forty years ago, if you were having a stroke, there was not much we could do,” Easton said. As the field shifted from siloed neurology to multispecialty clinical neuroscience, coordinated stroke teams were able to mobilize quickly to remove clots, restore circulation and preserve brain tissue, dramatically improving the odds of survival and recovery. “These days, you wouldn’t dream of a department of neurology not being surrounded by neurosurgery and radiology,” Easton said.

Neurology today and tomorrow

When began in the department as a resident and later as a faculty member in the late 1980s, the department included seven neurologists who were primarily focused on stroke research and care. 

“When I was a resident, we didn’t even have MRIs. We could diagnose disease, but we had very little to offer patients,” said Jackson, chair of the Department of Neurology in the Long School of Medicine and professor of neurology and otolaryngology.

Today, the Department of Neurology spans nearly every subspecialty and works closely with the to advance care for many conditions, including Parkinson’s disease, amyotrophic lateral sclerosis, or ALS, and dementia. Just one incoming residency class now exceeds the size of the entire program from decades ago. Seven fellowship programs support advanced training, while 115 active clinical trials provide patients with access to emerging therapies. Dedicated infusion services deliver treatments, supported by advanced technology, including .

“Every year I’ve been here, there has been a dramatic increase in what we can offer,” Jackson said. “While it’s not always cures, many treatments now extend life or improve quality of life.” She sees a bright future in preventive neurology, using biomarkers, genetics and early detection to protect brain health across the lifespan. “We’re beginning to think about how we protect the brain from conception through the entire lifespan,” Jackson said.

Culture that endures

Despite its growth, one defining feature of the department remains unchanged — its extraordinary people. “I loved my program because it felt like family,” Jackson said of her time as a resident and young faculty member. 

For decades, mentorship has shaped departmental success. Senior leaders invested deeply in junior faculty, both professionally and personally, which fostered a culture Jackson now sustains through engagement, leadership development and physician wellness initiatives.

From early gatherings in faculty members’ homes to today’s multidisciplinary teams, collaboration remains central as the department moved from a trailer and modest offices to state-of-the-art facilities at the Center for Brain Health. “My job is fun. It’s an incredible blessing,” Jackson said.

The next frontier

Easton, Carter and Jackson all believe some of the most important discoveries in brain health are yet to come for Alzheimer’s and other neurodegenerative diseases. “We used to think cures for these brain diseases would never happen in our lifetime. But now, there is a high probability they will,” Easton said.

Carter believes future breakthroughs will emerge from a growing understanding of immune biology and the brain’s interaction with systems throughout the body. “If the advances in the next 40 years are like the last 40, it’s going to be beyond anything we can imagine,” he said.

With brain science accelerating rapidly, possibilities are expanding and the Department of Neurology at UT San Antonio stands ready to lead the way as a comprehensive academic enterprise advancing patient care, education and discovery across South Texas and beyond.