The Clinical Neurophysiology Electroencephalography Fellowship begins with the two-month Clinical Neurophysiology Introductory Course that covers all areas of clinical neurophysiology. The anatomy, physiology, pathophysiology, and clinical neurophysiological features of disease are emphasized, along with technical aspects of testing methods.

Clinical training

During the subsequent months, you alternate rotations in the electroencephalography laboratory and epilepsy hospital-based services.

Rotations

• Electroencephalography (EEG). In the EEG lab, you interpret a large number of both routine and ambulatory EEG records from adults and children with a wide variety of disorders. Our lab performs more than 4,000 routine EEGx and more than 250 ambulatory EEGs annually, ensuring you will experience a wide variety of clinical scenarios and associated EEG findings.
• Evoked potentials. You also read evoked potentials two days per week during their EEG lab rotation. This includes brainstem auditory evoked responses, visual evoked responses, and somatosensory evoked potentials.
• Surgical and ICU Monitoring Service (SIMS). On the SIMS service you perform all monitoring for adult inpatient non-EMU hospital prolonged EEGs, pediatric and neonatal ICU prolonged EEGs, intraoperative EEG monitoring for vascular surgeries, intraoperative electrocorticography, extra- and intraoperative stimulation mapping, and stereoelectroencephalography (SEEG) monitoring performed for surgical epilepsy evaluations. Our SIMS service is responsible for more than 2,500 studies annually.
• Epilepsy monitoring units (EMU). In the EMU you monitor patients during evaluations for epilepsy and other types of spells. Both adult and pediatric EMU rotations are included throughout the year. In the EMU you also assess patients with drug-resistant epilepsy for epilepsy surgery, including planning additional studies and, when appropriate, preliminary SEEG planning based on the initial non-invasive evaluation. You present these patient cases at our weekly surgical epilepsy conference. Our EMUs admit more than 900 patients annually.
• Epilepsy clinic. A clinically-grounded education is important in understanding neurophysiology. Clinical neurophysiology electroencephalography fellows see patients in the epilepsy clinic and maintain a continuity clinic of patients with epilepsy to understand the clinical intersection of EEG and epilepsy. Clinics may be adult or pediatric based on your training background.
• Neurophysiology selective. As part of the ACGME accreditation, all fellows must have two months of a non-electroencephalography clinical neurophysiology selective of their choice from one of the following: intraoperative neurophysiologic monitoring (IONM), electromyography (EMG), or sleep medicine.

Didactic training

In addition to two months of intensive clinical neurophysiology introduction, you attend clinical conferences, lectures, lecture-demonstrations, Journal Club lectures, seminars, and small discussion groups as part of the clinical neurophysiology electroencephalography curriculum.

You also attend other seminars and conferences related to electroencephalography and epilepsy care.

• EEG Planning Conference (weekly)
• Epilepsy Surgical Conference (weekly)
• Interesting EEG Conference (every other week)
• Interdisciplinary and Cares Meeting (monthly)
• Epilepsy Division Tri-Site Video Conference (quarterly)
• Outcome Case Presentations (quarterly)
• ACNS In-Service Exam Prep Course (January-February) 

You also may attend other weekly seminars and conferences in neurology, neuropathology, and pediatric neurology.

Research training

Fellows are expected to complete at least one investigative project during their training. The type of research project you select depends on personal interests, capabilities, and the time available. Opportunities are available for collaborative studies with other clinical and basic science sections at Mayo Clinic.

You are expected to present completed research at a scientific meeting or prepare it for publication in a scientific journal. This experience teaches how to comprehend and critically evaluate other reported investigations and gain insight into the conduct and principles of research. Mayo covers the expenses for travel, hotel, and registration to support the presentation of research performed during fellowship training.

Evaluation

You are evaluated by supervising faculty members after each clinical rotation and meet with your program director on a quarterly basis to get comprehensive feedback on your performance in addition to the active feedback you receive during rotations.

You are also asked to regularly evaluate the faculty to ensure that your educational needs are being met. The EEG and epilepsy program directors meet regularly with fellows as a group on a weekly basis to communicate relevant department information and give fellows a venue to provide program feedback in order to effect positive change quickly.