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.
During the subsequent months, you alternate rotations in the electroencephalography laboratory and epilepsy hospital-based services.
Electroencephalography (EEG). In the EEG lab, you interpret a large number of EEG records from adults and children with a wide variety of disorders. As you gain experience in EEG, you are given increasingly independent responsibility to oversee complex problems, take emergency call, oversee and perform prolonged EEG and surgical monitoring, learn about evoked potentials, teach new residents, and present lectures and seminars.
You are exposed to EEG interpretation for people with a variety of seizure disorders, monitoring techniques used to evaluate people with epilepsy (including prolonged monitoring and ambulatory monitoring), and techniques used for epilepsy surgery. You also see and interpret EEGs with a wide variety of other disorders during the EEG rotation.
During the fellowship, you have the opportunity to rotate to the electromyography (EMG) or sleep labs, or with the intraoperative monitoring (IOM) services, to get a broad experience in clinical neurophysiology.
- Epilepsy. During your time on the epilepsy services, you take care of patients on the inpatient epilepsy monitoring service, see patients in the epilepsy outpatient clinic, and assist in the evaluation and management of patients monitored with EEG on other hospital services.
The schedule of clinical activities is designed to achieve a balance between outpatient and inpatient EEG and patient care, and ensure that you have experience with different aspects of epilepsy care and EEGs. You work with both adult and pediatric patients, and are involved with drug therapy and surgical treatment for new-onset seizures or refractory epilepsy.
The rotations are designed so that you have gradually increasing responsibilities in these areas. By the end of your fellowship, you should be able to perform these activities independently.
Clinical conferences, lectures, lecture-demonstrations, seminars, small discussion groups and one-on-one instruction are integral parts of the Clinical Neurophysiology Electroencephalography Fellowship.
You have the opportunity to attend weekly conferences in both the EEG and EMG laboratories. There is a weekly multidisciplinary epilepsy surgery conference. In addition, a patient problem-oriented journal club for epilepsy and EEG meets monthly. A weekly lecture series has been developed to cover key elements of integral epilepsy care.
These conferences include clinical EEG and EMG case reports, lectures and lecture-demonstrations about:
- Electronics and instrumentation
- Evoked potential studies
- Autonomic function studies
- Basic neurophysiology
You also may attend other weekly seminars and conferences in neurology, neuropathology and pediatric neurology.
During your clinical neurophysiology fellowship, you participate in a series of formal didactic sessions and regularly scheduled conferences in all aspects of clinical neurophysiology. There are regular conferences in EEG, EMG, epilepsy, neuromuscular and peripheral nerve disorders, movement disorders, and sleep disorders. Opportunities for teaching and research are available.
Fellows are expected to complete at least one investigative project during their training. The type of research project you select depends on your interests and capabilities and the time available. Opportunities are available for collaborative studies with other clinical and basic science sections at Mayo Clinic.
When you complete your research, you are expected to present it at a scientific meeting or prepare it for publication in a scientific journal. This experience teaches you 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.
You have the opportunity to study in Mayo Clinic's EMG laboratory to learn about the techniques and interpretation of evoked potential studies. This includes exposure to:
- Brainstem auditory evoked responses
- Pattern reversal visual evoked responses
- Somatosensory evoked potentials
In Mayo Clinic's EEG and EMG laboratories, you can also learn about techniques for assessing movement disorders, including tremors, myoclonus, seizures, botulinum injections and more.
Center for Sleep Medicine
The Center for Sleep Medicine at Mayo Clinic is a multidisciplinary center staffed by consultants in pulmonary medicine, neurology and psychiatry. Elective rotations are available in the Center for Sleep Medicine to give you experience performing and interpreting nocturnal polysomnography and multiple sleep latency tests.
You also have the opportunity to see people with a wide variety of sleep disorders, including:
- Sleep apnea syndrome
A separate one-year Sleep Medicine Fellowship also is available, which fulfills training requirements for certification by the American Board of Sleep Medicine.
To ensure that you acquire adequate knowledge and develop your technical skills, your performance is monitored carefully during the Clinical Neurophysiology Electroencephalography Fellowship. You are evaluated formally by your supervising faculty member after each clinical rotation and meet with the program director to review these evaluations.
In addition, you will regularly evaluate the faculty to ensure that your educational needs are being met.