Mission
To provide each of our trainees with an exceptional, well-balanced, and individually tailored immersion in clinical neurophysiology to achieve the most all-encompassing education possible. The training is based upon a deep and extensive hands-on experience that comprises mastery of both electroencephalography and electromyography at one teaching site within one year.
Fellowship Program Director: Andrew Blum, MD, PhD.
Program Overview
Fellowship rotations last from ~four weeks in EEG/Epilepsy and in EMG/Neuromuscular over one year. We admit two to three fellows annually who rotate between these two main concentrations. Fellows spend four to six months per year in EMG and six to eight months in EEG. (We also offer an affiliated Epilepsy Fellowship Program, and therefore in any year may have two CN fellows plus one Epilepsy fellow or three CN fellows per year. So, depending on the overall distribution of the three fellows, our CN fellows may have 6 mos. each of EMG and EEG or they may have 4 mos. EMG and 8 mos. EEG.) We endeavor to individually tailor this time allotment to permit fellows to augment their experience in one or the other of these specialties.
When on the EEG/Epilepsy rotation, fellows preview EEG's, provide preliminary readings to requesting services, and read out EEGs each day with our faculty. Our EEG faculty consists of ten adult and pediatric EEG specialists. We are a level four Comprehensive Epilepsy Program and offer a full range of medical and surgical treatments for patients with epilepsy. Our EEG labs perform more than 6800 studies each year. These include inpatient and outpatient EEG's, (both adult and pediatric), routine and portable studies, long-term monitoring (LTM) tracings in our Epilepsy Monitoring Units (EMU) and prolonged EEGs in ICU and floor patients. LTM studies are conducted in our 18-bed Neurocritical Care Unit at Rhode Island Hospital, as well as in many other ICU's. EEGs are also conducted in the Rhode Island Hospital and Hasbro Children's Hospital Emergency Departments and in the neighboring Women & Infants Hospital Neonatal ICU. We have two dedicated LTM beds in our adult EMU, two in our pediatric EMU, one in the Neonatal ICU, and one in the EEG lab that can monitor outpatients for up to six hours. We also provide EEG interpretation for The Miriam Hospital, another Brown-affiliated hospital (read from the RIH EEG lab via a common server). During the EEG/Epilepsy rotation, fellows participate in one to two half-day clinics each week where they see new patients who may present with spells, seizures, and epilepsy. The clinic is supervised by our epilepsy faculty.
On the EMG/Neuromuscular rotation, fellows perform diverse types of EMG studies in the RIH EMG laboratory. This involves six half-day sessions each week. Fellows are supervised by one of our four EMG faculty in each session. The EMG lab performs over 2,000 studies annually. These involve inpatient and outpatient studies and include routine tests of nerve conduction and electromyography, plus repetitive nerve stimulation and single fiber EMG testing. Our fellows also perform bedside EMG studies in patients at RIH when they are unable to come to the lab, such as in MICU, RICU, and NCCU. Exposure to EMG-guided Botox® administration for dystonia care is available. In addition to this vigorous laboratory component, fellows participate in different clinics while on this rotation. These include a Neuromuscular clinic, an MDA clinic, and a multidisciplinary ALS clinic. These provide a robust and diverse clinical experience that complements our rich EMG lab-based learning.
Education in sleep study interpretation occurs through a dedicated one-week rotation for each trainee under the supervision of our sleep medicine faculty. This also includes experience in outpatient sleep medicine clinics, thereby providing an integrated exposure to sleep medicine practice and testing.
Teaching opportunities are many and are well integrated into the fellows’ day-to-day experience. Supervision of medical students and residents rotating in our labs is expected of all fellows. Each PGY-2 neurology resident spends three weeks in the EEG lab with one-on-one instruction by our fellows. Each PGY-3 neurology resident rotates for two continuous months in the EMG lab and receives similar supervision and teaching. Fellows convey preliminary results of electrophysiological studies to residents across the hospital every day. In this way, our fellows are fully integrated into the life of the Department of Neurology, helping teams understand and make use of their patients' EEG and EMG results and providing care advice where appropriate (e.g., ICU LTM study results and status epilepticus care).
Didactics in our CN Fellowship Program includes a weekly conference that covers the basics of clinical neurophysiology. This conference parallels a textbook on clinical neurophysiology, edited by Dr. Andrew Blum, Program Director. Most lectures are provided by the fellows to other fellows, faculty, and rotating neurology residents on such topics as EEG, EMG, sleep, and autonomic testing. Journal clubs and lectures on clinical topics are woven into this conference schedule over the year. When on EMG rotation, there is a weekly Neuromuscular Pathology Conference, and there are monthly adult and pediatric multidisciplinary Surgical Epilepsy Conferences when on the EEG rotation. Fellows help our EEG faculty conduct a twice monthly EEG review session for our neurology residents. Additional fellow and faculty EEG review sessions also occur monthly. In-service examinations are conducted on EEG, EMG, sleep, EP, and related topics during the year and, together with follow-up review sessions, help our trainees to successfully prepare for their board examinations.
Research is also woven into the CN Fellowship Program. Fellows are encouraged to participate in research with one or more of our teaching faculty. This often leads to a poster presentation and eventually to publication. As this is a one-year clinical fellowship, research is necessarily a modest component. Trainees present a Neurology Department Grand Rounds talk at the end of their year. Usually this will focus upon a topic of their interest and may also incorporate some of the research conducted during the year. Attendance to at least one regional or national conference per year is a feature and the program helps to defray the cost of such.
Accreditation Status
Full accreditation by the ACGME Neurology Residency Review Committee, Program #: 1874321015.
Length of training
1 year; (a 2-year sequence with the second year as an Epilepsy Fellowship is a possibility. A second year for research may be feasible, depending upon research and funding availability.)
Prerequisites
Completion of an ACGME-accredited Neurology, Child Neurology or Psychiatry residency.
Training Features
Location: Our CN Fellowship training takes place at Rhode Island Hospital, the largest of the Alpert Medical School – Brown University affiliated hospitals, a 719-bed tertiary level teaching hospital and the only level I trauma center serving southeastern New England.
Vacation: 4 weeks
Call: On-call duties are modest. Fellows take turns providing week-day evening call (from ~6-11pm) to provide preliminary readings of LTM studies and urgent EEG’s. There is no weekend call obligation for our fellows.
Conferences:
Click here to view a description of all recurring conferences listed in the Residency Pages.
- Clinical Neurophysiology Didactic: Tuesdays alternating with Thursdays, noon, weekly
- Neuropathology (Muscle/Nerve): Thursdays, 9:00am, weekly
- Epilepsy Surgery Case Conference: First (adult) and third (pediatric) Mondays, Noon, bimonthly
- Residents' EEG Review: Tuesdays, Noon, biweekly
- Fellow & Faculty EEG Reviews: Thursdays, noon, monthly
- Neurology Grand Rounds and Case Conference: Wednesdays, 8:00-9:30am, weekly
- Neuroradiology: Wednesdays, noon, weekly
Application Process:
Our CN Fellowship Program participates in the NRMP Match, supported through ERAS. To apply, three letters of recommendation are needed, including one from your current Residency Program Director, along with your CV and Personal Statement. (See ERAS for details.)
Requests for information should be sent to:
Andrew S. Blum, MD, PhD
Director, Clinical Neurophysiology Fellowship Program
5th floor, APC Building
593 Eddy Street, Providence, RI 02903
Tel: (401) 444-4364
Fax: (401) 444-8781
E-mail: [email protected]
Faculty:
Adult EEG/Epilepsy Pediatric EEG/Epilepsy EMG/Neuromuscular Other
Andrew Blum, MD, PhD John Gaitanis, MD Kara Stavros, MD John Donahue, MD
Julie Roth, MD Luca Bartolini, MD Swee Lim, MD Richard Millman, MD
Jason Richards, MD Rachit Patil, MD Vincent LaBarbera, MD
Neishay Ayub, MD Duyu Nie, MD George Sachs, MD, PhD
Vincent LaBarbera, MD David Mandelbaum, MD, PhD