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 Directors: Andrew Blum and George Sachs

Program Overview

Fellowship rotations last from 1 to 3 months in EEG/Epilepsy and in EMG/Neuromuscular over one year.  We admit two Fellows annually who rotate between these two main concentrations.  Many Fellows spend six months per year in each discipline though some opt to tailor this time to be able to concentrate 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 studies each day with our EEG faculty.  Our faculty consists of five physicians specializing in adult medicine and one in pediatrics. Our EEG lab performs more than 5,500 studies each year. These studies 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 EEG's in the ICU and for floor patients. Many LTM studies are conducted in our new 18-bed Neurocritical Care Unit at Rhode Island Hospital, as well as in other ICU's. EEG's 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 able to monitor for a period of up to 6-hours for outpatient studies. As part of this rotation, Fellows also 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.

For the EMG/Neuromuscular rotation, Fellows perform diverse types of EMG studies in the RIH EMG laboratory. This involves five half-day sessions each week. Fellows are supervised by the 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. Fellows also help our faculty and technologists provide ischemic forearm and autonomic testing in the EMG lab, as well as evoked potential studies.  Intraoperative studies (EMG and EP) are available and exposure to EMG-guided Botox® administration for dystonia care.  In addition to this lab component, Fellows participate in different clinics while on this rotation. These include a Neuromuscular clinic, an MDA clinic, and a multidisciplinary ALS clinic.

Sleep study interpretation occurs over two-weeks in the spring for each trainee. This also includes experience in the outpatient sleep clinic with the majority of time focused on learning how to approach sleep studies.

Research is woven into the Fellowship. 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 Grand Rounds talk at the end of their year. Usually this will focus on a topic of their interest and will often incorporate some of the research conducted during the year.

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 highly integrated into the life of the Department of Neurology, helping teams understand the implications of their patients' EEG and EMG results and providing care advice where appropriate (e.g. status epilepticus care in relation to ICU LTM studies).

Didactics in the Fellowship Program includes a weekly conference that covers the basics of clinical neurophysiology. This conference parallels a textbook on clinical neurophysiology, edited by Andrew Blum, MD, Program Director. Most lectures are provided by the Fellows to other Fellows, faculty and rotating neurology residents with such topics as EEG, EMG, sleep, and autonomic testing. Journal clubs and lectures on specific clinical topics are woven into this conference schedule over the year. When on EMG rotation, there is a weekly Neuromuscular Pathology Conference and a monthly Surgical Epilepsy Case Conference when on EEG rotation.  Fellows help our EEG faculty conduct a twice monthly EEG review session with our neurology residents. In-service examinations are conducted on knowledge of EEG, EMG, sleep, EP's, and related topics during the year and help the trainees to identify areas of strength and weakness, as they prepare for their board examinations.

Accreditation Status

Full accreditation by the ACGME Neurology Residency Review Committee, Program #: 1874321015.

Length of training

1 year; (2 years possible, depending upon research and funding availability.)

Prerequisites

Successful completion of an ACGME-accredited Neurology, Pediatric Neurology or Psychiatry residency.

Training Schedule

All training takes place at Rhode Island Hospital.

  • 6 to 9 months in an area of extensive training, either EMG or EEG.
  • 3 to 6 months  of the reciprocal major area, EMG or EEG.
  • 1 to 3 half-days per rotation of weekly, supervised outpatient clinics, in epilepsy and in neuromuscular.
  • 4 weeks of vacation.
  • Call:  There are no on-call responsibilities for our Fellows.

Core Conferences

Click here to view a description of all recurring conferences listed in the Residency Pages.

  • Residents' EEG: Tuesdays, Noon,  biweekly
  • Clinical Neurophysiology: Wednesdays,  9:45 am, weekly
  • Neurology Grand Rounds and Case Conference: Wednesdays,  8:00-9:30am, weekly
  • Neuroradiology: Wednesdays,  noon, weekly
  • Neuropathology (Muscle/Nerve): Thursdays, 9:00am, weekly
  • Epilepsy Surgery Case Conference: first Thursday of the month , Noon, monthly 

Application Process

To apply, an application form and three letters of recommendation are needed, including one from your current Residency Program Director.

Requests for information and applications 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

A roster of our core faculty can be found on the Epilepsy and Neuromuscular Division pages.

Affiliated Faculty

John Donahue, MD

Associate Professor of Pathology and Laboratory Medicine, Associate Professor Neurology

David Mandelbaum, MD, PhD
Professor of Neurology, Professor of Pediatrics
Director of Pediatric Epilepsy

Richard Millman, MD

Professor of Medicine, Professor of Pediatrics
Director of the Sleep Disorders Center of Lifespan Hospitals

Edward G. Stopa, MD
Professor of Pathology and Laboratory Medicine, Professor of Neurosurgery
Director, Division of Neuropathology, Rhode Island Hospital