Mission

To provide each of our trainees with an exceptional, well-balanced and individually tailored immersion in epilepsy to achieve an all-encompassing education.  The training is based upon a deep and extensive hands-on experience that comprises mastery of epilepsy and electroencephalography at one teaching site within a year.

Fellowship Co-Directors: Dr. Monica Dhakar and Dr. Neishay Ayub

 

Program Overview

Fellowship rotations last from 1 week to 1 month in Routine EEGs/Pediatric Long-Term Monitoring and in Long-Term Monitoring (Adult ICU/EMU) over one year.  We admit 1 fellow annually who rotate between these two main concentrations.  There is also a one-month elective as well as a one month of vacation.

Our epilepsy faculty consists of five physicians specializing in adult epilepsy, four in pediatric epilepsy, and three epilepsy surgeons. Our EEG lab performs more than 6,500 studies each year. These studies include inpatient and outpatient EEG's, (both adult and pediatric), routine and portable studies, long-term monitoring (LTM) in Epilepsy Monitoring Units (EMU) and prolonged EEG's in the ICU and for floor patients. Many LTM studies are conducted in our 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 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.

The fellow will be integrated into our Comprehensive Epilepsy Program (CEP) of Rhode Island Hospital/Hasbro Children's Hospital, which is a multidisciplinary program providing state-of-the-art diagnostic and treatment services to adults and children with epilepsy.  The CEP is particularly oriented to provide tertiary-level care to those with more complex needs, including those whose epilepsy has proven to be refractory to first-line therapies. Disciplines involved are neurology, neurosurgery, neuropsychology, neuroradiology, clinical neurophysiology, psychiatry, and nursing. The CEP is accredited Level 4 center by the Nation Association of Epilepsy Centers. We provide state of the art epilepsy surgical interventions, including stereoelectroencephalography (SEEG), Responsive neurostimulation (RNS), Deep Brain Stimulation (DBS), Laser interstitial thermal therapy (LITT), Vagal Nerve Stimulation and Resection. We work closely with the Epilepsy Foundation of Massachusetts & Rhode Island for to provide local resources and support groups.

When on the Routine EEGs/Pediatric Long-Term Monitoring rotation, fellows review routine EEG's and pediatric LTM, provide preliminary readings to requesting services and read out studies each day with our EEG faculty.  As part of this rotation, fellows also participate in one half -day continuity clinic each week where they manage their own patients who may present with spells, seizures and epilepsy.  The clinic is supervised by our epilepsy faculty.

When on the Long-Term Monitoring rotation, fellows review adult LTM, provide preliminary readings to requesting services and read out studies each day with our EEG faculty.  As part of this rotation, fellows will follow and manage patients admitted to the epilepsy monitoring unit (EMU), who may be admitted for diagnostic (spell capture), phase 1 (scalp monitoring for surgical evaluation) or phase 2 (intracranial investigation). This will be supervised by the EMU attending. During this rotation, they will also participate in one half -day clinic each week where they see new patients who may present with spells, seizures and epilepsy.  The clinic is supervised by our epilepsy faculty

Elective: Elective time can be structured to fit the goals of the epilepsy fellow. This could include the following:

  • Research :  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.
  • 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.
  • Rotations in other disciplines or subspecialties, such as neuropsychiatry, neurosurgery, or neuroradiology, may be available upon request.

Fellows have the opportunity to teach medical students and residents. Each PGY-2 neurology resident spends three weeks in the EEG lab with instruction by our fellows and attendings. 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 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 shared weekly conference with the clinical neurophysiology fellowship. This conference parallels a textbook on clinical neurophysiology, edited by Andrew Blum, MD, Program Director. Lectures are provided by fellows, faculty, and rotating neurology residents. Journal clubs and lectures on specific clinical topics are woven into this conference schedule over the year. There is a monthly Surgical Epilepsy Case Conference, with the expectation of Epilepsy fellow to present and actively participate over the course of the year.  The 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 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 #: 1844318001

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.

  • 5 months in Routine EEG/Pediatric LTM.
  • 5 months in LTM EEG (Adult EMU/ICU).
  • 1 half-days per rotation of weekly, supervised outpatient epilepsy attendings.
  • 4 weeks of vacation.
  • 4 weeks of elective.
  • Call:  There is at home on-call responsibilities for our Fellows during their LTM months. There is no weekend call. There is no overnight EEG call.

Core Conferences

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

  • Residents' EEG: Thursdays, 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
  • Epilepsy Surgery Case Conference: first and third Monday of the month , Noon, monthly 
  • Epilepsy Surgery Workgroup: third Tuesday of the month, noon, monthly.

Application Process

This year, we will be participating in the ERAS Match. To apply, an application form and three letters of recommendation are needed, including one from your current Residency Program Director.

Questions about application process should be sent to:

Dr. Neishay Ayub
Director, Epilepsy 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  Division pages.