Clinical Neurophysiology

4

1 year

ACGME

PGY-5 Level

This one-year fellowship is designed to enhance the technical skills and clinical application of clinical neurophysiology (CNP). The fellow will work closely with the Neuromuscular and Epilepsy services. Under the guidance of these services, the fellow will become proficient at the performance and interpretation of nerve conduction studies, electromyography, electroencephalography, long-term video/EEG monitoring and evoked potentials. Experience is also available for intraoperative monitoring (IOM) and sleep disorders, but these modalities are not available as an area of concentration. Clinical experience is obtained in our outpatient Epilepsy and Neuromuscular specialty clinics, as well as inpatient services. Additionally, the fellow may obtain exposure to nerve and muscle pathology and experience in biopsy interpretation.

At completion of the program, fellows are eligible for the American Board of Psychiatry and Neurology (ABPN) Clinical Neurophysiology Boards. Fellows may also be eligible for the Electrodiagnostic Medicine boards through the American Board of Electrodiagnostic and Neuromuscular Medicine (AANEM) or selected boards through the American Clinical Neurophysiology Society (see ABCN website abcn.org for available options).

For those that are interested, the CNP Fellowship may be coupled with an Epilepsy Fellowship for a two-year experience. The second year provides additional time for more in-depth pursuits, both clinical (e.g. in surgical epilepsy) and research.

The fellow’s training includes significant didactic and clinical experience in two of the following, with the overall goal of becoming capable of interpreting studies in two of the following disciplines:

1. electroencephalography (EEG)
2. electromyography and nerve conduction studies (EMG/NCS)
3. intraoperative monitoring (IOM)
4. polysomnography (PSG) and assessment of disorders of sleep

Two tracks are available: (1) General CNP and (2) CNP with emphasis in Epilepsy. 

General CNP fellows spend approximately three months on the Emory epilepsy service, three months with the Emory Neuromuscular service and the remainder of their time on either epilepsy or neuromuscular services at Grady Memorial Hospital.

CNP fellows with special emphasis in Epilepsy spend approximately 10 months gaining experience in EEG/epilepsy at either Emory or Grady and two months in another domain of clinical neurophysiology, typically in EMG/neuromuscular.  

Emory University Hospital is a quaternary care center, specializing in the care of acutely ill adult patients from the state of Georgia as well as surrounding states. It has over 700 beds, and is a comprehensive stroke center, as well as one of the highest volume centers for subarachnoid hemorrhage in the southeast United States. It is one of the only National Association of Epilepsy Centers (NAEC) Level 4 epilepsy centers in the southeastern United States, with over 8500 patients annually.

Grady Memorial Hospital is one of the largest hospitals in the state with almost 1000 beds and one of four Level 1 trauma centers in Georgia, being the only Level 1 trauma center in Atlanta. Grady is, additionally, home to the Marcus Stroke and Neuroscience Center, which offers a state-of-the-art Neurocritical Care Unit.

• Epilepsy clinic at the Brain Health Center, including a continuity clinic and time in a dedicated neurostimulation clinic (cumulatively >15,000 encounters per year)
• Outpatient EEGs at our Brain Health Center (>1100 routine and 330 ambulatory EEGs/year) and inpatient routine/stat EEGs within Emory Healthcare (>1400 studies/year)
• Epilepsy Monitoring Unit at Emory University Hospital, including on the intracranial EEG service (>1600 patient days/year, including 50 intracranial cases, contributing to approximately 50 laser ablations/resections and one of the most robust sites of neurostimulation device placement nationally)
• ICU EEG monitoring throughout Emory Healthcare
• Epilepsy rotation at Grady Memorial Hospital including Epilepsy Monitoring Unit (>60 patients/year), continuous ICU EEG monitoring (>650 patients/year), routine inpatient and outpatient EEGs (>1600 cases/year) and ambulatory EEGs (>50 cases/year).
• Epilepsy Clinic at Grady Hospital (>450 patients/year)

• Neuromuscular clinics at The Emory Clinic
• Peripheral Nerve Clinic at The Emory Clinic
• Muscular Dystrophy Association Clinic at The Emory Clinic
• ALS Clinic at The Emory Clinic
• Emory Electrodiagnostic Laboratory (>1400 EMG examinations/year)
• Grady Electrodiagnostic Laboratory (>800 EMG examinations/year)
• Neuromuscular ultrasound
• Neuromuscular Pathology Laboratory (>350 muscle and >115 nerve specimens/ year)
• Inpatient neuromuscular consults and inpatient electrodiagnostic studies

After completion of the fellowship, the physician will be eligible to take the board certifications offered by American Board of Electrodiagnostic Medicine and the American Board of Psychiatry and Neurology.

• Clinical Neurophysiology Fellowship Lecture Series (Friday afternoons, July-October)
• Weekly Combined Neurophysiology Conference at Brain Health Center Executive Park 12 (Thursday mornings, October-June)
• Weekly Epilepsy surgery conference (Tuesday mornings, adult and pediatric)
• Weekly Epilepsy Lectures (Friday afternoons, November-June)
• Weekly EMG Conference (Friday mornings, September-June)
• Weekly Neurology Grand Rounds at Executive Park 12 (Friday mornings, September-June)

Fellows are offered the annual American Association of Neuromuscular & Electrodiagnostic Medicine Electrodiagnostic Medicine In-Service exam, and the annual American Clinical Neurophysiology Society In-Service Exam.

Successful completion of an ACGME-accredited residency in neurology, child neurology, neurodevelopmental disabilities or psychiatry is required.

To learn more about the Emory Training Program policies, benefits, and University Affiliated Hospitals, please refer to Emory's Graduate Medical Education website.