School of Medicine

Wayne State University School of Medicine

Program Overview

The Clinical Neurophysiology fellowship requires training in central nervous system clinical neurophysiology as well as exposure to the peripheral neurophysiology. The program typically provides six months rotations in EEG/Epilepsy service with concurrent exposure to the Pediatric EEG/Epilepsy. The rest of the year is spent in the EMG lab studying and performing peripheral neurophysiology (EMG and nerve conduction) studies and evaluating patients with peripheral nervous system diseases.

The Neuromuscular Track Program offers an integration of diagnostic evaluation and clinical care that is relatively unique when compared to the usual EMG elective. We view the EMG evaluation as an extension of the clinical examination. Therefore, the Neuromuscular Track is designed to offer continuity to both the patients and to you as the patients move through their diagnostic evaluation.
 
GOALS IN THE NEUROMUSCULAR TRACK FELLOWSHIP ARE TO:
 
1.        Learn how to provide efficient patient diagnosis and high quality continuity of care.
2.        Become knowledgeable in electrodiagnosis and neuromuscular disorders
 
SCHEDULE
The Neuromuscular program includes the Neuromuscular Clinic, Neuromuscular Diagnostic (EMG) Laboratory, and the Neuromuscular Inpatient Consultation Service. As a fellow, your time and efforts are required in the Neuromuscular Clinic, EMG Laboratory, and Laboratory attendance at biopsy readings. There is a weekly Neurophysiology lecture that you are required to attend and a more clinically focused neuromuscular didactic series. We highly encourage our fellows to participate in clinical research. We also expect Fellows to participate in Grand Round lectures on Friday’s. Exposure to the other services within the Neuromuscular Program may be arranged on an individual basis if you have a strong interest. .

NEUROMUSCULAR CLINIC
Neuromuscular Clinics at the University is a means to increase your knowledge about the diagnosis and management of neuromuscular diseases. Active participation is essential to all. There are specialized clinic the fellows will attend including the MDA and MDA/CMT clinics.

NEUROMUSCULAR CONSULT SERVICE
The neuromuscular consult service exists both to provide expert consultation to in-patients with neuromuscular disease and as an educational service for us and the rest of the medical center.
 
NEUROMUSCULAR BIOPSY MEETINGS
Meetings are coordinated with the neuropathologist. They are scheduled biweekly.
 
CLINICAL NEUROPHYSIOLOGY FRIDAY LECTURES
This is a formal lecture covering all elements of clinical neurophysiology. The content is specifically designed to prepare fellows to take the added qualification board examination.

EMG READING
Fellow driven presentation to discuss interesting cases. They are held once weekly.   This is a time to review difficult or interesting cases, discuss a pertinent article, and informally talk as a group.  

EXPECTATIONS AND EVALUATION OF NEUROMUSCULAR FELLOWS
Monthly written evaluation forms will be filled out by supervising faculty members. Each fellow will meet with the program director at the end of six months of training to go over his/her performance, attendance, behavior, etc. Near the end of the year, a year-end evaluation will be conducted in a similar fashion. When necessary, the program director and/or faculty members will meet with individual fellows more often. All of these evaluations will become part of the fellow’s permanent file.

The Neurophysiology Fellowship is a challenging and rewarding year. We have set out expectations as an aid to your acquiring the necessary and appropriate knowledge.

According to ACGME guidelines, every rotation need measurable objectives, and these are designed in that spirit. In addition, it is mandated that your evaluation at the end of your rotation be based upon these objectives.

IN-SERVICE EXAMINATION
Every year, in the spring, a required "In-Service Exam" in PNS Clinical Neurophysiology is sponsored by the American Association of Electrodiagnostic Medicine. This test is similar to the written part of the board certification exam and provides you a means of determining in which academic areas you are deficient. The results of the exam are confidential and will be used only in defining areas in which you need additional instruction.

CLINICAL/EDUCATIONAL
Develop proficiency at designing, performing, and interpreting Electrodiagnostic studies.
Read books and articles on performing nerve conduction and EMG studies that we recommend.
Become knowledgeable about major classes of neuromuscular disorders, including basic clinical features, diagnosis, treatment, and management.
Become proficient at evaluating and presenting neuromuscular cases.
Attend the required lectures.
We ask that you participate in your own research project during this year.
You are asked to coordinate the reading of at least one biopsy each month.

ORGANIZATIONAL
All fellows must be available by pager 24 hours per day, 7 days per week.
Please arrive to clinic and EMG laboratory before time so that patients can be attended to promptly.
It is essential to dictate clinic visits within 24 hours. It is important not to keep the next patient waiting while you dictate the previous patient.
Please send a copy of the dictation to the referring and primary care physicians and to the patient. Please supply the physicians’ addresses (call the office if necessary) and the patient’s address in the dictation.

 

Typical Block Schedule of Clinical Neurophysiology Fellow
Track
July
Aug
Sept
Oct
Nov
Dec
Jan
Feb
Mar
Apr
May
Jun
EMG
EMG
EMG
EMG
EMG
EMG
EMG
Neuromusc clinic
EMG
EEG
EEG
EMG
EMG
Combined
EMG
EMG
EMG
EMG
EMG
EMG
Neuromusc/Epi cinic
EEG
EEG
EEG
EEG
EEG