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School of Medicine
Neurology

Program Experience

The Adult Epilepsy program at Wayne State University and Detroit Medical Center is housed at the Detroit Medical Center midtown location.  It is a part of a NAEC Level IV epilepsy center. 

During fellowship training, the fellows experience:
 

  • Weekly outpatient epilepsy continuity clinic

  • Outpatient specialized epilepsy experience including

    • Epilepsy in Older Adults clinic

    • Pregnancy & Epilepsy clinic

    • RNS clinic

  • Pediatric epilepsy rotation (1 month) at our partner hospital Children's Hospital of Michigan

  • Clinical research opportunities and protected research elective time

  • In-house Neuropsychological testing training during elective time

The outpatient clinics, EEG reading room, fellow offices and Holden Neurodiagnostics lab are located in the University Health Center (UHC) building within the midtown medical center complex.

The inpatient experience includes rotation on the six-bed state-of-the-art adult epilepsy monitoring unit (EMU) located at Harper hospital within the same campus, large volume of long-term EEG monitoring in neuro-intensive care units and busy surgical program for epilepsy and brain tumor. The hospitals provide neurological care for a large number of patients from the Detroit metropolitan area and beyond.

The Adult Epilepsy program works collaboratively with the Pediatric Epilepsy program located in the Children's Hospital of Michigan. The fellows participate and engage in lively discussions and case presentations during our weekly joint adult and pediatric Epilepsy Case Management conference.

The fellows also have the opportunity to teach the neurology residents and medical students.

Daily & Weekly Experience

Fellows rotate between being on EEG service and EMU service every other week. EEG rounds are supervised by one of our five epilepsy specialists and begin around 9-10 AM and last for 2-3 hours. This includes reviewing all routine and long term EEGs, evoked potentials and physical patient rounds on EMU. Afternoons provide flexibility and are spent catching up on self-education, report-writing, research and epilepsy clinic.

When on EEG service, the fellow is the primary contact person for EEG tech and clinical teams. Fellow is responsible for providing rapid review of stat EEGs and other urgent EEG scenarios and communicating to clinical teams. The fellow is expected to provide long-term EEG reads three times a day. The fellow is not on call during the EEG service week between 11 PM and 7 AM. The attending on service is responsible for handling all urgent issues during that time.

Neurology residents on EEG rotation provide support by reading and reporting EEGs and are expected to be provided education and guidance by the fellow (and the attending).

On the EMU service week, the fellow will be reviewing EMU EEGs and creating daily reports. The fellow is not responsible for any urgent EEG reads and no responsibilities after 5 PM. The EMU admissions, daily progress notes and discharge summaries and performed by Neurology residents. EMU service is typically from Monday to Friday and the EMU closes during the weekend except when an intracranial EEG case is ongoing.

Rounds on the weekend are asynchronous where the fellows provide EEG reads to the faculty who review them separately. This allows for flexibility and work-life harmony for the fellows.  

Educational & Didactic Experience

The educational experience is broadly divided into five categories:

  1. Daily teaching during EEG rounds, which includes actual EEG reading, report creation, discussion of semiology, lateralization and localization in EMU cases. This also includes guidance on having difficult but important conversations with EMU patients including discussion of diagnosis of function seizures and plan for surgical evaluation.

  2. Teaching during EMU admissions, which focus on seizure and epilepsy nomenclature, semiology, seizure onset lateralization and localization, etiology of epilepsy and the unique management of anti-seizure medications in the context of EMU admission.

  3.  Didactic weekly teaching in the form of

    1. Traditional talk by an epilepsy or other related faculty

    2. Journal club presented by epilepsy and CNP fellows (once a month)

    3. Interesting EEG sessions attended by all epilepsy faculty (once a month

  4. Teaching during fellow epilepsy continuity clinic that focuses on diagnosis of seizures and epilepsy, management of chronic epilepsy and anti-seizure medication use.

  5. Weekly epilepsy surgery conference (on Mondays) that are held virtually in collaboration with pediatric epilepsy group and are attended by adult and pediatric epilepsy specialists, neurosurgeons, neurology residents, neuroradiologists, neuropsychologists, epilepsy nurses, dietitians, and social workers.