Clinical Neurophysiology Fellowship Program

Program Overview

The McGaw Medical Center offers ACGME accredited adult and pediatric Clinical Neurophysiology (CNP) Fellowship training:

Adult CNP fellows are predominantly trained at Northwestern Memorial Hospital (NMH) and participate in a minimum of 6-month EEG/Epilepsy training with an additional 3-6 months in either PSG/Sleep Medicine or EMG/Neuromuscular Medicine. Up to 3 months can be spent in Evoked Potentials/Intraoperative Monitoring.
Pediatric CNP fellows are predominantly trained at Children’s Memorial Hospital (CMH) and participate in up to 9-months EEG/Epilepsy training and a minimum of 3 months in either PSG/Sleep Medicine or EMG/Neuromuscular Medicine.

Fellows are eligible for the American Board of Clinical Neurophysiology (ACNS) and Subspecialty of Clinical Neurophysiology (ABPN) examinations.

Program Goals

  1. Prepare fellows for the independent practice of clinical neurophysiology, i.e. the measurement and assessment of function of the central, peripheral, and autonomic nervous systems and skeletal muscles for the purpose of diagnosing, monitoring and treating neurological disorders.
  2. Provide fellows with the opportunity to acquire a thorough understanding of clinical neurology, normal neurophysiology and abnormal findings that occur in various neurological disorders so that they can select and apply properly clinical neurophysiological procedures to evaluate and manage patients.
  3. Provide fellow training based on supervised clinical work of increasing responsibility with both inpatients and outpatients in association with a foundation of organized instruction in basic neurosciences and neurophysiology.

Educational Objectives

  1. CNP fellow education is to include at minimum the proper application of clinical neurophysiological procedures including, but not limited to, EEG, EMG, nerve conduction studies, evoked potentials, epilepsy monitoring, intraoperative monitoring, polysomnography, and autonomic nervous system testing.
  2. Clinical and/or didactic experience is to include, but is not be limited to, the evaluation and treatment of encephalopathies, epilepsies, cerebrovascular disease, demyelinating disorders, tumors, CNS infections, movement disorders, sleep disorders, trauma, myelopathies, neuropathies, neuronopathies, radiculopathies, myopathies, and neuromuscular transmission disorders.
  3. The level of supervision provided to the CNP fellow and the clinical and teaching responsibilities of the fellow will evolve with his/her skill level, knowledge, and experience. Direct instruction of the fellow by CNP faculty will be replaced in turn by continuous and then selected supervision. Similarly, the CNP fellow will evolve from an assistant in medical student and neurology fellow education to a supervised instructor and finally to an independent instructor.

Curriculum

Fellows participate in a four week full day neurophysiology course at the beginning of their training covering basic principles and techniques of EEG, EMG/NCS, PSG, IOM/EP and other aspects of clinical neurophysiology. Subsequently, fellows are offered didactic training in EEG/Epilepsy/IOM, EMG/Neuromuscular and PSG/Sleep through a dedicated weekly lecture series for each of these areas.

  1. EEG/Epilepsy
    1. Overview - This subspecialty track consists of training in clinical neurophysiology focused on EEG and epilepsy. The main objective is to master skills necessary for recording and interpreting EEG and epilepsy monitoring studies and to develop competence in clinical management of patients with epilepsy.
    2. Clinical Duties - Fellows will be responsible for attending 1-2 half days of outpatient epilepsy clinic per week.
    3. EEG - Fellows will be responsible for pre-reading CNP laboratory EEGs daily, for reviewing these EEGs with an EEG attending daily, and for creating a final report.
    4. Long-term EEG Monitoring - Fellows will be responsible for pre-reading longterm video EEG recordings daily, for reviewing these records with an Epilepsy attending, and for creating a final report. These recordings will include intracranial EEG from epilepsy surgery candidates, as well as routine scalp EEG monitoring in the Epilepsy Monitoring Unit and the Intensive Care Unit.
    5. On Call: Fellows at NMH are provided with remote access and will take EEG/Video EEG monitoring call from home, on average once every 4 weeks. There is no call for the fellow at CMH.
    6. Conferences – Fellows participate in a weekly EEG training session and video EEG conference. Fellows will be responsible for preparing materials for the monthly epilepsy surgery conferences. Data to be organized and presented include patient history and exam, EEG and video monitoring, radiographic and neuropsychological findings.
    7. Teaching - Initially fellows will be expected to assist EEG and Epilepsy attendings in teaching activities. After four to six months experience the fellows will be expected to progress from supervised to independent teaching of the basics of EEG and epilepsy monitoring to other CNP fellows, technologists, neurology residents, and medical students.
    8. Research Opportunities - Fellows are encouraged to participate in the ongoing clinical research of the Adult Epilepsy Center or to initiate new projects deemed appropriate by the Program Director.
  1. EMG/Neuromuscular
    1. Overview - This subspecialty track consists of training in clinical neurophysiology focused on electromyography and neuromuscular diseases. The main objective is to master electromyography skills and to develop competence in clinical management of patients with neuromuscular diseases.
    2. Clinical Duties - The fellow will attend one day per week in a neuromuscular clinic.
    3. EMG - The fellow is expected to obtain a brief history and examine the patient prior to performing the tests in order to tailor the exam accordingly. The following tests will be performed and interpreted:

      NCV and Reflex Studies

      Repetitive nerve stimulation

      Needle Exam

      Autonomic and Quantitative Sensory Testing

    4. Conferences - The fellow will participate in the monthly neuromuscular pathology conference and journal club in addition to the weekly neuromuscular lecture series. 
    5. Teaching - Initially fellows will be expected to assist EMG attendings in teaching activities. After four to six months experience the fellows will be expected to progress from supervised to independent teaching of the basics of EMG and NCV studies to other fellows, technologists, neurology residents, and medical students.
  2. PSG/Sleep Medicine
    1. Overview - This subspecialty track consists of training in clinical neurophysiology focused on polysomnography and sleep disorders. The main objective is to master scoring and interpretation of overnight sleep studies and to develop competence in clinical management of patients with sleep disorders.
    2. Clinical Duties - The fellow will attend one day per week in the sleep clinic.
    3. Sleep Lab - The fellow is expected to master the technical aspects of sleep recording and scoring first before s/he is advancing to independent interpretation of sleep studies under supervision. The fellow should be able to independently interpret 2 to 5 studies per reading session, prior to reviewing it with the attending physician. 
    4. Conferences - The fellow will participate in the sleep case conference and journal club in addition to the weekly sleep lecture series.  
    5. Teaching - Initially fellows will be expected to assist sleep attendings in teaching activities. After four to six months experience the fellows will be expected to progress from supervised to independent teaching of the basics of sleep studies to other fellows, technologists, neurology residents, and medical students.
  3. EEG/Evoked Potential/Intraoperative Monitoring (adult fellow only)
    1. Overview - This subspecialty track consists of training in clinical neurophysiology focused on EEG and evoked potentials of both outpatients and inpatients undergoing operative procedures. The main objective is to master skills necessary to record and interpret EEG and evoked potential studies and to develop competence in clinical management of patients being monitored during surgery.
    2. Clinical Duties - Fellows will be responsible to attend the morning sign in and hook up of patients in the operating room and facilitate communication between the surgical team, anesthesia, IOM technologist and neurophysiologist. 
    3. Intraoperative Monitoring - Fellows will be expected to attend intraoperative monitoring sessions at least two half days per week and to prepare monitoring reports.
    4. Teaching – Initially, fellows will be expected to assist the Intraoperative Monitoring attendings in teaching activities. After four to six months experience the fellows will be expected to progress from supervised to independent teaching of the basics of EEG and intraoperative monitoring to technologists, neurology residents, and medical students.
    5. Research Opportunities - Fellows are encouraged to participate in the ongoing clinical research or to initiate new projects deemed appropriate by the EEG Laboratory Director.

Eligibility Criteria

  1. The ACGME accredited training in CNP must be preceded by the completion of a residency program in neurology or child neurology accredited in the United States or Canada.
  2. The training must be separate and distinct from all training required for the certification in neurology or child neurology.
  3. All applicants must fully complete the application form and process. Necessary information to be provided include education, training, and certifications to determine eligibility. This includes a certificate of completion from the director of the neurology, child neurology, or psychiatry residency program at the institution where the applicant completed training. Three letters of reference from faculty members are also required.

How to Apply

All Fellowship program spots are filled up until 2014 year.

Click here to Download an Application. 

Interviews for the Clinical Neurophysiology positions are by invitation only and will take place in May/June for adult fellow candidates and in late summer/fall for the pediatric applicants the year prior to start of the fellowship. Please indicate in your application if you are interested in EMG/Neuromuscular Medicine or PSG/Sleep Medicine as second specialty to complement your EEG/Epilepsy training.

In order to be considered for an interview at that time, we require the following items:

  • Completed GME Application (PLEASE NOTE several other documents, including three letters of recommendation, must be incorporated in order for the application to be considered complete). One of the letters of reference should be from your neurology or child neurology program director.
  • CV
  • Personal Statement
  • A copy of your state-of-residency (temporary or permanent) Medical License is required
  • Copy of official USMLE Step/Scores I, II & III

You should know that, if you are selected as a Neurophysiology Fellow, you would be required to provide us with the following PRIOR TO your fellowship start date:

Be aware that the application process for these licenses can take up to three months to complete and that you need the licenses in hand in order to begin your fellowship. We encourage you to begin the process as soon as you are selected for a position.

All the required items can be mailed, faxed, or emailed using the following contact information:

For adult applicants:
Erin van Bladel
Northwestern University
Department of Neurology
Program Assistant
710 N. Lake Shore Drive
Abbott Hall #1113
Chicago, IL 60611
Direct: 312-908-8266
Fax: 312-908-5073

For pediatric applicants:
Majid Hussaini
Administrative Director
2300 Children's Plaza
Division of Neurology, Box 51
Chicago, IL 60614
Email: MHussaini@childrensmemorial.org
Direct: 773-880-4736
Fax: 773-880-3374

Residents are selected for the CNP fellowship from eligible applicants based upon their preparedness, ability, aptitude, academic credentials, communication skills, and personal qualities. No discrimination is made based upon sex, race, age, religion, color, national origin, disability, or veteran status. Approximately half of the eligible applicants are invited for personal interviews.

Invited applicants are interviewed by the program director, at least one laboratory director, and as many CNP faculty as possible, particularly in the area in which the applicant wishes to subspecialize. Interviewers rate each applicant independently.

A CNP faculty meeting is held after interviews are completed at which time applicant ratings are reviewed. Subspecialty lab directors each provide a summary of those candidates applying for their subspecialty. Decisions regarding appointments to the fellowship are then made by concensus.

Stephan Schuele, MD, MPH
Clinical Neurophysiology Fellowship Program Director

 

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