asking for advise regarding fellowship. Neurophysiology vs. neuromuscular vs. epilepsy

[Alpetragius]

I'm interested in both EMGs and EEGs and in private practice settings.

I'm confused about my decision about fellowship and I hope you guys can help me. What would be the difference in terms of EMG skills of someone who did neuromuscular fellowship vs. someone who did 6 months of EMG / EEG split fellowship? that goes also for someone who did epilepsy fellowship for a year vs. 6 months of EEG /EMG.

Which one of them will help me to get better reimbursement?


Thank you

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[Thama]

Do epilepsy or neuromuscle. Either way you have a patient population, you choose the tests, how to use them and how to interpret them. CNP just gets you technical skills without any context and it's not clear how viable that pathway will be in the future.

The larger centers I'm familiar with have already stopped hiring people with CNP fellowships in favor of real neuromuscle and epilepsy specialists that can do more than just run the study and spit the patient back out to someone else with a context-less interpretation.

 

[GuillainMollaret]

I agree with Thama.

CNP is a dying fellowship in my opinion and most CNP programs are heavily weighted towards either EEG or EMG anyway. The 6 month / 6 month split that you mentioned is pretty rare.

CNP only makes sense if you're going to be a general neurologist in a rural or small town setting in my opinion.

 

[Telamir]

What they said. I did a CNP-EEG and managed to get grandfathered into the epilepsy board. I was incredibly lucky, and I saw the writing on the wall.

 

[Postictal Raiden]

Is there an advantage to doing CNP-EEG as opposed to 1-year epilepsy?

 

[Alpetragius]

Thank you all for your replies

 

[Alpetragius]

Is there an advantage to doing CNP-EEG as opposed to 1-year epilepsy?

I wonder actually because when I try to look for CNP fellowship , they say that they closed it and instead they have either epilepsy or neuromuscular for 1 year and second year optional for research

 

[jd1031]

Current neuromuscular fellow. What the above people said is true. After R2 year, I was originally planning to do CNP, but the knowledge base is now so vast in both epilepsy and neuromuscular that it's impossible to be truly competent in both in one year (including EMG and EEG). Furthermore, jobs are starting to ask specifically for epilepsy or neuromuscular specialists, especially at big healthcare systems (especially in academia, but also big community systems). Decide which one you like best and roll with it.

 

[Alpetragius]

Current neuromuscular fellow. What the above people said is true. After R2 year, I was originally planning to do CNP, but the knowledge base is now so vast in both epilepsy and neuromuscular that it's impossible to be truly competent in both in one year (including EMG and EEG). Furthermore, jobs are starting to ask specifically for epilepsy or neuromuscular specialists, especially at big healthcare systems (especially in academia, but also big community systems). Decide which one you like best and roll with it.

Thank you fir your reply. Are you doing 1 or 2 years fellowship? Is there any difference in terms of competence and jobs opportunities after graduation if you do 1 or 2 years fellowship ?

 

[thenerveofu]

The trend is do one or the other. I completed NM fellowship but when in residency I had same question and wanted to understand diff bw NM vs Epilepsy vs CNP. Neuromusc is a diff world of neurology and the CNP fellowships train more for tech procedural skill than for how to clinically manage those pts. Many of EMG leaning CNP programs are in process of becoming NM. On top of that must do a NM fellowship to be NM boarded, just like Epilepsy for most part. So board certification matters and the skill in performing procedures by someone who did entire 1-2 yrs focusing on that area will be much greater than someone who split their time.

 

[Alpetragius]

The trend is do one or the other. I completed NM fellowship but when in residency I had same question and wanted to understand diff bw NM vs Epilepsy vs CNP. Neuromusc is a diff world of neurology and the CNP fellowships train more for tech procedural skill than for how to clinically manage those pts. Many of EMG leaning CNP programs are in process of becoming NM. On top of that must do a NM fellowship to be NM boarded, just like Epilepsy for most part. So board certification matters and the skill in performing procedures by someone who did entire 1-2 yrs focusing on that area will be much greater than someone who split their time.

Thank you very much.

Do you advise to do 1 or 2 years of fellowship ? Does it matter in regards of clinical skills / EMG or is it more of a research year ?

 

[thenerveofu]

Thank you very much.

Do you advise to do 1 or 2 years of fellowship ? Does it matter in regards of clinical skills / EMG or is it more of a research year ?

I think it depends on your goals. If you are certain to go into academics it can certainly be helpful to work on research projects, build your CV, but not necessary as 1 yr will get you the exposure and training you need for EMG and clinical treatment/management. Although you will keep learning beyond even then. At the end of a year you are board eligible, so i think you would really have a particular research project that already had some legs to continue training beyond. An additional year typically will be for research, and in some cases for advanced skills i.e. single fiber emg. However each program is different and depending on the setup it may be to focus on a particular aspect of neuromuscular disorders such as myopathy.

 

[kevinbrainy]

Anyone can suggest the best clinical neurophysiology fellowships with mostly EMG? No pain, no EEG.