Neurophysiology fellowships

[tkhan1031]

Hi PGY 3 applying for fellowships and strongly interested in clinical neurophysiology fellowship, but with focus on epilepsy. Do people who have gone through the process have suggestions for strong programs.. especially in NYC area which is where i would like to stay. but am also open to going far away to get good training as its only for a year and want it to count.
I would still want to be trained in EMG as well but the EEG focused ones seem to offer only 2 mos in EMG which even for EEg focused neurophysiology positions seem short. Maybe thats how these fellowships are, the 6mos each combos are fairly rare but would appreciate any input!
It would also be nice to hear from people who have gone thru their fellowships and how they liked it too.

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[GuillainMollaret]

Agreed that most neurophys fellowships are either strongly EMG or EEG focused. I don't necessarily think this is a bad thing.

I think people have varying perspectives on this, but in some ways it almost makes the most sense to just pick one and do either an epilepsy or neuromuscular fellowship (as long as they're only one year in duration, some are two). Even if you're not thinking academics.That way you can get really, really good at reading EEGs and managing complex epilepsy patients or vice versa and you can also sell yourself as an expert in that particular subspecialty. The obvious downside is less experience with the other modality, but this can be somewhat remedied by judicious use of elective time in residency.

For example, I know a neuromuscular/EMG fellow who took a non-academic job where he sees a mix of general neurology and neuromuscular pts. All the complicated EMGs and neuromuscular patients go to him, but he also wanted to be able to read routine outpt EEGs on his pts especially since he sees a lot of general neurology, so he spent most of his fourth year elective time getting extra EEG experience as his fellowship didn't include any.

The above approach probably doesn't make sense if you want to do straight gen neuro with routine outpt EEG and straightforward EMG for things like entrapment mononeuropathies and axonal polyneuropathy. But if you're more interested in epilepsy like you say, then maybe an epilepsy/EEG fellowship with some extra EMG time during PGY4 might make sense.

 

[Telamir]

I just finished a CNP-EEG fellowship, and I only had 2 months (if that) exposure to EMG, which is fine by me. I did however have a lot of epilepsy clinic, EEG/cEEG/ECOG/qEEG experience. I decided to take a job as a neuro-hospitalist however and in that regard I think the fellowship was helpful. One word of caution though is if you want to specialize in epilepsy it's best to just do an epilepsy fellowship as this is the last year you can grandfather into the epilepsy board with a CNP fellowship (which I intend to do). I think the 2 year fellowship is useful if you plan to do presurgical evaluations and are part of an epilepsy surgery center, otherwise I think it's probably too much however it's the one way you can get board certified in it.

Hope that helps

 

[tkhan1031]

I just finished a CNP-EEG fellowship, and I only had 2 months (if that) exposure to EMG, which is fine by me. I did however have a lot of epilepsy clinic, EEG/cEEG/ECOG/qEEG experience. I decided to take a job as a neuro-hospitalist however and in that regard I think the fellowship was helpful. One word of caution though is if you want to specialize in epilepsy it's best to just do an epilepsy fellowship as this is the last year you can grandfather into the epilepsy board with a CNP fellowship (which I intend to do). I think the 2 year fellowship is useful if you plan to do presurgical evaluations and are part of an epilepsy surgery center, otherwise I think it's probably too much however it's the one way you can get board certified in it.

Hope that helps

I did not realize this was the last year you could still qualify for epilepsy boards with CNP! how do you know?

 

[Telamir]

I found out by pure luck. Everyone in my program including my PD and Associate PD were telling me "You realize you can't take the epilepsy board with this fellowship, right?", which I was fine with however one day I was thinking about how much clinic I was doing and decided to find out what the difference between a CNP and an epilepsy fellowship was and lo and behold, this is the last year you could grandfather into epilepsy with CNP, however the ABPN makes you choose between using your CNP fellowship for the CNP board or the Epilepsy board. That being said, if you were adamant about being certified by both you could've then taken the ABCN which did not have such a requirement.

I just think you should know about Epilepsy vs CNP fellowships before you commit to CNP. If your desire is mostly epilepsy then you should do epilepsy fellowship.