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Fellowship time may be divided equally among EEG/Epilepsy and EMG/Neuromuscular disorders, or the fellow may spend nine months in one subspecialty and three months in the other.
EMG, 3-7 months
MCVH, VAMC, and Children's Hospital
Participate in weekly MDA clinic at MCVH and the bi-monthly pediatric MDA clinic at Children's Hospital of Richmond. Perform and interpret EMGs under guidance of attending. Fellow is expected to learn peripheral nerve and nerve root innervations of the muscles commonly studied, and understand the principles of nerve conduction and synaptic transmission. The fellows are also expected to learn the basics of needle EMG examination. The fellows are responsible for participating in neuromuscular clinic, becoming familiar with the clinical presentations, diagnostic evaluation, treatment options, and social issues associated with neuromuscular disease.
EEG, 3-7 months
MCVH and VAMC
Participation in the weekly Adult seizure clinic at MCVH and the Pediatric seizure clinic at MCVH. During clinics, they review the history, examine the patient, and present each to the attending. The resident will review inpatient and outpatient, routine and prolonged, adult and pediatric EEGs and EPs with guidance of faculty members who interpret these studies.
EMU, 1-2 months
MCVH
The fellow obtains complete histories containing all relevant details regarding a patient's seizure disorder and presents all patients to an attending. Fellows review, with the EMU attending, long-term video monitoring studies of adults and children who are admitted for evaluation of refractory epilepsy and possible epilepsy surgery. Seizure semiology is learned. Acute and chronic anticonvulsant management is extensive as are clinical correlations of neuroimaging studies including CT, MRI, SPECT, and PET.
Sleep, 1-2 months
VAMC
Participate in polysomnogram reading sessions, reviewing and interpreting with attending physicians. Participate in sleep disorders clinics.
Intraoperative Monitoring, 6 months (occurs concurrently with other rotations)
MCVH
Fellows will be exposed to a variety of modalities for various clinical situations, participating in choosing appropriate testing and monitoring techniques. To include: cerebral monitoring such as EEG (e.g., during carotid endarectomy), EEG cortical recording and functional mapping, as warranted, (e.g., brain tumor). Spinal cord monitoring which may include evoked potentials (SSEP, MEP) or EMG/NCV, including use of appropriate monitoring and tests. BARP for acoustic neuromas.
Required Conferences
Neuromuscular Conference
Weekly conference held Monday mornings covering the basic science underlying neurophysiology, with an emphasis on neuromuscular disorders and EMG technologies.
Epilepsy/EEG Conference
Bi-weekly conference covering the basic science underlying EEG, with an emphasis on seizure disorders and EEG technologies.
Epilepsy Surgery Conference
Multi specialty monthly review of epilepsy surgery candidate(s).
Clinical Neurophysiology Noon Conference
Weekly noon conference which serves to reinforce the basic science underlying neurophysiology, as well as fundamental clinical applications. Participation includes both attendance as well as presenting at least six conferences throughout the one year fellowship.
Other Conferences
Daily noon conferences covering the following: neuro-ophthalmology, neuropathology, neuroradiology, child neurology, and combined child neurology and pediatrics. Neurology basics course held each July through August. Basic science, board reviews, morbidity and mortality conferences held on Fridays.
Grand Rounds
Held every Thursday from September through June. Visiting and local neurologists give updates on the latest developments in the field of neuroscience.
Chairs Rounds
Dr. Towne meets with the residents monthly to attain feedback from residents regarding the program. Also covers various topics such as costs of healthcare, insurance and billing, practice management, quality assurance, and medical ethics.
GME Core Lecture Series
VCU GME sponsored lectures which cover the following topics: medical ethics, quality assurance, healthcare organization, practice management, financing of healthcare, and management information systems.
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