Structure

The Henry Ford Hospital Clinical Neurophysiology Fellowship offers three tracks: Neuromuscular/EMG, Epilepsy/EEG, or a combined track.  Fellows in each track receive lectures in the neuroanatomical, neurochemical, and neurophysiologic foundations of clinical neurophysiology.  They also obtain a solid foundation in the planning, performance, and interpretation of a wide range of electrodiagnostic tests.  Throughout the fellowship, frequently scheduled didactic lectures make up the core of the Clinical Neurophysiology portion of the curriculum.

Neuromuscular/EMG track

Track Includes:

• 9 months Neuromuscular/EMG
• 2 months EEG
• 1 month elective (choose between sleep disorders, IOM, EEG, or EMG)
• 4 weeks vacation (during the 12 months)

For Neuromuscular/EMG fellows, the EMG rotation (major track) forms the core of the fellowship. The main and satellite labs run by the Department of Neurology collectively perform more than 5000 studies per year. The full gamut of adult neuromuscular and occupational diseases is seen in these laboratories.

During the first month, the fellows gain hands on experience performing nerve conduction studies with their colleagues.

Upon passing a practical test, the fellow begins conducting patient exams under the supervision of the attending physician. At this point the fellow begins the supervised performance of the needle exam. Throughout the year, the fellow participates in the study of increasingly complex cases.

By the completion of the fellowship, the fellows are comfortable and competent in planning and performing the electrodiagnostic examination of any patient. Clinical neurophysiology fellows rotate throughout the year in various neuromuscular clinics (ALS, Botox and Neuromuscular) where they learn the evaluation and treatment of a wide range of complex neuromuscular diseases. The fellows also rotate at Children's Hospital of Michigan for exposure to Pediatric EMG.

The remaining rotation time focuses on gaining experience in reading EEGs, critical care studies, epilepsy monitoring, Sleep Clinic and polysomnography studies, and evoked potential studies.

Epilepsy/EEG track

Track Includes:

• 9 months EEG/EMU
• 2 months EMG
• 1 month elective (choose between sleep disorders, IOM, EMG, or EEG)
• 4 weeks vacation (during the 12 months)

In the Epilepsy/EEG track, fellows spend majority of their time in the EEG Laboratory and the Epilepsy Monitoring Unit (EMU). The EEG laboratory at Henry Ford Hospital performs over 3,000 EEGs and over 450 video-EEGs on patients ranging from neonates to the elderly. The fellows get an indispensable experience at our active, 7-bed EMU (Detroit) where a wide variety of patients are monitored.

During the first month, fellows learn how to perform EEGs as they are learning the basic foundations of electroencephalography. In the EEG laboratory, the fellows assume a more supervisory/teaching role and are expected to read EEGs as well as teach the neurology residents who rotate through the laboratory. In addition, they get extensive experience in reading continuous long-term video EEG recording and become well acquainted in cases like nonconvulsive status epilepticus and encephalopathy.

During EMU months, in addition to interpreting both scalp and intracranial electroencephalography completed during diagnostic and presurgical admissions, the fellows learn to perform intracarotid amobarbital (Wada) tests, brain mapping, and electrocorticography.

The fellows rotate throughout the year in a weekly Epilepsy Clinic and learn how to treat epilepsy using both pharmacologic and nonpharmacologic (i.e. RNS) treatment modalities.

The remaining rotations focus on gaining experience in EMG/NCS studies, Sleep Clinic and polysomnography and evoked potential studies. If interested, the fellows learn to interpret MEG studies including the performance and interpretation of spike mapping and evoked responses (including language mapping).

Combined Track

Track Includes:

• 6 months EMG
• 6 months EEG/EMU
• 4 weeks vacation (during the 12 months)

Lecture schedule

Expectations

The fellowship is designed to lead to board certification in "Clinical Neurophysiology" through the American Board of Psychiatry and Neurology (ABPN).

Alumni

Our fellows have gone into academics and private practices.

Research

The faculty is involved in clinical research ranging from antiepileptic drug clinical trials, outcome studies and investigator-initiated studies, including in MEG.  We are one of the few medical centers in the country participating in Responsive Neurostimulation (RNS) (Neuropace) Pivotal and Long Term Treatment Clinical investigation. Our fellows are expected to participate in the research activity and complete one research project by the end of the fellowship year. They are also encouraged to participate in a Quality Improvement Project.