Schedule
Over the course of a year, the fellows schedule will be broken down as follows:
Electives
Neurophysiology fellows have one month dedicated to electives. Fellows will have two weeks of sleep included in this time. Adult fellows will have a sleep elective primarily based out of Michael E. DeBakey Veterans Affairs Medical Center while pediatric fellows will spend most of their sleep elective at Texas Children’s Hospital. There are two weeks of dedicated time performing EMGs and spending time in the neuromuscular clinic and a 1 week focused clinical experience in intraoperative monitoring.
Scholarly Activity
Fellows have on average ½ day per week dedicated to scholarly activity. Fellows are expected to identify a research mentor during the first three months of their fellowship and work with their mentor on a scholarly activity. Prior fellows have presented their findings at the annual American Epilepsy Society or American Clinical Neurophysiology Society meetings with submission for subsequent publications.
Fellows are also expected to work on a quality improvement project at Baylor St. Luke’s Medical Center, Michael E. DeBakey Veterans’ Affairs Medical Center, or Texas Children’s Hospital under the supervision of a faculty mentor aimed at improving inpatient and/or outpatient practice. This should involve clinical care of patients with epilepsy, EEG interpretation/performance, intraoperative monitoring, epilepsy monitoring unit care or other aspects or clinical neurophysiology and epilepsy.
At the end of the year, there will be noon conferences dedicated to the fellows presenting their scholarly activity and QI projects.
Examination
Fellows will have ample opportunity to prepare for the ABPN board examinations over the course of the year through didactics and practice examinations. Fellows are scheduled to take an in house in-service examination developed by our faculty in December. CNP fellows will also take the ACNS in-service examination in February.
Training Sites
Fellows interested in the 12-month, ACGME clinical neurophysiology fellowship at Baylor will have the option of selecting a fellowship with an emphasis on EEG interpretation or a dual track, offering a balanced exposure to EEG and EMG. Adult fellows will have one month experience on the pediatric side and pediatric fellows spend one month in the adult hospitals.
Texas Children's Hospital is one of the nation’s largest pediatric hospitals and the primary pediatric teaching hospital for Baylor. It is one of the top five children’s hospitals in the country and serves as both a primary community hospital and a tertiary referral center. The epilepsy center at Texas Children’s is a level 4 epilepsy center with a busy surgical program and a 12-bed, epilepsy monitoring unit.
Fellows at Texas Children’s will primary participate in three rotations while there. Neurophysiology fellows will spend the bulk of their time in the first two experiences.
• Outpatient EEG rotation: This rotation will emphasize outpatient routine EEGs, ambulatory EEGs with exposure to intraoperative monitoring and select outpatient clinic experiences.
• Continuous EEG rotation: This rotation will emphasize interpretation of the long term EEG studies that primarily are performed in the ICUs at Texas Children’s.
• Epilepsy monitoring unit: This rotation will involve interpretation of the EEG recordings of patients in the epilepsy monitoring unit at Texas Children’s including all invasive phase II patients. This also includes exposure to intraoperative electrocorticography cases.
The Michael E. DeBakey Veterans Affairs Medical Center, one of the largest VA hospitals in the country serving Harris County and 27 surrounding counties, has a primary stroke certification and also boasts only one of six national Parkinson's Disease Research, Education, and clinical centers as well as a Comprehensive Epilepsy Center of Excellence.
Fellows at MEDVAMC will participate in two rotations while there with most of the time dedicated to the first experience
• Outpatient EEG rotation: Fellows will read all studies performed in the neurophysiology lab including outpatient EEGs, inpatient EEGs including continuous long term monitoring studies. The fellows experience also includes evoked potentials.
• Epilepsy Monitoring unit: Fellows also spend time in the 4-bed EMU. The Michael DeBakey VA Hospital is a Comprehensive Epilepsy Center of Excellence and has referrals from many out of state patients. The EMU principally sees patient undergoing diagnostic evaluation for spells of unclear etiology and pre-surgical workups with occasional intracranial monitoring cases. The afternoon is set aside time to see patients in epilepsy clinic at McNair campus alongside the adult epilepsy faculty.
• EMG: Fellows on EMG rotations will have select half days set aside to perform outpatient EMGs at the MEDVAMC with neuromuscular faculty.
Baylor St. Luke's Medical Center, our primary adult teaching hospital is a 900-bed hospital with a comprehensive stroke center, a 20-bed NICU, and a 4-bed EMU.
Fellows at Baylor St. Luke's will participate in two rotations while there with most of the time dedicated to the first experience
• Outpatient EEG rotation: Fellows will read all studies performed in the neurophysiology lab including outpatient EEGs, inpatient EEGs including continuous long term monitoring studies, intraoperative monitoring and evoked potentials.
• Epilepsy Monitoring unit: Fellows also spend time in the 4-bed EMU. Baylor St. Luke's is a level 4 epilepsy center and includes diagnostic evaluations, presurgical evaluations and phase II epilepsy surgery evaluations. The afternoon is set aside time to see patients in epilepsy clinic at McNair campus alongside the adult epilepsy faculty.
• EMG: Fellows on EMG rotations will have select afternoons set aside to perform inpatient EMGs at Baylor St. Luke's.
The McNair campus houses outpatient adult neurology clinics as well as the EMG lab. Fellows will spend afternoons in the epilepsy clinic with the epilepsy faculty while on the epilepsy monitoring unit at the MEDVAMC and Baylor St. Luke's. While on EMG rotations, fellows will rotate with select neuromuscular faculty in the EMG lab for a half-day as well as spend time in the neuromuscular clinic (MDA transition clinic and ALS clinic).