Neurology Site

University of Pittsburgh Epilepsy Fellowship Program

Overview

The mission of the University of Pittsburgh Epilepsy Fellowship Program is the training of academic epileptologists.  The Epilepsy Fellowship Program provides supplementary advanced subspecialty training in epilepsy and electroencephalography (EEG) beyond what is provided in a one year EEG-Epilepsy focused Clinical Neurophysiology Fellowship.  The Epilepsy Fellowship provides one year of balanced educational and clinical experience that includes the amount of clinical research commensurate with the candidates’ aspirations.  A second year of the Epilepsy Fellowship may be considered for a highly motivated individual depending on the candidate’s clinical and research interests and long term career goals.  This second fellowship year would allow the candidate to devote additional time to research and more extensive interest-based clinical training to better prepare for a career as an academic epileptologist. 

The Epilepsy Fellowship Program at the University of Pittsburgh combines the resources of the University of Pittsburgh, University of Pittsburgh Medical Center, Center for the Neural Basis of Cognition and University of Pittsburgh Comprehensive Epilepsy Center (a level IV NAEC Epilepsy Center) to provide a unique educational environment with diverse resources and a plethora of clinical and scientific expertise available for clinical and research training in the field of epilepsy.  

Overall Program Goals and Objectives

Goals:

The overall goal of the program is to provide fellows with the opportunity to develop the competence and expertise necessary to evaluate and manage the most complicated patients with epilepsy. The fellows achieve and exhibit this competence in a professional manner, with respect, compassion and accountability to all patients.  The fellows communicate effectively with peers, superiors, families and other members of the health care team.  The fellows use the experience of practice to reflect upon their learning and guide ongoing learning which is essential for effective practice.  The fellows function as members of a health care team, among which mutual respect and communication are practiced to deliver proper health care to all patients.  By the conclusion of the program, fellows demonstrate sufficient competence to enter practice without direct supervision.

Objectives: 


Epilepsy Fellowship Rotations

  1. Extraoperative presurgical epilepsy monitoring (invasive and non-invasive) (6 months):

    It includes in depth exposure to diagnostic evaluations of patients with epilepsy and similar paroxysmal disorders within the epilepsy monitoring unit (EMU) with an emphasis on the patients who are surgical candidates using video electroencephalography/electrocorticography, ictal and interictal SPECT, neuropsychological testing (NPT) and other novel techniques.  The fellow will acquire valuable experience in these techniques as well as related outpatient techniques such as positron emission tomography (PET), magnetoencephalography (MEG), fMRI, Wada, etc., and he/she would be prepared at the end of this year to comprehensively assess and manage complex epilepsy surgery cases. 

    During this period, a fellow may be involved in providing epilepsy consultations for inpatient services under supervision of an attending subspecialist.

  2. Intraoperative monitoring (6 months):

    This rotation takes place in conjunction with #1 and includes training in a variety of techniques of intraoperative seizure localization (electrocorticography), eloquent brain mapping using somatosensory evoked potentials and cortical stimulation techniques.  This rotation is very important for the essential training in various cortical function mapping techniques. 

    During this period, a fellow may be involved in providing epilepsy consultations for inpatient services under supervision of an attending subspecialist.

  3. Outpatient and Inpatient EEG reading with continuous EEG reading (6 months):

    The fellow will read (under supervision) outpatient and inpatient routine EEG records along with continuous EEG records.  During this period, a fellow may be involved in providing epilepsy consultations on patients on continuous monitoring for inpatient services under supervision of an attending subspecialist.

    During this period, a fellow may be involved in providing epilepsy consultations for inpatient services under supervision of an attending subspecialist.

  4. Research module (3 months):

    The fellow is expected to learn how to design and perform a clinical research project.  At the end of this module the fellow is expected to generate a manuscript that will be submitted to a peer reviewed journal.  As a part of this module, a fellow will attend a selection of seminars and shorter courses provided by the Institute for Clinical Research Education (ICRE) of the University of Pittsburgh (http://www.icre.pitt.edu/) commensurate with ongoing educational and clinical activities.

  5. Outpatient clinic(s) (1 or 2 per week):

    The fellow will have his/her weekly continuity Epilepsy Clinic with one of the staff physicians at the Division of Epilepsy.  This clinic lasts 4 hours and spans throughout the year.

  6. Elective (3 months):

    The fellow will have 3 elective months when 50% of her/his time will be dedicated to scheduled elective of their choice from the following:  Clinical electives in neuropharmacology, intraoperative monitoring, or sleep; neuroradiology, epidemiology or commensurate research elective.

    All above rotations will most likely be ½ day blocks but if patient volume requires additional effort, commensurate adjustments will be made.

The University of Pittsburgh Epilepsy Fellowship Core Curriculum


The Program will follow the American Academy Of Neurology Epilepsy Fellowship Core Curriculum (www.aan.com/globals/axon/assets/2730.pdf) supplemented with the latest developments in the basic science of epileptology, clinical epileptology with an emphasis on diagnosis and all treatment options, and social aspects of epilepsy.

 

Didactic Conferences and Related Didactic Activities


Daily Rounds: For a fellow in EMU

Daily EEG Discussions: For a fellow on EEG Rotation


Available Formal Didactics
(Schedule for some didactics is flexible and may vary)
Monday
  3:50-5:00 pm: Multidisciplinary Epilepsy Patient Management Conference (MEPMC) Weekly

Tuesday
  8:00 9:30 am: Clinical Research Seminar Series (CRSS): The Basic Science of Clinical Research (LHAS Auditorium 7 Main UPMC Montefiore) - Monthly
  12:00-1:00 pm: Epilepsy Conference (Fellows alternate presenting core epilepsy topics) Biweekly

Wednesday
  8:00-9:00 am: Neuroradiology Epilepsy Conference Six times per year [time tentative]
  4:00-5:00 am: Neurology Grand Rounds Weekly
  4:00-5:00 am: Neurosurgery Grand Rounds Weekly

Thursday
  12:00-1:00 pm: Journal Club - Diagnostic Methods (EEG, vEEG, MRI, PET, SPECT, MEG, NPT, WADA, fMRI) Monthly
  1:00-2:00 pm EEG Conference Weekly

Friday
  12:00-1:00 pm Current Topics in Epilepsy - Journal Club and Epilepsy Case Conference (the topics will alternate) Monthly
  4:00-5:00 am: Neurology Grand Rounds Weekly


Call Schedule

Epilepsy fellows participate in call coverage of the EMU on a shared basis that depends in part on the number of fellows. On average, a fellow will be covering two (2) weekends per month. When on call, a fellow is expected to come in every day, pre-round and pre-review video EEGs from the previous 24 hrs and prepare preliminary Daily V-EEG Progress Reports before rounding with an attending.  Other related subspecialty (EEG) responsibilities may be assigned to the fellows on call.