Neurology &
Neurological Sciences
Stanford Epilepsy Center

Stanford Comprehensive Epilepsy Program Fellowship

 

We have now completed our search for the 2015 positions 
Applications for July 2016 positions will be reviewed in December 2014 

 

The Stanford Comprehensive Epilepsy Program accepts 3 fellows per year for intensive advanced training in Epilepsy and Clinical Neurophysiology. This training program is accredited by the American College of Graduate Medical Education (ACGME).

Two-year fellowships are encouraged, but one-year fellowships are also offered. A greater degree of supervisory responsibility is expected in the second year of fellowship. A larger fraction of time should be made available for research projects in the second year, but this will depend upon the availability of other fellows and house staff to work in the Epilepsy Monitoring Unit.

Interested applicants should have completed Neurology residency by the time of entry and have a US license to practice medicine. Applicants should be moving toward a likely career in academic practice. Acceptance is on a competitive basis and applicants from diverse groups are encouraged to apply.

To apply, please send
1. A curriculum vitae
2. Short personal statement
3. Minimum three letters of recommendation via email to:
Josef Parvizi, MD, PhD [jparvizi]
Associate Professor of Neurology


Detailed Information About The Fellowship Program:

Stanford University Medical Center (SMC) is located in Palo Alto, California and serves as a premier referral center for patients with neurological and neurosurgical disorders. SMC is a 575 bed hospital that combines aspects of general and specialty clinical care, teaching, research and academic medicine. Up to 34 beds are available for Neurology and Neurosurgery cases. There is a 23 bed intensive care unit and additional beds for step-down intermediate care.

SMC has available superb neuro-radiology facilities including CT, 1.5, 3 and 7 Tesla MRI, 3-dimensional MRI angiography, functional MRI, SPECT, and FDG-PET, and investigational imaging technologies. Interventional neuroradiology for vascular disease is also performed.

Outpatient neurology clinics are active Monday through Friday. Multiple teaching conferences occur almost every day, spanning the areas of clinical neurology, epilepsy and EEG, cerebrovascular disease, pediatric neurology, neuropathology, neuropsychology, neuroradiology, neurosurgical case management, and research issues.

Structure of the Fellowship:

Preference is given to fellows who wish to make a two-year commitment, with an emphasis on epilepsy and EEG, but one year fellowships is also offered. Patients with epilepsy will be seen in the clinic jointly by fellows and staff. Fellows will attend one or two seizure clinics a week, including adult and pediatric seizure patients. From four to eight months will be spent each year in the epilepsy monitoring unit. The remaining time will be devoted to outpatient and intraoperative EEG studies and clinical or basic research projects.

Acceptance to the program assures a minimum of 1 year of salary, assuming satisfactory performance. Where appropriate, application may be made to outside agencies such as the Epilepsy Foundation of America or American Epilepsy Society for funding support to defray costs of the fellowship. Individuals who bring their own funding may be considered on an individual basis for special training programs.

Application may be made for fellowship support from outside agencies. Such outside funding is encouraged, both as an honor for the fellow and as additional support funds for our program. Obtaining such funding is not, however, required for fellows accepted into the program.

Responsibilities:
Fellows should expect to partake of the following responsibilities:

VIDEO-EEG MONITORING: Serve in the Epilepsy Monitoring Unit for a maximum of eight months in the first year, six months in the second year. While in the monitoring unit the fellow will provide a history and physical exam on each patient admitted to the Monitoring Unit and write admitting orders, confer with the nursing and technical staff on the plan and montage. The fellow will interact with patients and family to help give them an idea of what to expect in the monitoring unit, in conjunction with nursing staff. The fellow will decide whether and to what extent to reduce antiepileptic medications. All of the above responsibilities will be performed under the direction of the attending.

PREPARING SEIZURE REPORTS: While participating in the Epilepsy Monitoring Unit, typically Monday through Friday and on a rotating weekend call schedule, the fellow will review the seizures and baseline EEG files and enter preliminary interpretations into the Epilepsy Monitoring Unit report. These will be reviewed daily with the staff attending. Patient orders and plans for discharge or other types of monitoring will be made after the daily review of the EEG material.

PATIENT ORDERS: Both fellows and attendings may write orders on the patients in the Epilepsy Monitoring Unit, as per agreement and unit policy. Fellows will be responsible for preparation of the final EMU report and the usual admission and discharge dictations. Faculty typically provide additional notes and daily chart notes.

INTRACRANIAL MONITORING: When patients are in the monitoring unit with intracranial electrodes, the fellow will work closely with attendings in performing procedures. Fellows will be expected to gain familiarity with placement of depth electrodes and subdural strips in seizure patients, by attending such placements in the operating room on a few occasions, and participating in the daily interpretation of the EEGs recorded from invasive electrodes.

EDUCATIONAL CONFERENCES: Fellows are invited to participate in any and all educational conferences provided for faculty and house staff in the Departments of Neurology, Neurosurgery, and related departments. Such participation will require a "common sense" allocation of time in relation to other clinical responsibilities. Typically, fellows would attend Neurology Grand Rounds, clinical case conferences, and an individualized subset of the other daily teaching conferences in the program.

EPILEPSY SURGERY CONFERENCE: It will be the fellow's responsibility to present 1-3 cases, or didactic topics, at the weekly epilepsy surgery conferences. The fellow will generate from the database a summary history, and arrange to present suitable Video-EEG segments for digital display. Discussion of the case will be the responsibility of the group as a whole, not just that of the fellow.

SEIZURE CONSULTATION: Fellows will perform seizure consultations when requested by the inpatient services or neurology service, and will present these cases to the attending on the epilepsy service.

EEG'S: On months when not in the epilepsy unit fellows will be expected to read EEGs under a schedule to be interdigitated with neurology resident EEG training.

CLINIC: Fellows typically will attend seizure clinic a minimum of two half-days per week. In clinic, the fellows will see new and return patients. Some clinics may be at affiliated programs in the Bay area. Some fellows may support their salaries with a general neurology clinic, on a schedule not to intefere with the educational functions of the Fellowship.

INTRAOPERATIVE MONITORING OF AWAKE PATIENTS: Fellows will participate in intraoperative monitoring of awake patients to map functional regions of brain prior to resection. Such cases typically arise every few months.

ROUTINE INTRAOPERATIVE MONITORING: Fellows will be expected to become familiar with intraoperative evoked potential monitoring by participating in several such studies in the operating room and interpreting the studies during the EEG reading sessions.

WADA TESTING: Fellows will participate in Wada testing, also known as intracarotid amobarbital testing. Reports will be prepared by neuropsychology.

CLINICAL TRIALS: Fellows will participate in anti-epileptic drug studies, in some cases including the design phase, in most cases by implementing the study with suitable patients.

RESEARCH PROJECT: Fellows will develop a research project after discussion with faculty. This may be a clinical research project, a research project based on electroencephalography or a basic science research project. The expectation is for abstracts, presentations at national meetings and peer reviewed publications resulting from the research projects.

EMG: Fellows may elect time on the EMG-neuromuscular service if they wish to be eligible for the AMA special expertise in Clinical Neurophysiology boards. This aspect of the program will be individualized.

SLEEP DISORDERS: Some fellows may wish to spend time in the Stanford Sleep Disorders Center. This can be accomplished by special arrangement.


Core Competencies:
Upon completion of the Fellowship, the trainee is expected to perform the following tasks:
1. Interpret routine adult electroencephalograms (EEGs)
2. Interpret pediatric EEGs, including neonatal studies
3. Interpret intracranial electrode recordings
4. Interpret long-term video-EEG monitoring studies
5. Interpret evoked potentials
6. Have general familiarity, though not independent competence, in nerve conduction
studies and electromyograms (EMGs)
7. Have an expert level understanding of the outpatient and inpatient management of patients with epilepsy
8. Be expert in clinical and EEG diagnosis of conditions that imitate epilepsy
9. Know the emergency treatment of status epilepticus
10. Be able to critically review literature pertaining to epilepsy
11. Know how to design and execute research projects in epilepsy.

 

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