Epilepsy Fellowship
Overview
The Epilepsy Fellowship at Montefiore Medical Center/Albert Einstein College of Medicine is an ACGME-accredited one-year program. Clinical training focuses on the diagnosis and treatment of epilepsy, including its comorbidities as well as its advanced pharmacologic, surgical and dietary management. Our fellowship aims to develop epilepsy specialists capable of directing an epilepsy program and an EEG laboratory.
The fellowship provides an extensive epilepsy monitoring unit and outpatient epilepsy clinical experiences, as well as extensive experience with long-term EEG monitoring of critically ill patients. The fellow’s time is divided equally between adult and pediatric services.
Participants will engage in the interdisciplinary evaluation of medically refractory patients for epilepsy surgery, where the focus is on the integration of seizure semiology with phase one EEG data, high-density EEG studies, neuropsychological assessments, and MRI, SPECT and PET studies to develop surgical hypotheses and select patients for intracranial investigation, resective surgery, thermoablation or neurostimulation.
Fellows will learn to perform: 1. intracarotid sodium amobarbital procedures (Wada tests); 2. electrocorticography and intra- and extra-operative functional mapping; 3. plan and interpret sEEG and grid-strip phase two monitorings; 4. learn to program responsive neurostimulators (RNS) and vagus nerve stimulators (VNS).
Finally, participants also learn a multidisciplinary approach to the assessment and management of epilepsy’s comorbidities in collaboration with neuropsychiatry, endocrinology and social work. Training includes the selection of patients for dietary treatment of epilepsy with the support of an epilepsy-trained nutritionist.
Program Didactics
The programs’ didactics investigate the processes that give rise to seizures and epilepsy, the neurophysiologic bases of the EEG, the medical and surgical management of epilepsy, and the consequences of epilepsy and its comorbidities.
Fellows attend two lunchtime didactic sessions per week, a weekly session dedicated to interesting and challenging EEGs and a weekly journal club. Faculty members present most lectures. Our fellows also attend our weekly epilepsy surgery and EMU conferences and attend weekly departmental grand rounds.
Rotations
Adult EMU (three months)
Pediatric EMU (three months)
Critical Care EEG (three months)
Elective / Research (two months)
Vacation (one month)
Fellows generally attend two afternoon pediatric or adult epilepsy clinics per week, and read routine EEGs three afternoons per week.
Fellows attend monthly neurostimulation (VNS or RNS) clinics.
Elective and research time is tailored to the fellow’s interests and career goals. Training in intraoperative monitoring and electives, including sleep medicine and neuroradiology, are available. All fellows participate in the program’s QA processes. Fellows are encouraged to participate in research.
Fellows generally prepare and present patients at our epilepsy surgery conference every other week, and present patients at our EMU conference weekly.