Residency Training

books and brain photo

Training of neurology residents in epilepsy and EEG comprises an essential component of the overall training scheme of the UF neurology residency program. Dr Maria Hella heads the resident training effort on behalf of the Division’s faculty. Epilepsy rotations are divided into two blocks of four weeks each, Epilepsy1 and Epilepsy2. The former occurs within the first six months of the PGY2 year, and the second four weeks is taken sometime during the PGY3-4 years. Residents with a particular interest in epilepsy may choose to spend extra elective time to gain more experience or pursue a research topic. In general, we aim to impart knowledge that is clinically important and comprehensive for the everyday practice of neurology, yet succinctly conveyed. In addition, being a tertiary referral center, we also expose trainees to the challenges of complex and surgical epilepsy syndromes, so that they may glimpse the excitement and promise of this rapidly-evolving neurology subspecialty. In addition, all new entering residents are provided a set of lectures dubbed the ‘epilepsy bootcamp’ during their first week that equips them to appropriately request investigations and manage seizures in the emergency room or wards.

The goals of the Epilepsy1 and Epilepsy2 rotations are

  • Basic competency with EEG reading (milestone based evaluations)
    • Epilepsy 1 rotation: normal vs abnormal, straightforward variants, epilepsy types
    • Epilepsy 2 rotation: more advanced EEG including ICU/LTM EEG
  • Recognition of status epilepticus and initiation of therapy
    • Epilepsy 1: basics of identification and treatment of status epilepticus
    • Epilepsy 2: increased sophistication with management of refractory status epilepticus and subclinical status epilepticus.
  • Basic treatment of epilepsy and inpatient management in the EMU (Phase 1)
    • Epilepsy 1: basics of video EEG monitoring and diagnostic workup of spells and medically refractory seizures
    • Epilepsy 2: management of more complex and refractory cases and more complex seizure localization including intracranial monitoring

 

Residents spend their time on both of the epilepsy services every day: the EMU service that deals with hospitalized patients and any inpatient procedures (Wada or electrocorticography in the OR) and the EEG service, that is responsible for interpretation of for short EEGs (stats and routines), long-term monitoring, ambulatory, day lab video-EEGs and evoked potentials.  A sample weekly time-table might be:

 

Monday Tuesday Wednesday Thursday Friday
AM Rotation activities Meet with EMU attending

Observe EEG tech

EMU Admissions

EMU Rounds/Admissions

8 -9:30 AM Surgical conference

9 AM Wada testing (if applicable)

 

EMU Rounds

 

 

 

OR day

EMU Rounds

EMU rounds

 

 

Residency/ ACGME Noon conference

 

Noon: Grand Rounds Noon conference

1 PM Residency director meeting

Noon Conference Noon conference

 

PM Rotation Activities

 

 

 

 

Review EEGs/LTM

Meet with EEG attending

 

Review EEGs/LTM

Meet with EEG attending

 

Review EEGs/LTM

Meet with EEG attending

 

Review EEGs/LTM

Meet with EEG attending

 

VA EEG reading session

 

Review EEGs/LTM

Meet with EEG attending