Training of neurology residents in epilepsy and EEG comprises an essential component of the overall training scheme of the UF neurology residency program. Dr. Yue Wang heads the resident training effort on behalf of the Division’s faculty. Epilepsy rotations are divided into two blocks of four weeks each, Epilepsy I and Epilepsy II. 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 Epilepsy I and Epilepsy II rotations are
- Basic competency with EEG reading (milestone based evaluations)
- Epilepsy I rotation: physiological patterns in wake and sleep, normal variants, intro to the abnormal EEG
- Epilepsy II rotation: emphasis on pathological patterns including ICU/LTM EEG
- Recognition of status epilepticus and initiation of therapy
- Epilepsy I: basics of identification and treatment of status epilepticus
- Epilepsy II: management of refractory status epilepticus and subclinical status epilepticus
- Inpatient management in the epilepsy monitoring unit (EMU)
- Epilepsy I: basics of video EEG monitoring and diagnostic workup of paroxysmal spells
- Epilepsy II: workup of refractory epilepsy and seizure localization by 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 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. Resident didactic conferences are held every day at noon. Epilepsy specific didactics take place on Wednesday mornings and Friday mornings. Residents are also welcome to the divisional patient management conferences on Monday afternoons and Tuesday mornings.
A sample weekly time-table might be: