The University of Michigan Epilepsy fellowship and Clinical Neurophysiology fellowship are twelve-month ACGME accredited programs devoted to assisting trainees in developing expertise in the diagnosis and management of seizure disorders in adults and children including the interpretation and implementation of many neurodiagnostic evaluations that are used in treatment of epilepsy. Most of our candidates apply for an epilepsy fellowship and we have six ACGME accredited positions per year. Candidates interested in learning other neurophysiological techniques as well (intraoperative monitoring (IOM), sleep, EMG, etc.) may choose to do fellowship in clinical neurophysiology with epilepsy emphasis. The fellowship includes rigorous training in electroencephalography (scalp and intracranial), electrocorticography, decision making in all types of epilepsy surgery (resective surgery, source modeling, LITT, RNS, DBS, VNS), intraoperative and extraoperative functional mapping, intraoperative monitoring, understanding imaging and cognitive modalities, as well as medication management in both adults and children.
There are opportunities to teach and several basic science mentors with exciting research opportunities.
Upon completion of the fellowship, trainees are eligible to sit for the American Board of Psychiatry and Neurology added qualification in Epilepsy examination or the American Board of Clinical Neurophysiology examination depending on the track that they have chosen.
Interested trainees may elect to do a second year of Advanced Epilepsy training for additional experience with surgical techniques and neuromodulation, or mentored research in our basic science or clinical areas, and are provided with opportunities of attending a formal course on medical education.
Clinical Experience, Electrodiagnostics and Procedures
The University of Michigan epilepsy clinic is a tertiary referral center, commonly drawing patients from the metropolitan Detroit area, the state of Michigan, Ohio, Indiana, and a few other out-of-state areas. Our inpatient, long-term video monitoring services care for about 1,500 adult and 1,500 pediatric patients yearly, with diagnoses including pre-surgical evaluation, intensive care monitoring, treatment of status epilepticus, and diagnosis of non-epileptic paroxysmal disorders. The primary responsibility for fellows on the adult and pediatric services is reading the EEG studies and multidisciplinary communication of these results. There is an adult and pediatric epilepsy consultation service where our fellows can assist more directly with management of complex cases. Rotations are tailored to the needs and interests of each fellow; for instance, the pediatric epilepsy fellows have predominantly pediatric rotations. Fellows have no in house call, but do rotate through EEG reading call at home. We are putting a great effort into managing the workload with careful attention to fellow feedback and satisfaction. Fellows are directly involved in decisions about how best to accomplish their work and have a monthly fellow education conference to discuss the customization of their education, call schedule, and any challenges that may arise. Creating a good work-life balance for our trainees is a continuous process and one of the programs’ priorities.
Fellows are given intensive early instruction in surface EEG, ECoG, and sEEG interpretation. For the first three months of the fellowship, every tracing is reviewed simultaneously by an attending. After a self-assessment examination with a successful demonstration of electrodiagnostic skills, fellows are given progressive responsibilities and independence to decide when to call the attending. However, faculty member is always on call with the fellow and is readily available to share workload and provide backup when needed.
Rotations expectations and guidelines are provided during orientation in July and reviewed periodically throughout the year.
Education
Throughout the year, there is a comprehensive didactic schedule offering two conferences per week with emergent topics being reviewed in the first few months. All didactic conferences are video and audio archived, and accessible at any time. There is a mandatory pre-surgical epilepsy conference once a week. ICU-EEG conference focusing on challenging critical care EEGs is offered once a month. The fellows lead weekly journal club discussions that take place in the last few months of their training. Additional lectures on evoked potential and IOM are available. We have workshops in VNS, RNS, and DBS. New didactics can be added per fellow request. Fellows receive outstanding teaching from diverse epilepsy faculty with a variety of clinical and research interests.
Our fellows are offered problem based learning quality improvement training and are encouraged to participate in quality projects. If interested, fellows are given the opportunity to present didactic lectures to other trainees and receive mentoring for teaching. All fellows are mentored through a research project and put up a research poster at the departmental Neuroscience Research Conference. Our fellows attend at least one national meeting per year.
Fellows take a self-assessment examination in the fall and the Epilepsy in service exam (EpiFite) and/or American Board of Clinical Neurophysiology (ACNS) in service exam each spring.
How to Apply
We participate in the National Residency Matching Program and only accept the following required application materials via the Electronic Residency Application Service (ERAS).
• ERAS application
• CV
• ECFMG Certificate if you graduated from a foreign medical school
• USMLE or COMLEX Scores
• Personal statement that describes your interest in epilepsy or CNP fellowship
• Three letters of recommendation (including one from a current/former program director or chair)
The Department of Neurology is an equal opportunity employer and does not discriminate with regard to sex, race, age, religion, color, national origin, disability, or any other applicable legally protected status.
You must be a United States citizen, permanent resident (green card holder), or have a J-1 visa sponsored through ECFMG. We do not sponsor any other visas.
For more information, please contact Samantha Payer at [email protected] or Dr.Temenuzhka (Nusha) Mihaylova at [email protected]
Competitive Salaries and Benefits
The University of Michigan offers highly competitive salaries and tremendous benefits to our residents/fellows. An overview of salary, benefits and employment eligibility is available on the GME Office website linked below.
Work and Living Environment
Ann Arbor, MI is a family friendly city renowned for its cultural offerings. Ann Arbor is home to Michigan Medicine, a leading clinical and research medical facility. It has been ranked highly as a preferred city because of its sporting, music and active cultural life and welcoming natural setting. The department of neurology is a highly ranked, academic department with a bid residency training program and internationally renowned faculty.
Fellows are given ample private storage and work spaces in several areas, strong administrative and faculty support. Call is only from home reading EEG tracings but there is a call room in the hospital available to the fellows if needed. Call schedule is ready for the whole year and is overseen by the fellows who take administrative ownership. The schedule carefully integrates fellow and faculty feedback to provide optimal work-life balance for all.
Program Director
Nusha Mihaylova, M.D., Ph.D.
Assistant Program Director
Nancy McNamara, M.D.
Program Administrator
