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Faculty availability is a high priority in the Clinical Neurophysiology,
Electromyography Fellowship. Your rotations, clinic schedules and
research time are designed to maximize your interaction with faculty
members. Although you will learn and see patients with several specialists,
you will develop your own style for evaluating and managing patients.
Clinical Training
The clinical experience during Clinical Neurophysiology,
Electromyography Fellowship includes direct training under the supervision
of the consultants working in the Electromyography Laboratory. By
the time you successfully complete this program, you will have performed
studies on patients with all types of neuromuscular disorders, including:
- Spine and limb disorders
- Peripheral neuropathy
- Myopathy
- Motor neuron disease
- Disorders of neuromuscular transmission
First Six Months
The fellowship begins with a two-month Clinical Neurophysiology
Introductory Course. The course is a formal didactic program covering all areas of clinical
neurophysiology. You will study the anatomy, physiology, pathophysiology,
pathology and clinical neurophysiological features of disease while
learning basic EMG methodologies. You will be tested in these areas
before performing clinical studies on patients.
You will spend the next four months gaining experience by performing
EMG studies on patients with a wide variety of neuromuscular disorders.
You will also identify and begin to implement one or more research
projects.
Second Six Months
During the second six months, you will have the opportunity to learn
more advanced techniques - including single-fiber electromyography,
evoked potentials and surgical monitoring.
You will perform EMG studies on patients with more complicated
neuromuscular problems and take increasing responsibility to work
independently on most problems. If you wish, you also can gain experience
in quantitative sensory, computer-assisted myometry and autonomic
laboratories.
In addition, during the last three months, you will teach neurology
residents from Rochester who elect to take a two-month rotation
in the Mayo Arizona Electromyography Laboratory. Dedicated time
will be provided so you can complete your research projects.
Didactic Training
Clinical conferences, lectures, lecture-demonstrations, seminars,
small discussion groups, and one-on-one instruction are all an integral
part of Mayo Clinic's clinical neurophysiology programs.
Throughout the fellowship, you will participate in a series of
formal didactic sessions and regularly scheduled conferences in
all aspects of clinical neurophysiology including:
- Bi-monthly EMG/Neuromuscular case conference
- Weekly Neuroscience conference
- Monthly Neuromuscular Journal Club
Research Training
you are encouraged to complete at least one investigative project
during your training. The type of research project you select will
depend on your interests and capabilities and the time available.
Opportunities are available for collaborative studies with other
clinical and basic science sections at Mayo Clinic.
When you complete your research, you will be expected to present
it at a scientific meeting or prepare it for publication in a scientific
journal. This experience teaches you how to comprehend and critically
evaluate other reported investigations and gain insight into the
conduct and principles of research.
Additional Training
Evoked Potentials
You will have the opportunity to study in Mayo Clinic's EMG and
EEG laboratories learning about the techniques and interpretation
of evoked potential studies. This includes exposure to:
- Brainstem auditory evoked responses
- Pattern reversal visual evoked responses
- Somatosensory evoked potentials
Movement Disorders
In EEG and EMG laboratories, you also will learn about techniques
for assessing movement disorders - including tremors, myoclonus,
seizures, botulinum injections and others
Sleep Disorders Center
The Sleep Disorders Center is staffed by consultants in pulmonary
medicine.
You may spend time in the laboratory, where you can gain experience
in performing and interpreting nocturnal polysomnography and multiple
sleep latency tests. Here, you also have the opportunity to see
patients with a wide variety of sleep disorders, including:
- Narcolepsy
- Sleep apnea syndrome
- Parasomnia
- Insomnia
Autonomic Laboratory
If you would like experience in the Autonomic Laboratory,
you can arrange time in this area before or after completing your
clinical neurophysiology fellowship. This three-month experience
includes lectures, supervised reading, training in autonomic testing,
and possibly a research project under the supervision of staff.
Mayo Clinic's Autonomic Laboratory focuses on clinical studies.
Routine tests performed in the laboratory include:
- QSART (quantitative sudomotor axon reflex test)
- Orthostatic BP and HR response to tilt
- Heart rate (HR) and response to deep breathing
(HRDB)
- The valsalva ratio (VR)
- Beat-to-beat BP (BPBB) to valsalva maneuver,
tilt and deep breathing
- Tests to detect sympathetically maintained pain
or reflex sympathetic
dystrophy (RSD)
- Resting sweat output
- QSART
Research Extension
After a one- or two-year fellowship, you may apply for
an extension in one of the research programs. This additional 12
months of training will be devoted to research under the supervision
of the laboratory director. This extension requires the endorsement
of the chair of the Neurology Education Committee.
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