NYU Langone’s Division of Epilepsy offers an American Council for Graduate Medical Education (ACGME)–accredited, one-year fellowship in epilepsy, with an emphasis on electroencephalography (EEG) and the clinical evaluation and management of epilepsy.
Under the direction of Patricia C. Dugan, MD, fellows gain wide-ranging experience in various clinical settings and in routine, ambulatory, and long-term video EEG interpretation on both adult and pediatric services. Fellows also participate in the presurgical and surgical evaluation of patients and have extensive exposure to intraoperative electrocorticography, cortical mapping procedures, intracranial EEG interpretation, and intracarotid sodium amobarbital procedures (Wada tests).
Two key elements are central to our fellowship program’s mission: producing expert board-eligible clinicians who deliver high-quality, patient-centered care and fostering an academically minded work environment where inquisitiveness is an integral part of professional development. Fellows acquire the technical and clinical skills needed to practice as independent epileptologists in either academia or private practice. Some of the most complex epilepsy patients from across the United States, and internationally, are cared for at NYU Langone’s Comprehensive Epilepsy Center, leading to a rich clinical experience for our fellows.
Our epilepsy surgical program is one of the most robust in the country and involves regular multidisciplinary collaboration with neurosurgeons, neuropsychologists, neuroradiologists, and neuroscientists. As a fellow, you become adept at intracranial configuration and interpretation, and have routine exposure to bedside mapping and intraoperative procedures.
You are encouraged to take advantage of the abundant and diverse research opportunities at the Comprehensive Epilepsy Center. Our faculty members are leaders in the academic community. A stimulating research environment is at the core of our center’s culture, and fellow participation is welcomed and encouraged.
Fellows who have successfully completed the year of training are eligible for subspecialty certification in epilepsy through the American Board of Psychiatry and Neurology. Graduates may also opt to pursue a second year of fellowship training (not ACGME accredited) at NYU Langone in epilepsy research. The second year of fellowship is recommended for individuals who wish to pursue a career in academic medicine as an epileptologist. The dedicated research time gives you the opportunity to develop a research project in an epilepsy-related area of interest in collaboration with some of the country’s leading experts in the field.
Epilepsy Fellowship Experience
NYU Langone’s Comprehensive Epilepsy Center is a Level 4 Epilepsy Center and is among the largest epilepsy programs in the United States. In addition to adult and pediatric inpatient video EEG monitoring units, NYU Langone also has a busy epilepsy surgery program, an epilepsy consult service, and an outpatient clinic.
Epilepsy fellows spend 11 months of their fellowship completing various rotations in the Kimmel Pavilion and Tisch Hospital and at the Comprehensive Epilepsy Center. Fellows are entitled to one month of vacation time.
All incoming fellows begin the program in July, on the first day of the academic calendar year. Before orientation, we provide materials to assist you with scheduling medical record system training and understanding rotation-related procedures and expectations. During orientation, you receive materials including a fellowship training handbook with policies and procedures, expectations, and responsibilities for each rotation, and various relevant schedules for training modules, rotations, and call.
You have access to an electronic PDF library of selected EEG and epilepsy-related articles. You are also provided with a USB drive that contains instructional videos on general policy and procedures, as well as orientation material in the form of video tutorials. This instructional series takes you step-by-step through the mechanics of different rotation-dependent tasks.
EEG/Epilepsy Experience and Inpatient Services
Fellows rotate through several core services and gain extensive clinical experience with both adult and pediatric video EEG monitoring, invasive intracranial monitoring, and epilepsy consults in the intensive care unit (ICU) as well as non-ICU settings. Through NYU Langone’s large video EEG monitoring units, you have access to a vast array of electrographic data that you can study.
Kimmel Pavilion has 20 hardwired beds on the adult acute neurology floor, as well as 6 in the adult neuroscience ICU, 12 on the pediatric floor, and 6 in the pediatric ICU. In addition, portable EEG units may be deployed throughout the hospital for bedside EEG monitoring. We have one of the most active epilepsy surgery programs in the United States, performing 60 to 80 procedures, including electrode implantation and surgical resection, each year.
Fellows rotate at one-month intervals on the adult video EEG service, the pediatric service, the consult service, and the surgical service. During the adult video EEG service rotation, you practice and perfect their electroencephalogram-reading skills during a daily review of records with the attending physician, during which they receive one-on-one interaction and feedback. You also learn how to write a proper EEG report, a necessary skill in a career as an epileptologist.
Fellows encounter a variety of patient conditions on the adult inpatient service, including temporal lobe epilepsy, frontal lobe and other extratemporal epilepsies, multifocal epilepsy, primary generalized epilepsy and symptomatic generalized epilepsy, Lennox-Gastaut syndrome, and focal status epilepticus. Indications for admission include but are not limited to disease characterization, the presurgical evaluation, and the acute management of seizure exacerbation.
On the epilepsy unit, you also observe and learn from cases involving brain tumors, stroke, malformations of cortical development, and central nervous system inflammatory diseases such as lupus encephalitis and NMDA-receptor antibody encephalitis. You may also regularly encounter nonepileptic seizures or other conditions (with psychiatric or organic origins) that have been mistaken for refractory epilepsy.
The adult epilepsy monitoring unit team includes a dedicated neuropsychiatrist who consults on cases of inpatients in need of psychiatric evaluation and care as well as neuropsychologists who provide comprehensive patient assessments. On the adult floor, we admit 80 to 90 patients for monitoring monthly. This patient volume gives you comprehensive and invaluable clinical experience.
As a fellow, you learn to read pediatric recordings while working directly with our pediatric epileptologists on the inpatient pediatric video EEG service. As with the adult epilepsy monitoring unit rotation, EEG review on the pediatric rotation is done directly with the attending physician. The pediatric unit monitors 40 to 60 patients per month, including neonatal patients. Frequently seen conditions include temporal and extratemporal neocortical epilepsies, infantile spasms, metabolic and neurodegenerative diseases, tuberous sclerosis complex, malformations of cortical development, hemimegalencephaly, absence seizures, benign rolandic seizures, status epilepticus, and nonepileptic etiologies.
On the consult service, you encounter a range of clinical scenarios and have the opportunity to manage routine cases, which can include providing guidance on antiepileptic drug management. You also make new seizure and epilepsy diagnoses and take part in the management in the care of acutely ill epilepsy patients in the medical, cardiac, surgical, and neurosurgical ICUs.
On the epilepsy surgery service, you work with the attending physician to interpret intracranial electrode recordings and coordinate mapping procedures and Wada tests. Each year, approximately 70 patients have epilepsy surgery and invasive monitoring at NYU Langone. We typically perform 20 to 30 bedside cortical mapping procedures, 15 to 30 intraoperative mapping procedures, and 40 to 50 Wada tests annually. You become adept at creating intracranial electrode montages and lead a weekly multidisciplinary conference presenting cases of patients being considered for epilepsy surgery.
During elective months, you are encouraged to pursue individual research interests or gain additional experience in neurostimulation, sleep medicine, neurogenetics, cognitive neuroscience, intraoperative and extraoperative procedures, and other areas of clinical neurophysiology.
On the outpatient ambulatory rotation, you have the opportunity to see outpatients under the mentorship of various epilepsy faculty. This rotation exposes you to an array of epilepsy disorders and different approaches to and styles of outpatient epilepsy management. Under the guidance of faculty members, you also interpret both routine and ambulatory EEG studies.
Epilepsy Fellows Continuity Clinic
All epilepsy fellows participate in a weekly outpatient epilepsy clinic. Here, you can hone clinical management skills by seeing patients throughout the year, ensuring continuity of care. An epilepsy attending staffs the clinic, treats all patients with you, and discusses patient evaluation and treatment plans. Nursing staff help coordinate patient care. Interpreter services are also available when needed.
Conferences and Didactics for Fellows
All epilepsy fellows are expected to attend regularly scheduled conferences that make up the epilepsy fellowship curriculum. Topics related to EEG, epilepsy, and other aspects of clinical neurophysiology including electromyography (EMG) and nerve conduction studies, intraoperative monitoring, sleep, evoked potentials, and neuromuscular disease are covered across the year. Lectures are held every Thursday at 12:00PM and prepared and given by faculty.
Epilepsy fellows are encouraged to attend the Multidisciplinary Conference, held on Mondays at 3:30PM, where patient cases being considered for surgery are presented to the Comprehensive Epilepsy Center. Participants include epileptologists, neurosurgeons, psychiatrists, neuropsychologists, and nursing staff.
Every Wednesday morning, a separate journal club–style conference is held at the Comprehensive Epilepsy Center. Invited lecturers from NYU Langone, as well as other external facilities, lead the discussions, in addition to our own Comprehensive Epilepsy Center faculty. Epilepsy fellows have the opportunity to lead one journal club each year. In addition, at the end of the academic year during Wednesday morning conference, you present a quality assurance project, which you may work on as a group across the year.
Epilepsy Research for Fellows
Research at the Comprehensive Epilepsy Center is organized into five working groups composed of clinicians from multiple disciplines, basic science researchers, neuropsychologists, and graduate students. Each working group is focused on one primary problem area in epilepsy and meets on a regular basis.
To optimize the value of the research experience, all fellows interested in research projects are encouraged to speak with the faculty to develop an appropriate hypothesis and refine the experimental methodology. You are also regularly invited to participate in the division’s research working groups and formal laboratory meetings.
Second-Year Epilepsy Research Fellowship
For candidates who have completed an ACGME-accredited neurology residency and an ACGME-approved clinical neurophysiology or epilepsy fellowship, we offer the opportunity to apply your knowledge to epilepsy research and obtain further training in scalp and intracranial EEG, electrocorticography, cortical mapping, and clinical management of epilepsy.
This is a non–ACGME-accredited fellowship program. For more information, contact Siddhartha S. Nadkarni, MD, director of the second-year epilepsy research fellowship program, at 646-558-0870 or firstname.lastname@example.org.
How to Apply
Applicants must submit the following materials before the deadline of December 12, 2018. Early application submission is encouraged, as applications will be reviewed on a rolling basis.
- a complete application form
- a one-page (maximum) personal statement detailing your interest in our fellowship program, career accomplishments, and short- and long-term career goals
- a current CV
- one letter of recommendation from your residency program director
- two letters of recommendation from other individuals
Additional supporting materials, including copies of papers or abstracts in which you are listed as an author, are encouraged but not required. Only qualified applicants will be invited for an interview.
If possible, please combine your application form, personal statement, and CV into one PDF file (Word files are acceptable). Send all application materials to Luisa Gutierrez, program coordinator, at email@example.com, or mail it to the following address:
462 First Avenue
New York, NY 10016
Our current 2018–19 epilepsy fellows are Jacob Pellinen, MD, and Dana Price, MD.
For more information on our fellowship programs, please contact Dr. Dugan, epilepsy fellowship program director, at firstname.lastname@example.org or 646-558-0803.
For application information or questions, please contact Ms. Gutierrez at email@example.com or 212-263-3737.