Epilepsy Fellowship Training

Training at University Hospitals Cleveland Medical Center

Most training occurs at University Hospitals Cleveland Medical Center, a comprehensive care academic medical center with 1,032 beds. Founded in 1866, this renowned academic medical center is intricately linked to the history of Cleveland and nurtured and supported by the city's great industrial families of the late 19th and 20th centuries. It is the hub of University Hospitals consisting of 18 hospitals and over 40 ambulatory centers employing 4,700 physicians and over 25,000 employees, which makes it one of the most integrated healthcare systems in the nation. The hospital includes two Epilepsy Monitoring Units (adult and pediatric), and the Reinberger Neuroscience Intensive Care Unit, a 20 bed unit with ten long-term EEG monitoring beds.

UH has been awarded for its clinical excellence by some of the most prestigious, credited institutions and publications in the world such as the U.S. News & World Report and many others. It is a Magnet Award and Beacon Gold Award winner and has achieved and maintained its status as a Level IV Epilepsy Center by the National Association of Epilepsy Centers (NAEC).

Diverse Clinical Opportunities

Our epilepsy fellows are actively involved in patient care, managing patients in the Epilepsy Monitoring Unit and guiding treatment decisions for nearly all patients presenting with seizures to the UH Cleveland Medical Center. Fellows receive extensive clinical experience bolstered by several outpatient clinics across Northeast Ohio, where they garner a wealth of experience in treating diverse patient populations at all levels of epilepsy and all walks of life. In addition to these fundamental and advanced epilepsy experiences, fellows are exposed to and trained in intraoperative neuromonitoring, a growing and important skill set that improves outcomes for brain, spine, and cardiovascular surgery patients. All of this is conducted across University Hospitals' award-winning hospital system with a 6 bed Adult Epilepsy Monitoring Unit, a 6 bed Pediatric Epilepsy Monitoring Unit, a 10 bed Neuroscience ICU Monitoring Program, and a busy routine and long-term EEG service monitoring patients at numerous facilities over Northeast Ohio.

The clinical rotation offerings of the program during this one-year fellowship include:

• Adult Epilepsy Monitoring Unit rotation: ~11 weeks
• Pediatric Epilepsy Monitoring Unit rotation: ~4 weeks (minimum)
• EEG reading and epilepsy consulting: ~12 weeks
• Outpatient clinic with administrative time: ~10 weeks
• Intraoperative neuromonitoring rotation: ~6 weeks (integrated with clinical weeks)
• Elective time: 5 weeks
• Vacation: 4 weeks

The above schedule is flexible towards fellows’ individual interests and goals, provided that all ACGME requirements for clinical education and experience are maintained. UH/CWRU prides itself on graduating competent and talented electroencephalographers and epileptologists, so no matter what fellows’ career paths may entail, they will be exceptional at the care, interpretation, and management of patients with epilepsy.

A Didactic Powerhouse

In addition to clinical experience, fellows receive unprecedented instruction in the reading and interpretation of EEG. This education commences with participation in the International Epilepsy & EEG Course, an intensive educational course that has been developed and delivered for over 30 years and attracts physician learners from all over the world. The course covers everything from the basics of electroencephalography to advanced topics in the surgical management of refractory epilepsy. Outside of this, on an average week, there are 4-5 hours of lectures on various topics in seizure semiology, surgical management, quantitative EEG, anamnesis, and cutting-edge topics in both neurology and epilepsy. All education is guided by the Center’s staff who in recent years have been awarded multiple high-level teaching awards, both from within University Hospitals' esteemed Neurological Institute and on the world stage by the International League Against Epilepsy. Here below is the lecture schedule for a typical week:

• Monday AM – Epilepsy Grand Rounds
• Tuesday AM – Morning Didactic Conference with Hans Lüders, MD, PhD
• Wednesday AM – Intraoperative Neuromonitoring Conference (select weeks)
• Thursday AM - Morning Didactic Conference with Hans Lüders, MD, PhD
• Thursday PM – Afternoon Multidisciplinary Management Conference
• Friday AM – Neurology Grand Rounds
• Friday PM – Fellow Lecture and Meeting

Finally, fellows are highly encouraged to attend a national conference in either epilepsy, clinical neurophysiology, or neurology. There is stipend money that can be put towards conference registration and lodging, with additional funding available if fellows have a conference submission (abstract, presentation, etc). Fellows typically attend either the American Epilepsy Society meeting, the American Clinical Neurophysiology Society meeting, or the American Academy of Neurology meeting. However, other educational conference offerings may also be considered.

Research and Innovation

The UH Epilepsy Center has long been associated with research into the semiological classification of the epilepsies, spearheaded by the ground-breaking works of Hans Lüders, MD, PhD, and his development of the Four Dimensional Epilepsy Classification system. With a robust commitment to clinical discovery, this work continues across the faculty. Clinical fellows will also collaborate with a large number of international visiting epileptologists and research scholars who heavily contribute to the academic and work environment.

It is an expectation of the fellowship to produce at minimum a poster presentation for the UH Neurological Institute’s Annual Research Day. Fellows from the Epilepsy Center have won top prizes in the past, and continue to produce exceptional research into a variety of epilepsy related topics. Fellows are also encouraged to engage in quality improvement projects that produce better outcomes for epilepsy patients and serve as a foundation for developing leadership skills from which to draw upon throughout their careers.

Join Us, Won’t You?

The fellowship program has five one-year Accreditation Council for Graduate Medical Education (ACGME)-accredited positions in epilepsy, which are generally accepted through the American Epilepsy Society Match program. As our epilepsy family continues to grow, each generation builds upon the knowledge and successes of its predecessors, as the growing understanding of epilepsy and the technology used to treat it expands toward new capabilities and greater possibilities. We are eager to welcome the next class of world-class epilepsy graduates, and look forward to hearing from you soon!