EMG/Neuromuscular Track Details
Program director: S.M. Vishnubhakat, MD
The role of the fellow is progressively expanded over the training period. Introductory training includes understanding basic principles of electronics, electrical safety, ethics, OHSA and HIPPA regulations.
At the beginning of the training, waveform recognition and the performance of basic studies is done under the direct supervision of the site director and other faculty. Once proficiency is noted the fellow performs all studies independently under indirect observation of the program director. Patient evaluation, diagnostic formulation, study design and accuracy, report writing and management are discussed. Methods of evaluation include direct observation, multiple choice questionnaires, literature review, and direct assessment of the fellow’s ability to teach other residents during their elective rotation. Mastery of interpretation of nerve conduction studies, reflex studies, blink reflex studies, needle electromyography, single fiber EMG, autonomic testing, and spinal, visual and brain stem auditory evoked responses is anticipated.
The fellow performs the EMG/NCS including obtaining clinical history, examination of the patient, electrode placement, needle insertion and personally interprets the results under the supervision of the program director. Each study or case is discussed by the director with the fellow in detail, with appropriate formulation, literature citation and current management. As the training advances, progressive independent responsibilities are assigned to the fellow with appropriate intensive clinical monitoring by the program director, including constructive critique. All fellows must participate in the teaching of residents during their rotation through the EMG lab.
Quarterly evaluations include all six core competencies and feedback. By the end of six months, 200 independent studies are expected from the fellow and thereafter greater responsibilities are assigned. In-service examinations are sponsored by American Association of Neuromuscular and Electrodiagnostic Medicine and the American Clinical Neurophysiology Society for self evaluation. The results are discussed with the fellows and appropriate remedial measures are taken to improve their knowledge base. Participation in clinical research is expected.