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Epilepsy EducationFor Epilepsy Fellows (Neurology, Neurosurgery, Neuropsychology)
OverviewYale School of Medicine and Yale New Haven Hospital currently have a two-year Epilepsy Fellowship that follows Neurology postgraduate training. Fellowship can be one-year in special situations, but this decision must be made within three months of the start of Fellowship and cleared with the Fellowship Director ahead of time. Most of the time, however, the Fellowship includes two years and encompasses clinical training in an inpatient and outpatient setting, as well as research which may be basic or clinical. Fellows assume a considerable amount of clinical responsibility including inpatient evaluation and admission, orders including decisions on antiepileptic drug withdrawal, sleep deprivation, and other activation procedures for monitoring, construction of montages for printing and review of all recorded EEG video data, screening for artifactual results, presentation of results to the Epilepsy Attending, and formulation of results of the monitoring session. The Fellows gain expertise in antiepileptic drug manipulations, pharmacokinetics and pharmacodynamics, as well as interpretation of continuous video EEG. The latter includes application of additional scalp electrodes, specialized electrodes including sphenoidals, intracranial, depth, and subdural EEG electrodes, interpretation of sleep and activated EEG in an inpatient setting, and utilization of all these skills in the study of both children and adults. Studies are done to evaluate ongoing epilepsy with difficult management issues, as well as diagnostic situations in which epilepsy or nonepileptic seizures are among the diagnostic possibilities. The inpatient monitoring is supervised by full-time Yale Epilepsy Faculty who specialize in epilepsy. The Fellows work extensively and directly with the Epilepsy Faculty in their clinical training. In addition, the Fellows receive more formal education in the setting of a specific lecture series covering a broad range of topics in epilepsy evaluation, diagnosis, categorization, treatment and mechanisms. Fellows also are encouraged to and mentored through research projects of their choice. These may include basic and/or clinical areas as the specific interests of the Fellow dictate. Research projects are supported by and mentored by Epilepsy Faculty who will assume a key role in designing and directing the research of the Fellow. It is our hope that the Fellows will accomplish a sufficient amount to present their work at the American Epilepsy Society, The American Academy of Neurology, Child Neurology Society, Society for Neuroscience annual meetings and publish their work. The Fellowship includes, at any given time, two or three Epilepsy Neurology Fellows (a mixture of first and second year). Sometimes up to four are present because of independent funding for additional Fellows. In addition, visiting Scholars from other countries join this group at various times. The Fellowship has existed for nearly two decades and from this environment and setting, has produced multiple academic and practicing Neurologists with expertise in epilepsy and its subtypes, its evaluation and treatment, and its investigation. Currently, there is no accreditation or certification for Epilepsy, but The American Academy of Neurology and its Epilepsy Section are working to accomplish Epilepsy Subspecialty recognition. This fellowship is specifically for Epilepsy training, not Clinical Neurophysiology, although extensive training and education in EEG is included. 
CurriculumFellows rotate on the inpatient monitoring service for pediatrics and the inpatient monitoring service for adults, and on elective. In each of these rotations, which occur for one month at a time, the Fellows have specific outpatient epilepsy clinic responsibilities which involve at most two half days per week. The outpatient epilepsy clinics occur with one of the Epilepsy Faculty, the specifics of which vary depending on the rotation. The Fellows also attend weekly epilepsy surgery patient conference, weekly neurology grand rounds, weekly EEG conference, weekly clinical neurophysiology lectures, and monthly Epilepsy Journal Club. While rotating on the monitoring services, the Fellows attend morning rounds with the Epilepsy Attendings. The Fellows are expected to (and are supported to) attend the annual meeting of the American Epilepsy Society and selected other meetings including sometimes that of the American Academy of Neurology, the American Neurological Association, the Child Neurology Society, and the Society for Neuroscience. Research topics are decided after discussion and agreement between the Fellow, the Fellowship Director, or other Epilepsy Attendings as interests dictate and coincide.
AlumniPost Doctoral Fellows Trained in this Epilepsy Program include:
FacultyThe Yale Epilepsy Faculty combined have received multiple National and International research awards, include several past Presidents of the American Epilepsy Society, and have extensive and renowned educational and research accomplishments.
Application ProcessEpilepsy Fellowship Application [PDF] Applications for the Fellowship are received beginning in the spring of the year preceding start of the Fellowship on July 1. Thus, applications will be accepted for Fellowships beginning July 2007 in March of 2006. Application requires completion of the formal application form which can be downloaded below, as well as submission of a CV, letter of intent, and three letters of reference which the applicant should arrange to be forwarded to the Fellowship Director. All materials should be sent to Dr. Susan Spencer, Department of Neurology, Yale School of Medicine, P.O. Box 208018, 333 Cedar Street, New Haven, CT 06520-8018, (203) 785-3865, susan.spencer@yale.edu. Upon review of completed applications and materials, the applicant may be invited for an interview in New Haven which will take a complete day, beginning at approximately 9:00 am and ending at about 5:00 pm. Flights can be obtained into either Hartford's Bradley Field or New Haven's Tweed Airport. Additionally, auto and train service are satisfactory for travel to New Haven. Please contact Dr. Susan Spencer at anytime for further information regarding the Fellowship, requirements, application procedures, or content. Prerequisites for the Fellowship include completion of a US Accredited Neurology Residency and at least four months of EEG/clinical neurophysiology (during training the Residency or in a separate Clinical Neurophysiology Fellowship). Applicants should be Neurology Board eligible.
Helpful Links Regarding Epilepsy Fellowships, Research, Funding
Suggested ReadingsEngel J Jr and Pedley TA. (eds) Epilepsy, a comprehensive textbook. Philadelphia, Lippincott-Raven, 1998.
Epilepsy Education at AESFellows:
Living in New HavenNew Haven is a remarkable community for its size, possessing an excellent quality of life with reasonable cost of living, many pleasant living situations, and a remarkable level of culture in the musical and artistic worlds mostly provided by Yale University and by proximity to Boston and New York. Links are provided below to various informational sites for New Haven housing, shopping, and other important data.
Epilepsy NeurosurgeryThe epilepsy surgery program offers a flexible experience in the diagnostic and therapeutic approaches to medically intractable seizures. A single position for six months to one year is available either following completion of neurosurgical training or embedded within the residency. A Yale-New Haven Hospital resident may elect to concentrate within this specialty for six months to one year and, if choosing this path, may combine clinical experience with ongoing research related to epilepsy. For individuals choosing the one-year course, either during or following neurosurgery training, the year begins in July and the first three months are spent in Neurology. Here the fellow works with the medical epileptologists attending outpatient clinics, evaluating patients for the surgical program, learning about the appropriate selection of anticonvulsants, and studying both scalp and intracranial electroencephalography. The surgical fellow rotates with the neurology fellows supervising the audiovisual monitoring (AVEEG) of Phase-1 patients (24-hour scalp monitoring selection for surgical candidacy) and caring for the patients undergoing chronic intracranial study (Phase 3). The fellow is supervised in the AVEEG monitoring suite by an epileptology faculty and is then responsible for presenting these patients at the weekly Monday epilepsy surgery conference. The next nine months are then spent in the surgical arm of the program where they take part in both diagnostic and therapeutic surgical procedures. There is a close interaction with the other residents who also take part in the surgical procedures assuming the role of assistant or primary surgeon, depending on year of training and ability. The fellow is expected to carry out at least one clinical research project during this year, attend twice weekly clinics, present at monthly Journal Club, and at the end of the year prepare an abstract for the yearly meeting of the American Epilepsy Society. Contact: Dennis D. Spencer, M.D.
Epilepsy NeuropsychologyThe Post-Doctoral fellowship in Clinical Neuropsychology is a 2 year program that provides advanced training in the theory and practice of Neuropsychology with a special emphasis in Epilepsy. The program combines extensive direct clinical experience with didactic learning and individual supervision to form the basis of a more comprehensive understanding of the cognitive and psychological status of patients with epilepsy. Direct clinical experience includes detailed assessment of cognitive abilities and emotional function, participation in multidisciplinary case conferences, and treatment of cognitive disorders associated with epilepsy. Didactic experiences include a broad range of case conferences, seminars, rounds, and courses offered through Yale Interdepartmental Neuroscience Program. Clinical and basic science research experience is also available through collaboration with the Epilepsy program faculty. The Neuropsychology program is designed to meet Houston Conference guidelines for advanced training in Neuropsychology, and will prepare the fellow for board certification in Clinical Neuropsychology. Contact: Michael Westerveld, Ph.D.
Epilepsy Fellow & Attending Rotation Schedule 2007-08Download PDF of On-call schedule.
Epilepsy Clinical Neurophysiology Fellows Lecture Series 2007-08
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