Four positions are offered per year. Eligible trainees include physicians who have completed an adult neurology residency program in North America. In addition to all of the above activities, adult EEG-epilepsy trainees participate in epilepsy monitoring of adult and pediatric patients, interpretation of routine EEGs and evoked potentials, and the management of patients with epilepsy and sleep disorders in the hospital and outpatient clinic. Trainees have their own longitudinal clinic where patients with epilepsy are evaluated under the supervision of staff neurologists. Video-EEG monitoring is performed on patients in the six-bed Adult Epilepsy Monitoring Unit under the direction of five adult epileptologists. Over 200 adults are evaluated annually with video-EEG, and over 100 proceed to surgery. Invasive monitoring is performed using depth or subdural electrodes. This program offers a comprehensive approach to the diagnosis and management of adults and children with epilepsy and sleep disorders, including surgical and investigational treatments.

The sections of Adult and Pediatric Epilepsy and Sleep Medicine offers one- and two-year programs in Adult EEG-Epilepsy, Pediatric EEG-Epilepsy, and Sleep Medicine.

For individuals eligible to apply for Subspecialty Certification in Clinical Neurophysiology by the American Board of Psychiatry and Neurology (ABPN-Neurology), the one-year program or the first year of the two-year program is accredited by the Accreditation Council of Graduate Medical Education (ACGME) and provides exposure to general clinical neurophysiology, but retains its focus in electroencephalography and epilepsy. Eligible applicants include trainees who have completed a neurology or pediatric neurology residency program in North America.

There is a core staff of ten neurologists with special interest in EEG, evoked potentials, and sleep, with an additional staff of five neurologists with special interest in EMG and neuromuscular disease. Over 8000 electrophysiological studies and 2700 EMG studies are performed per year. Also performed annually are 3500 adult and pediatric routine EEGs, 2000 polysomnograms, and 600 evoked potential studies.

The adult and pediatric EEG-Epilepsy training programs begin with a 12-week neurophysiology course. Morning sessions consist of lectures on basic neurophysiology, EEG, epilepsy and seizure classification, digital EEG, and neuroimaging of epilepsy. Morning group discussions of EEG records, evoked potentials, and sleep studies also take place. Afternoons are spent in rounds in the adult or pediatric Epilepsy Monitoring Units, EEG and evoked potential reading sessions, and the adult or pediatric outpatient clinic.

Elective rotations are offered in intra-operative monitoring, sleep medicine, and EMG. Adult and pediatric trainees are strongly encouraged to participate in clinical or basic research under the direction of staff physicians.

The following conferences and rounds are attended by adult and pediatric trainees and staff physicians. Trainees participate in the preparation and presentation of a number of conferences throughout the year.

• Daily Adult and Pediatric Epilepsy Monitoring Unit Rounds
• Weekly Epilepsy Patient Management Conference
• Weekly Case Presentations
• Weekly Epilepsy and Sleep Medicine Grand Rounds
• Weekly Neuroscience Grand Rounds
• Weekly Pediatric Epilepsy/Pediatric Neurology Conference
• Biweekly Evoked Potential Conference
• Biweekly Sleep Medicine Conference

The second year activities in the adult and pediatric programs include time on the following rotations: hospital service, epilepsy monitoring units, EEG/evoked potential reading, sleep, longitudinal clinic, and access clinic. Continuation of research activities is encouraged, and three months are set aside for elective rotations. For fellows interested in Sleep Medicine, a total of six months of experience in sleep medicine can be obtained over the two-year fellowship. An additional six months of sleep training under the supervision of a diplomate of the American Academy of Sleep Medicine before or after the fellowship provides eligibility for board certification in sleep medicine. Descriptions of the individual programs follow.

The Section of Cerebrovascular and Endovascular Neurosurgery oversees patient care and postgraduate education in both basic and clinical research pertaining to the microsurgical or endovascular treatment of cerebrovascular disease. Post-graduate fellowships in endovascular and cerebrovascular micro-neurosurgery are offered. Unique to Cleveland Clinic is the integration of the cerebrovascular surgery and the endovascular neurosurgery departments, optimizing patient care. It represents a vital component of a multi specialty cerebrovascular center providing a seamless environment for interaction with diagnostic neuroradiology, neuroanesthesia, neurosurgical intensive care, stroke neurology, and radiation oncology clinical services and the basic neuroscience research group. Since the inception, both surgical and endovascular case volumes have increased steadily.

Endovascular fellows on the unified cerebrovascular and endovascular neurosurgery service will find it both busy and challenging. Specialists in the section provide microsurgical and endovascular treatment for occlusive cerebrovascular disease, cerebral aneurysms, arteriovenous malformation and other extra- and intra-cranial cerebrovascular diseases. In addition to cerebrovascular disorders, additional experience is gained in the management of skull base lesions (pre-operative embolization and test balloon occlusions), as well as functional testing (WADA testing). Moreover, fellows will gain experience in other interventional techniques, including treatment of cranial facial vascular malformation, intra-arterial chemotherapy administration, and percutaneous therapeutic spinal procedures.

Section members view fellowship training education as an extremely important responsibility. The educational objectives include mastery of key interventional skills in cerebrovascular disease including management of patient data to provide unified care plans. In addition, there is an emphasis on real time development of problem-solving skills in the endovascular suite, intensive care unit, ward, and in the outpatient clinic. Routine interaction with the cerebrovascular surgeons allows the fellows opportunities to participate in a wide variety of microsurgical treatment options for patients with cerebrovascular disease.

The section has active clinical and basic research programs and fellows are strongly encouraged to participate in the cerebrovascular research laboratory under the supervision of the appropriate basic scientist or clinical faculty.

Endovascular training is an ACGME-eligible endovascular neurosurgery curriculum.

Program applicants will be accepted from Neuroscience residencies. All applicants must have completed an ACGME approved residency on Neurology, Neurosurgery, or Neuroradiolgoy. The program duration will be 2-3 years depending on the candidates background. The variation in the program length beyond two years is to accommodate applicants differing residency background.

• Neurology Fellowship Application

Dr. Thomas Masaryk
Cleveland Clinic
Director, Neuro Endovascular Fellowship Program
Phone 216.444.6653

Preparatory Experience

• One of two year experience will be designed to ensure adequate skill sets tailored to best serve the applicants background to produce equally qualified graduates in NES/INR.
• One year dedicated NES/INR experience.

The speciality requires significant clinical training in the logic of cerebrovascular therapeutics, and therefore, the program would include clinical (including NICU) experience, neuroimaging, medical physics, radiation safety; and catheter work in ENS/INR.

Training in NES/INR will be conducted primarily in the bi-plane angiography suite in the neuroradiology department, at the CCF neurosurgical operating rooms, as well as the investigational angiography suite in the animal vivarium at L10.

This is a one-year, ACGME-accredited fellowship in Neuromuscular Medicine. Three positions are available per year. The Neuromuscular Section of the Department of Neurology includes nine full-time staff physicians. Annually, we see over 400 inpatients and over 3000 outpatients with neuromuscular diseases, and perform over 3000 EMG studies. The Neuromuscular Section also operates an autonomic disorders laboratory (tilt table, valsalva, and pupillometry testing), quantitative sensory testing laboratory (QST, QSART, thermoregulatory sweat testing), quantitative muscle testing laboratory, histopathology laboratory for epidermal nerve fiber analysis, neuromuscular ultrasound laboratory, and skin, nerve and muscle biopsy services.

Program Structure

The program begins with a one-month didactic lecture series, covering basic clinical neurophysiology, EMG, NCS, neuromuscular anatomy, clinical disorders, and neuromuscular histopathology. Thereafter, 50% of the time is spent in clinical neuromuscular disease activities (adult and pediatric neuromuscular clinics, ALS clinic, myopathy clinic, inpatient and critical care neuromuscular consultations), and 30-40% of the time is spent in the EMG Laboratory. The remaining time is dedicated to nerve and muscle pathology and research. Additional opportunities include nerve, muscle, and skin biopsy techniques, interpretation of epidermal nerve fiber morphology, autonomic studies, QSART, QST, thermoregulatory sweat testing, single fiber electromyography, and nerve and muscle ultrasonography. Trainees can expect to perform 500 EMG studies during their year of fellowship, including the whole spectrum of neuromuscular disease. In the clinics, fellows develop competency in the assessment and management of neuromuscular disorders. Fellows rotate through a multidisciplinary ALS clinic.

A number of conferences occur throughout the year, including Neurology Grand Rounds, EMG case conference, nerve and muscle biopsy review conference, and journal club. Fellows participate in the preparation and presentation of a monthly neuromuscular CPC and neuromuscular seminar. Fellows are encouraged to pick among many available research topics, and work with a staff mentor to complete the project.

• Neurology Fellowship Application

Contact Person:

Kerry H. Levin, MD
Department of Neurology, S90
Cleveland Clinic
9500 Euclid Avenue
Cleveland, OH 44195
Tel: 216.444.8370
Fax: 216.445.4653
Email: levink@ccf.org

One or two positions are offered per year. Eligible trainees include physicians who have completed a pediatric neurology residency program in North America. Pediatric trainees participate in all of the educational and academic activities described above for the EEG-Epilepsy programs in general, and share in the interpretation of adult and pediatric routine EEGs, evoked potentials, and sleep studies. However, all clinical, hospital, and video-EEG work is exclusively pediatric.

Trainees have their own longitudinal pediatric epilepsy clinic where children are evaluated under the supervision of staff neurologists. Video-EEG monitoring is performed on infants and children in the four-bed Pediatric Epilepsy Monitoring Unit in Cleveland Clinic Children’s Hospital, under the direction of three pediatric epileptologists. Over 200 infants and children are evaluated annually with video-EEG, and over 50 proceed to surgery. Invasive monitoring is performed in selected cases using depth or subdural electrodes. The program offers a focused pediatric clinical experience, complemented by access to a wide range of adult and pediatric opportunities.

• Neurology Fellowship Application

Contact Person:

Andreas Alexopoulos, MD, MPH
Epilepsy Center, S51
Cleveland Clinic
9500 Euclid Avenue
Cleveland, OH 44195
Tel: 216.444.3629
Fax: 216.445.4378
Email: alexopa@ccf.org

Cleveland Clinic's Sleep Medicine Fellowship is a one-year, ACGME-accredited program designed to provide trainees with a range of competencies in Sleep Medicine. The fellowship provides eligibility for the American Board of Sleep Medicine. Trainees are provided with a broad exposure to Sleep Medicine including polysomnographic technology and the treatment of adult and pediatric patients with sleep disorders with a strong emphasis on clinical neurophysiology. Nearly 4000 studies are performed annually, including routine polysomnography, multiple sleep latency tests, maintenance of wakefulness tests, positive airway pressure titrations, neonatal and pediatric studies, esophageal pressure monitoring and combined PSG with extended EEG/EMG for the evaluation of nocturnal seizures and parasomnias. Sleep experts from the Departments of Adult and Pediatric Neurology, Psychiatry, Pulmonary and Critical Care Medicine, Psychology, Dentistry and Otolaryngology supervise trainees.

About the Fellowship

The program begins with an introductory Clinical Neurophysiology course in the mornings focusing on basic neurophysiology, EEG technology, electrical safety, normal EEG and benign variants and epileptiform EEG patterns. Afternoon sessions are dedicated to an introduction to Sleep Medicine that includes didactic presentations, group scoring sessions and review of laboratory protocols and procedures.

The fellowship is organized into outpatient clinic and laboratory core rotations. During the clinic rotation, fellows evaluate patients of all ages with sleep disorders under the supervision of a Sleep Medicine staff physician. Trainees also participate in weekly longitudinal care clinic where new and former patients are evaluated and treated by the same fellow over the course of the year. During the laboratory rotation, Sleep Medicine fellows learn to score sleep studies. Fellows are responsible for reviewing raw data and clinical information and generating a sleep report. Studies are reviewed daily with a Sleep Medicine staff physician in afternoon reading sessions.

Sleep Medicine trainees also spend time evaluating patients with ancillary staff in the Departments of Otolaryngology, Dentistry and Psychology. The Otolaryngology/Dentistry Sleep Clinic provides exposure to the surgical management and use of oral appliances for sleep-disordered breathing. The Sleep Psychology Clinic provides exposure to cognitive behavioral therapy and biofeedback for insomnia.

Sleep Medicine fellows are required to participate in research. Research proposals are presented in monthly research meetings and completed studies are presented at the Department of Neurology Neuroscience Day and at the annual meeting of the American Academy of Sleep Medicine. Fellows are provided with elective time dedicated to research.

A variety of educational opportunities are available to Sleep Medicine trainees. These include weekly Neurology Grand Rounds, Sleep Medicine Grand Rounds, Epilepsy Grand Rounds, Epilepsy Surgery Patient Management Conference and Pediatric Neurology/Epilepsy Conference. Visiting professorships are held each quarter in which prominent individuals in the field are invited to spend a half day with the fellows discussing interesting cases.

Sleep Medicine fellows share the on-call duties of the sleep laboratory. Call is rotated on a biweekly basis and taken from home.

Who Qualifies?

The ACGME guidelines specify that training in Sleep Medicine must be preceded by the completion of a residency program in neurology, child neurology, general psychiatry, internal medicine, family medicine or otolaryngology. Please note, in order to apply for our program you must have successfully completed a residency in the US, Canada or Puerto Rico. All International Medical Graduates must submit a certified copy of their current ECFMG certificate and qualifying exam results.

If you are interested in applying for a fellowship position please provide the following documents using ERAS

• Personal Statement
• CV
• Letter from Residency Program Director in lieu of Dean’s Letter
• At least 2 letters of recommendation from physicians whom have supervised you in a clinical setting
• USMLE/COMLEX Score Reports
• Certificate(s) of previous training
• Medical School Diploma

We begin accepting applications on July 1 and we will stop reviewing applications on October 1.

Carlos Rodriguez, MD
Program Director
Sleep Disorders Center
Department of Neurology, FA20
Cleveland Clinic
9500 Euclid Avenue
Cleveland, OH 44195
Tel: 216.445.7621
Fax: 216.636.0090
Email: rodrigc2@ccf.org

Robyn Perryman
Education Coordinator
Neurological Institute/S90
Cleveland Clinic
9500 Euclid Avenue
Cleveland, OH 44195
Tel: 216.444.6632
Fax: 216.445.9908
Email: perrymr@ccf.org

With an established stroke fellowship since 1982, the Cerebrovascular Center now offers an ACGME approved residency in Vascular Neurology. The Vascular Neurology fellowship is a one-year program designed to lead to one of three career pathways:

1. Vascular Neurology -- The program meets all ACGME requirements for board eligibility in Vascular Neurology.
2. Endovascular Surgical Neuroradiology (aka Interventional Neurology) -- One year of Vascular Neurology in an ACGME approved residency is a prerequisite for neurologists wishing to enter an Endovascular Surgical Neuroradiology residency.
3. Stroke Clinical Trials and Epidemiology Vascular Neurology residents have an opportunity to obtain a Masters Degree in Epidemiology and Clinical Trial Design in conjunction with The Cleveland Clinic Lerner College of Medicine and Case Western Reserve University. This program will entail an additional year of course work along with clinical responsibilities for the two year program.

The Vascular Neurology fellowship provides comprehensive training in the inpatient and outpatient management of cerebrovascular disorders under the supervision of an internationally recognized faculty. Training in transcranial Doppler and carotid ultrasound, stroke neuroimaging, neurointerventional procedures, and neurocritical care are notable strengths of the program. In addition, there are numerous opportunities in clinical research focusing on acute stroke reperfusion therapy, interventional stroke therapy, stroke prevention, and stroke epidemiology/outcomes. The Cerebrovascular Center has organized and participated in numerous cutting edge clinical trials over the past decade including PROACT, CREST, SAPPHIRE, MATCH, CLOSURE, DEDAS and SAMMPRIS . Additionally, the stroke faculty is actively involved in design and implementation of large clinical trials for therapeutic intervention in ischemic and hemorrhagic stroke.

• Neurology Fellowship Application

Contact Person:

Ken Uchino, MD
Cerebrovascular Center, S80
Cleveland Clinic
9500 Euclid Avenue
Cleveland, OH 44195
Tel: 216.445.4073
Email: uchinok@ccf.org