Introduction
The fellow will determine with the attending at the start of the day which case they will follow. The fellow will be in the OR for baselines and/or for critical portions of the case, monitors remotely during less critical portions, and writes the preliminary summary of the IOM report. Please remember to record your procedures completed in MedHub.
The fellows will have better access to live cases through Citrix and would be located in either the EEG reading room or MFCB 7116. This independent access will facilitate participation by the fellow in live communication with IOM Tech’s and attendings through the case. Fellow-directed readings and/or other didactics will be reviewed with an attending once per week.
This is an accordion element with a series of buttons that open and close related content panels.
Goals
- The fellow will learn how to use Intra-operative neuromonitoring techniques to improve surgical outcomes.
- The fellow will understand the neuroanatomy, IOM techniques (EEG, MEPs, VEP, SSEPs, direct cortical stimulation) and when these tools should be used.
- They will recognize that they are part of a team and will communicate with patients, allied staff, and referring providers with empathy, professionalism, and by effective transfer of knowledge, especially between IOM technologist and surgeons. They will participate in the timely reporting of studies.
- The fellow will be involved in improving the quality of the care of IOM through QI projects, scholarly activities, and/or participation in multi-disciplinary planning of surgery and neuromonitoring.
Objectives and Evaluation Matrix
IOM Rotation ObjectivesUpon completion of the curriculum, fellows will . . . | ||
| # | Description | Milestones |
| 1 | Know type of monitoring modalities and indications for each in IOM and evoked potentials | PC3, PC4, PC5, PC6, PC7, MK1, MK5, SP3 |
| 2 | Describe trouble shooting and ways to differentiate physiology from artifactual changes in IOM (BAER, EEG, SSEPs, MEP) | PC3, PC4, PC5, PC6, PC7, MK1, MK5, SP3 |
| 3 | Perform direct cortical stimulation at bedside and/or in the OR for language and/or motor mapping | PC1, PC2, PC3, MK1, MK3 |
| 4 | Demonstrate professional and effective communication with OR team (surgeon and anesthesiologist) and IOM technologists | PC1, PC2, PC3, MK1, MK3, IC4 |
| 5 | Learn the effects of anesthesia and systemic effects on IOM modalities and EP | PC3, PC4, PC5, PC6, PC7, MK5, PL1 |
| 6 | Know alarm criteria of IOM modalities | PC3, PC4, PC5, PC6, PC7, MK5, PL1 |
| 7 | Know placement of electrodes for commonly used IOM modalities | PC6, MK1, PL1 |
| Additional Milestones |
| PC9, PC7, PL1, PL2, PR1, PR2, IC4, IC5 |
Schedule
Monday-Friday they will spend time in the UH OR with initial hook ups and then subsequently participate in remote review of studies from the EEG reading room or MFCB 7116.
If the fellow is interested in an IOM elective, the best learning experience is one where the fellow will utilize all elective weeks for IOM combined into one block.
Conferences
Attend regular fellowship conferences.
Work Hours
Standard work hours
Suggested References
Husain, A. M. (2014). A practical approach to neurophysiologic intraoperative monitoring (2nd ed.). Demos Medical Publishing
Simon, M. (2010). Intraoperative Neurophysiology: A Comprehensive Guide to Monitoring and Mapping, New York: Demos Medical Pub.
Zentner, J., MacDonald D.B., Wegner C. (2024). Intraoperative Neuromonitoring: Fundamentals, Possibilities, Limitations, Springer.
Additional books and journal articles are available in the fellowship Box folder and the Ebling Library.
Latest Revision: 11/14/2025, Smitha Holla, MD
