Clinics

Weekly Clinics while on EEG service

The fellow will attend an epilepsy clinic one half-day per week at UW under the supervision of a faculty epileptologist. This clinic has a mix of new and return patients. The goal is to work with the same provider each week to get some continuity with longitudinal patient care. However, if the same faculty is out due to vacation or being on service, the fellow will work with another attending that day. The fellow must clearly communicate to applicable faculty and trainees that they will be unavailable for other clinical duties during these clinics, and immediately report any potential conflicts to the program director to resolve. In addition, fellows will attend the epilepsy clinic one half-day per week at the VA during EEG scheduled weeks on Monday morning.

Clinic Rotation

The goal of the weekly clinics is for fellows to learn to provide longitudinal care to epilepsy patients. The clinics rotation is a chance for fellows to go to clinic with providers who are not their primary attending for the longitudinal clinic. In particular, this is a chance for the fellow to spend time in our dietary epilepsy clinic and our clinic that focuses on neuro-stimulatory devices. This rotation ensures the fellow receives a well-rounded education in epilepsy care.

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ACGME Competency Goals

Patient Care

Goals:
To learn about non-pharmacologic treatment of epilepsy through experience in the dietary epilepsy clinic and neuro-stimulation clinic.

Objectives:
Fellows will be able to program and adjust a VNS, RNS, and now basic strategies and resources for dietary therapy in epilepsy.

Medical knowledge

Goals:
To know the efficacy, mechanisms of action, and indications for dietary therapy and neurostimulation in epilepsy.

Interpersonal and Communication Skills

Goals:
To develop a confident and effective communication with patients, nursing and dietary staff, as well as other fellows/residents, and attending physicians.

Practice-Based Learning and Improvement

Goals:
Identify ways to improve scientific practice.

Professionalism

Goals:
The fellow will be professional in verbal communications and in timely reporting of clinic notes.

Systems-Based Practice

Goals:
The fellow recognizes that he/she is part of a treatment team.

The fellow develops knowledge for clinical guidelines in indication, duration, and technical adequacy of dietary therapy and neurostimulation.

Objectives and Evaluation Matrix- (for weekly continuity clinics and the clinic rotation)

Rotation Objectives

Upon completion of the curriculum, fellows will . . .

#New EPA DescriptionMilestones
1Obtain a history and classify the events and the epilepsy syndromePC1, PC2, MK1, MK3
2Develop patients’ treatment plansPC3-5, SP3, SP4
3Appropriately utilize ancillary testing data (EEG, MRI, neuropsychological etc.. ) to refine diagnosis and treatment of epilepsyPC3, PC4, PC7, MK1, MK2, MK3
4Counsel patients with spells/epilepsy regarding study resultsPC3, MK1-3, PC7, IC1, IC3
5Counsel patients on indications and contraindications for dietary therapy for epilepsy and develop patients’ treatment plansPC3, IC1, IC3
6Counsel patients on indications and contraindications for VNS/RNS therapy for epilepsy and develop a treatment planPC3-4, MK1, SP3, IC1, IC3
7Counsel patients on SUDEP, Women’s Health issues, and AED medication side-effectsPC3, IC1, IC3
8Program the VNS and RNS devices with assistance from industry representativesPC3-4, IC4, IC5

Sample Schedule

This rotation consists of two weeks of rotating clinics. The clinics are a mixture of epilepsy clinic, including the ketogenic and RNS clinics. It also provides two academic half-days built into each week to allow the fellow to read about their patients’ conditions and/or engage in any other academic work.

Below is an example schedule, subject to change depending on attending availability. An individualized schedule for the rotation will be emailed to the fellow before the beginning of each rotation.

 MondayTuesdayWednesdayThursdayFriday
AMDr. Kotloski VADr. TunnellDr. TunnellAcademicDr. Felton
      
PMDr. FeltonDr. TunnellDr. StruckDr. JosiahAcademic

Latest revision: 10/28/2022, Aaron Struck, MD