Pediatric EMU (PEMU)

• The fellow will arrive by 8AM and begin by reading EMU studies undergoing SPECT, then for patients who will be discharged that day, then for other Phase 1 studies, then for other EMU studies that are not being discharged that day. The fellow will generate a report for each study using the pediatric EMU template.  The peds EMU attending may read some EEG studies concurrently if there is a high study volume.
• If the above are completed and time permits, the fellow will then talk with the Peds Epilepsy Consult attending to see if any other inpatient studies have not yet been read, starting with invasive EEG studies. Unread studies should be reviewed by the fellow as described below (time permitting).
• When instructed by the Pediatric EMU attending, the fellow will perform history and physical for phase 1 epilepsy surgery patients being admitted to the EMU.  This activity’s purpose is to better understand epilepsy surgery workup in children; the fellow will not do more than 2 history and physicals weekly.
• Over the course of the day, the fellow will read and generate reports for pediatric outpatient EEGs. These will be reviewed with the PEMU attending after staffing new EMU admissions.
• The fellow will attend any pediatric epilepsy surgery OR cases or functional mapping. These experiences will take precedence over reading EEGs or attending clinic.
• Pediatric Epilepsy Fellows will attend their continuity clinic Wednesday afternoons and will be freed from EEG reading responsibilities.
• Adult Epilepsy Fellows will attend complex epilepsy clinic with one of the pediatric epileptologists one afternoon weekly (they will be provided a schedule before the start of a two-week block).  In clinic the fellow will independently see new patients, formulate an assessment and management plan, and staff with the attending epileptologist.  It is up to the attending whether the fellow will independently see return patients.  The fellow will not be responsible for reading EEGs the afternoon they attend clinic.

Exceptions to the above expectations may be made with the Peds EMU attending to maximize the fellow’s educational experience.

• The fellow will learn to recognize and provide appropriate treatment for various pediatric epilepsy syndromes and the treatment of status epilepticus.
• The fellow will understand the basic principles of EEG from electrode placement, amplifiers, and digital signal processing. The fellow will be able to determine common EEG artifact, benign variants, normal background patterns in awake, drowsy, sleep in neonatal to pediatrics.
• The fellow will be diligent and thorough in hand-offs. He/she will maintain a professional demeanor during all interpersonal communications. His/her communications with treating providers will be effective regarding EEG findings and interpretation of these findings within the clinical context of patient. Reports will be timely.
• The fellow will be involved in improving the quality of the care of epilepsy patients and others with critical neurological illness through QI projects, scholarly activities, and/or participation in weekly multi-disciplinary EEG/epilepsy conferences which include peer-review and practice improvement.
• The fellow recognizes that he/she is part of a treatment team and participates within the treatment group effectively. The treatment groups include neurology/neurocritical care, neuroradiology, neurosurgery, and EEG technologists.

For all weeks of Pediatric epilepsy, the below schedule is modified such that Pediatric Epilepsy fellows attends Wednesday afternoon continuity clinic, while Adult Epilepsy Fellows will attend 1 afternoon of clinic weekly (schedule provided at start of 2 week block).

Attend pediatrics epilepsy conference (Thursday at noon) and all other required conferences.

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