Nascimento and Gavvala, we learn that most programs (64%) do not use objective criteria for assessing EEG milestones.
There is a discrepancy between the residents’ self-confidence and the PDs’ confidence in the residents’ abilities, and this raises an important concern about the measurement of EEG reading ability. 3 In an AAN survey of 147 residents, only 37% of adult neurology graduating residents and 67% of child neurology residents felt confident interpreting EEG independently. In another survey of 55 graduating residents, median confidence was only 67% for interpreting common EEG abnormalities and creating a report and 60% for recognizing normal EEG variants. Only 55% of PDs reported that at least 80% of their residents met the ACGME target to “interpret common EEG abnormalities and create a report.” The PDs appear to have higher confidence than their residents do. They received responses from 42 academic programs and 5 community or mixed programs (29% response rate). They surveyed all ACGME neurology residency program directors (PDs). Nascimento and Gavvala take an important step in addressing this question. In the article “Neurology Resident EEG Education: A Survey of US Neurology Residency Program Directors”, 1 Drs.
These moonlighting positions may require EEG expertise when managing inpatient neurology.Īre all neurology residents prepared to read an EEG independently upon their graduation? I find myself pondering this question every time one of my former coresidents messages me with an image of a wave-form on a weekend and question for advice. Moonlighting is also an option for generating extra income, especially for trainees recovering from medical school debt while earning fellowship salaries. In the midst of the COVID-19 pandemic with staffing shortages and increasing telehealth use, neurologists from the outpatient setting are expected to cover inpatient general neurology. This can be even more challenging when this call coverage is only a few nights or weekends a year. In academic and nonacademic settings, subspecialty neurologists may participate in call pools where there is a requirement to do overnight or weekend general neurology coverage. Another factor is the increasing complexity of in-hospital care, access to EEG, and need for general neurologists to staff inpatient consultations. Without the dependency on trained EEG technicians, now nearly any hospital can generate an EEG at any time of day or night when no electrophysiology-trained reviewer is on call, thus requiring a general neurologist to read and interpret it. One factor is the spread of novel EEG devices that can essentially be placed by any bedside nurse 2. There are a few reasons why my colleagues find themselves reading EEGs when they had not planned to do so in their career. They never intended to practice general neurology or epileptology, and certainly not to be responsible for interpreting an EEG independently. Two years later, I have been surprised by how often my co-residents have found themselves in the unexpected and panic-inducing position of having to read an EEG, by themselves, overnight. Do you feel prepared?Īfter my residency, I went on to epilepsy fellowship, while many of my colleagues went to other fellowships or general neurology practice. Commentary on: Neurology Resident EEG Education: A Survey of US Neurology Residency Program Directors 1Īs a neurology resident today, no matter what your future clinical plans are, you are likely to have to read an EEG in the middle of the night five years from now when you are done with residency and fellowship.