The epilepsy surgery program offers a flexible experience in the diagnostic and therapeutic approaches to medically intractable seizures. A single position for six months to one year is available either following completion of neurosurgical training or embedded within the residency. A Yale-New Haven Hospital resident may elect to concentrate within this specialty for six months to one year and, if choosing this path, may combine clinical experience with ongoing research related to epilepsy.
For individuals choosing the one-year course, either during or following neurosurgery training, the year begins in July and the first three months are spent in Neurology. Here the fellow works with the medical epileptologists attending outpatient clinics, evaluating patients for the surgical program, learning about the appropriate selection of anticonvulsants, and studying both scalp and intracranial electroencephalography. The surgical fellow rotates with the neurology fellows supervising the audiovisual monitoring (AVEEG) of Phase-1 patients (24-hour scalp monitoring selection for surgical candidacy) and caring for the patients undergoing chronic intracranial study (Phase 3). The fellow is supervised in the AVEEG monitoring suite by an epileptology faculty and is then responsible for presenting these patients at the weekly Monday epilepsy surgery conference. The next nine months are then spent in the surgical arm of the program where they take part in both diagnostic and therapeutic surgical procedures. There is a close interaction with the other residents who also take part in the surgical procedures assuming the role of assistant or primary surgeon, depending on year of training and ability. The fellow is expected to carry out at least one clinical research project during this year, attend twice weekly clinics, present at monthly Journal Club, and at the end of the year prepare an abstract for the yearly meeting of the American Epilepsy Society.