Speciality: Clinical Neurophysiology
GMC Reference: WOS/391
Clinical Neurophysiology is a small specialty which offers excellent career opportunities for anyone interested in clinical neurosciences along with work life balance.
Clinical Neurophysiology is a Group 2 specialty with no Internal Medicine commitment during higher specialty training. Trainees enter the 4 year training programme after completion of a core training program in internal medicine (stage 1), Acute Care Common Stem – Internal Medicine, Level 1 Paediatric training or Core Surgical Training. On satisfactory completion of higher specialty training, a single specialty CCT in Clinical Neurophysiology will be awarded.
Clinical neurophysiology is a diagnostic speciality but requires clinical skills and judgement to plan and carry out investigations and to interpret results in a relevant useful manner. The main investigations are nerve conduction studies/electromyography, electroencephalography (EEG), evoked potentials and intra-operative monitoring.
There is exposure to a wide range of central and peripheral nervous system disorders. We investigate patients from the new born to the elderly and interact with a wide range of medical and surgical specialties. There is significant interaction with intensive care units particularly regarding EEG. Many clinical neurophysiologists develop specialist interests in epilepsy and neuromuscular disease. Further information regarding the specialty can be found on the British Society of Clinical Neurophysiology website www.bscn.org.uk
Contact Dr Arup Mallik, Consultant Clinical Neurophysiologist and TPD at arup.mallik@ggc.scot.nhs.uk for information or taster sessions.
1 a. What particular specialty learning opportunities does this program provide e.g. sub-specialty exposure, especially those which are not available elsewhere?
There are two departments providing training in Glasgow and Edinburgh. Although each department has its own special interests, both offer comprehensive experience in the core techniques. Some examples of specialised work listed below.
- Videotelemetry EEG Unit to allow patients to be worked up for epilepsy surgery
- We work closely with neurologists who have specialist interests in muscle disease, motor neurone disorders, myasthenia and peripheral nerve disorders.
- National Brachial Plexus service based in Glasgow.
- Intraoperative neurophysiological monitoring such as awake craniotomies as well as paediatric surgery.
- Paediatric neurophysiology and neurology. Both departments in Glasgow and Edinburgh, benefit from the paediatric hospital being on the same hospital campus. Trainees have excellent access to paediatric EEG reporting, paediatric nerve conduction clinics, paediatric epilepsy clinics and epilepsy surgery MDT meetings.
b. How do trainees access these opportunities?
24 months experience of a wide range of neurophysiological techniques provides comprehensive training in almost all aspects of the specialty.
Clinical attachments for a total of 12 months are spent in neurology with an emphasis on exposure to neurology subspecialties appropriate to clinical neurophysiology. This can take the form of either neurology ward attachments or attendance at outpatient neurology clinics.
The remaining 12 months of training are individually tailored for each trainee and may include additional subspecialty training and also provide further opportunities for research.
2 a. What opportunities are there for research, audit and teaching?
Units in Glasgow and Edinburgh are both linked to major universities with opportunities for research. There is opportunity and expectation to do audits which are regularly undertaken in both departments. There are opportunities to teach medical students as well as student physiologists.
b. How do trainees access these opportunities?
They will be guided by their educational supervisors as well as their own interests.
3 a. How are rotations are hospital sites organised?
Trainees are either based in the Glasgow or Edinburgh Hospital sites for the duration of their training. They do not rotate between sites. Most trainees find this helpful in finding somewhere to live as well as limiting commuting.
b. Which hospitals are involved?
Glasgow: Queen Elizabeth University Hospital and Royal Hospital for Children, Glasgow.
Edinburgh: Royal Infirmary of Edinburgh & Royal Hospital for Children and Young People
c. What degree of choice is there for trainees?
Posts are advertised as being based in either Glasgow or Edinburgh depending on where the vacancy is. Trainees do not rotate between cities.
4. What teaching (e.g. day-release or exam preparation) or learning opportunities (e.g. e-learning, OOPE), are unique to this post or a key feature in the West?
Regular study time is included in weekly timetables. Trainees can participate in the monthly neurology training day release programme.
All UK trainees in clinical neurophysiology are encouraged to attend study days held in various UK locations. Formative (not pass-fail) Knowledge Based Assessments require to be completed during training.
5. What can trainees expect of their trainers in this post?
We aim to provide a supportive training environment and there is an emphasis on training rather than service delivery. New trainees will be encouraged to develop their clinical neurology skills and undergo basic training in electrophysiological testing. Supervision and advice will always be available, with trainees acquiring more complex skills and more responsibilities as training progresses.
6. What are key markers of success? (e.g. exam pass rates. MD, PhD, papers)
No specialty exit exam. Progress is assessed by work place based assessments and supervisors reports along with the ARCP decision aid.
7. What additional information would you like to include that may encourage trainees to apply for specialty training in this programme in preference to similar programmes in other parts of the UK?
Glasgow and Edinburgh are both major cities with diverse populations and all the social and professional opportunities this offers. However, both cities benefit from easy access to the surrounding countryside and outdoor pursuits.
There are three training posts based in Glasgow and one in Edinburgh but we encourage trainees to support each other as well as visit the other department if possible. Some paediatric neurophysiology training is done in both centres.
The trainers are an enthusiastic bunch and trainees are made to feel part of a team and we are small departments. The majority of our trainees have remained in Scotland on completing their training.
There are research opportunities with clinical colleagues in the respective neuroscience centres as well as with colleagues based at The University of Glasgow and The University of Edinburgh.
Clinic audit/QI is a curriculum requirement and is an integral part of training. There are plenty of opportunities to teach medical students and this is encouraged.
There are plenty of opportunities to develop management skills in terms of service development and interaction with several different specialties.
Royal Hospital for Children and Young People, 50 Little France Crescent, Edinburgh, EH16 4SF, The Royal Hospital for Children Glasgow, Royal Infirmary of Edinburgh, The Queen Elizabeth University Hospital Glasgow
| Programme Type | Deanery based or National: National |
| Administration office | West of Scotland |
| Lead Dean / Director | Professor Adam Hill |
| Responsible Associate Postgraduate Dean or Assistant Director (GP) | Dr Marie Freel |
| Specialty or Sub-specialty | Specialty or Sub-specialty: Specialty |
| Date of GMC recent approval | August 2010 |
| Associated Royal College - Faculty |
Joint Royal Colleges of Physicians Training Board (web site) |
| Curriculum and Associated Assessment System | https://www.jrcptb.org.uk/specialties/clinical-neurophysiology |
| Programme Administrator: |
Named Programme Administrator:
Kerry Anne Ferrie
Address: NES, 2 Central Quay, 89 Hydepark Street, Glasgow, G3 8BW Tel: Email: kerryanne.ferrie@nhs.scot |
| Programme Director |
Programme Director Name: Dr Arup Mallik Address: Queen Elizabeth University Hospital 1345 Govan Road Glasgow G51 4TF Tel: Email: arup.mallik@ggc.scot.nhs.uk |
| Quality of Training | Quality Management |