Fellowship Clinical Neurophysiology and Electrodiagnostic Medicine
 


Clinical Neurophysiology and Electro-diagnostic Medicine 

Clinical Neurophysiology and Electro-diagnostic Medicine (CNP and EDx Med) deals with evaluation of a wide range of neurological disorders including neuromuscular diseases (neuropathies, myopathies, radiculopathies, Myasthenia gravis, etc), spinal cord diseases, disorders affecting brain (Epilepsy, multiple sclerosis, etc), and disorders affecting visual and auditory pathways.  It also incorporates evaluation and treatment of sleep disorders and movement disorders.

Although neurologists receive some exposure during their residency to clinical neurophysiology, this generally falls short of making them independent practitioners of various electrodiagnostic and neurophysiologic procedures.  These procedures are of immense value in both general and academic neurologic practice.  The fellowship programme develops superb skills in neurophysiologic procedures, and in addition, also promotes capacity building in research. 

CNP lab at Aga Khan University is state-of-the-art laboratory, which provides comprehensive range of the neurophysiological services.  In addition to the routine EEG, EMG and evoked potential studies, available services include video EEG, transcranial magnetic stimulation, autonomic testing, Subspecialty programmes/clinic, e.g. epilepsy programme and Botox therapy for movement disorders and spasticity offer cutting-edge experience to the fellow. 

On an annual basis, we perform and interpret more than 5,000 neurophysiological procedures and the volume is growing.  This large referral base and academic environment provides exposure to a broad range of patients, physicians and medical trainees. 

Fellowship programme in CNP and EDx Med was initiated in November 1998 and ten fellows have graduated so far.  Eight of them are currently practicing in major teaching institutions in Pakistan and Middle East. 

The trainee is a trained neurologist, undergoing postgraduate medical education in Clinical Neurophysiology (EEG, sleep studies, evoked potentials, EMG, etc).  This is the only postgraduate training programme in Clinical Neurophysiology in Pakistan. 

Completion certificate is given at the completion of two years, if the fellow's performance is judged to be satisfactory, on periodic evaluations and peer-review.  The results of the in-service examination of the AANEM (American Association of Neuromuscular and Electro-diagnostic Medicine) are used purely for self-improvement and appraisal. 

This programme will prepare you for an academic career by providing you with experience in teaching, research and clinical studies.  After completing your training, you will have the knowledge and experience which enable you to establish and supervise a clinical neurophysiology laboratory in a teaching institution or in private practice. 

Objective 

The main objective of the fellowship programme in CNP and EDx Med is to produce scholarly, compassionate, ethical and clinically competent clinical neurophysiologists for Pakistan.  The programme meets this goal by providing an extensive hands-on exposure to the variety of neurophysiologic procedures under supervision of trained and experienced clinical neurophysiologists.    

The graduates of this fellowship programme will play a leadership role in further development of this field in Pakistan in both the public as well as the private sector.

Duration of training 

The duration of training is two years, with internal rotations through various subspecialties of Clinical Neurophysiology.  The primary institution for training purposes is Aga Khan University Hospital, Karachi, Pakistan. 

Eligibility 

  • MBBS or equivalent degree approved by the PM&DC 
  • One year of house job or internship, of which six months should be in medicine and allied and six months in surgery and allied disciplines 
  • Eligibility for either FCPS in neurology, MRCP ( UK) or Board certification of the American Board of Psychiatry and Neurology. MRCP, FCPS in neurology and Boards in neurology is preferred 
  • Completion of at least three years of neurology training from a national or international programme 

Scope and content 

Clinical training 

The programme will incorporate clinical and practical skills in evaluating patients who present for neurophysiological testing and on the actual procedure skills and knowledge in the performance of these tests.  This will be achieved by means of: 

  • Scheduled didactic teaching; 
  • Supervision of the fellow planning, performing, and reporting these procedures; 
  • Involvement in subspecialty clinics e.g. epilepsy clinic. 

The fellow will also learn administration of Botox for movement disorders. 

The fellow will also be involved in teaching technologists and trainee technologists, rotating Neurology residents, rotating residents from other disciplines and medical students interested in Clinical Neurophysiology. 

The fellow will organise and participate in clinical and technical audits within Neurophysiology.  S/he will play an active part in the development and implementation of newer techniques in clinical neurophysiology and electrodiagnostic medicine. 

She will be given incremental responsibility and independence in execution of these functions. 

The fellow is presently allotted a protected time for scholarly activities.  The fellow is encouraged to remain up-to-date with the neurophysiological literature. 

Development of scholarship and critical thought is an integral part of the programme, and will be encouraged in all spheres of activities undertaken by the trainee. 

The fellow is encouraged to choose and complete an original research project relevant to the field of Clinical Neurophysiology within the two-year period.  S/he will be expected to present this research and other work done at scientific meetings leading to publication in reputable indexed journals.  Fellow is also responsible to mentor the research and scholarly activities of the technologists. 

Evaluation 

The fellow's progress in knowledge, clinical and operative skills, and ethical management of patients will be evaluated on a quarterly basis.  The fellow will undergo a formal evaluation at the end of the six-month period and will be debriefed by the Programme Director. 

The fellow will sit the in-training assessment exam administered by the American Association of Neuromuscular and Electrodiagnostic Medicine in May/June every year.  This will help him/her compare his/her performance against similar in-training neurophysiology fellows in the North American programmes. 

Positions available 

One fellow is inducted every year. 

Selection process 

The position is advertised nationally and the short-listed candidates are interviewed by Clinical Neurophysiology faculty at AKU. 

Administrative set-up 

The Neurophysiology faculty consists of nine neurologists who have subspecialty training and experience in clinical neurophysiology working within robust academic section of Neurology.  Within the faculty, there are six full-time (one professor, three associate professors and one assistant professors), one geographic full time faculty and three part-time faculty members.  In addition, Senior CNP technologists are also a great resource for learning.

The programme is overseen by departmental fellowship committee, comprising of faculty and fellows.

The Programme Director, Dr Bhojo A. Khealani is FCPS (neurology) and graduate of CNP & EDx Med fellowship programme (AKU).

Full-time Faculty 

Professors 

Dr Saad Shafqat
MBBS AKU; PhD Harvard
Diplomate American Boards of Psychiatry and Neurology

Associate Professors 

Dr Mohammad Wasay
MBBS Karachi; FRCP Edinburgh
Diplomate American Boards of Psychiatry, Neurology and Neuroimaging 

Dr Mughis Sheerani
MBBS Karachi; MD Utah
Diplomate American Boards of Psychiatry and Neurology 

Dr Ayeesha Kamal
MBBS AKU; FAHA
Diplomate American Boards of Psychiatry, Neurology and Vascular Neurology

Assistant Professors 

Dr Bhojo Asumal Khealani
MBBS Sindh; FCPS Pakistan
Programme Director
Geographic Full Time faculty

Dr. Sara Khan
MBBS, AKU
Diplomate American Boards of Psychiatry, Neurology

Part-time Faculty 

Senior Lecturer 

Dr Aziz Sonawalla
MBBS, MD, DM Bombay 

Dr Nadir Ali Syed
MBBS AKU
Diplomate American Boards of Psychiatry, Neurology, Electrodiagnostic Medicine and Clinical Neurophysiology 

Lecturer 

Dr Fowzia Siddiqui
MBBS Karachi; MD SUNY Stonybrook
Diplomate American Boards of Psychiatry and Neurology 

Dr Shahid Mustafa
MBBS Rawalpindi
Diplomate American Boards of Psychiatry and Neurology​​

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How to Apply