Pediatric Neuroanesthesia and Intraoperative Neurophysiological Monitoring

  • Pediatric Neuroanesthesia and Intraoperative Neurophysiological Monitoring Fellowship

    The advanced fellowship in Pediatric Neuroanesthesia and Intraoperative Neurophysiological Monitoring (PNA-IONM) is a GME-approved advanced fellowship within the Department of Anesthesiology. Our neuro-anesthesiology faculty have appointments at both the Cincinnati Children’s Hospital Department of Anesthesia and the University of Cincinnati Department of Anesthesia and provide IONM coverage at both institutions. Our fellows are exposed to a broad mix of adult and pediatric IONM cases.

    Our Team

    Our five current IONM faculty are supported by a large group of physicians on the neuro-anesthesia service. All IONM faculty have received fellowship level training in IONM. The Program Director is board certified by the American Board of Neurophysiological Monitoring and is one of two anesthesiologists in the U.S. holding this certification.

    The other members of the IONM team include a group of technologists who work closely with us to provide high-quality patient care at both Cincinnati Children's and UC. These technologists are all CNIM certified and have extensive experience with complex cases.

    Goals and Expectations

    The goal of the Advanced Fellowship in Neuro-monitoring is to provide the didactic background and clinical experience required to function as an interpreting physician capable of providing IONM services.

    Advanced fellows may choose either a 6- or 12-month program. Fellows in the 6-month program will be expected to present a detailed case report, with an extensive bibliography to their academic committee. The fellow choosing the 12- month option will be expected to complete a research project in the field of IONM.

    Each fellow will be evaluated at regular intervals during the fellowship to assure that critical competencies are achieved and successful completion will be contingent on passing a comprehensive written examination at the end of the fellowship.

    Each fellow will have an academic committee that will meet with the fellow at regular intervals to assess progress and address concerns.

    Curriculum

    The PNA-IONM fellowship curriculum is divided into 3 basic sections: Didactics, IONM practicum, and PNA practicum. These are not independent but run in parallel.

    The didactics will be presented 2 days a week for the first 3 months at which time the fellow is expected to have successfully mastered this core content. The IONM and PNA practicum will be combined with lectures two to three days a week during the second three months of the 6-month program.

    Didactics: The didactic portion of the fellowship is predominantly focused on IONM. Each fellow will be given a thumb drive with a list of important articles that will form the basis of the core lecture content. Independent reading is expected and the fellow should be conversant with the material in the articles. Lectures covering basic neuro-anatomy, neurophysiology, techniques and technical subjects will be presented.

    IONM Practicum: During this phase of the fellowship the fellow will work with a member of the IONM faculty monitoring cases, initially as an observer but rapidly transitioning to the role of “provider” while under the direct supervision of a faculty member. The “provider” responsibilities include reviewing the patient medical history, interviewing patient and explaining IONM (when possible), discussing the monitoring plan with the technologist and surgeon, monitoring the case, and writing the procedural report. There will be a comprehensive written examination toward the end of the practicum designed to evaluate the fellow’s ability to integrate didactic knowledge with clinical scenarios to evaluate the clinician’s ability to properly interpret IONM data from actual cases.

    PNA Practicum: When possible the fellow will be assigned to neurosurgical cases employing IONM in order to merge knowledge of IONM with anesthesia and surgical techniques. Faculty anesthesiologists at Cincinnati Children’s Hospital will supervise these cases, with additional support by our IONM faculty.

    Teaching: The majority of teaching will occur on a one-to-one basis during the practicum. Advanced Fellows will also participate in a monthly IONM tele-conference with the University of Florida IONM service to discuss interesting cases and papers. In order to take maximum advantage of the opportunities afforded by the clinical cases it is imperative that the fellow also be committed to independent reading and scholarship.

    Download a sample timeline for our program.

    Contact

    For further information, please contact :

    John McAuliffe, M.D..
    John.Mcauliffe@cchmc.org
    Director of the Advanced Fellowship in Neuromonitoring