Intraoperative Neuromonitoring

Intraoperative Neuromonitoring Fellowship

Massachusetts General Hospital and Harvard Medical School

Dr. Mirela Simon
Program Director:
Dr. Mirela Simon

The Massachusetts General Hospital Intraoperative Neuromonitoring Fellowship is designed to create experts in the field of clinical intraoperative neurophysiology and prepare them to become leaders in the field.

The fellowship's curriculum is designed as a stand-alone one-year fellowship and is structured in three parts:

  1. Rotation 1 (2 months): offers intensive theoretical and practical learning through a set of lectures, workshops, and live technical set up in the operating room (OR). This will constitute the cornerstone for further training in this specialty.

  2. Rotation 2 (6 months): implements the basic knowledge learnt in rotation 1 and builds hands-on expertise in the OR by involving fellows in live coverage of monitoring and mapping cases and familiarizing them with the OR environment.

  3. Rotation 3 (4 months): allows a combination of in-OR and outside-OR training. Fellows will learn to prioritize their involvement in different cases, at different stages, and to different degrees, based upon necessity. Additionally, throughout the year, the fellow will gain research exposure by getting involved with an assigned intraoperative neuromonitoring research project.

During rotation 1, the IONM fellow will learn how to approach each clinical case in order to obtain valuable information from the patient's medical history, neurological examination, and additional test results (e.g., neuroimaging, EEG, EMG studies) to serve as the foundation for appropriate planning of the IONM procedure. During rotations 2 and 3 the fellow is expected to review in advance each of the clinical cases requiring IONM with which he/she will be involved. This includes review of medical records, results of neuroimaging and other studies, and performing pertinent neurological examination (e.g., preoperative language testing for obtaining baseline language function for language mapping). Working with the supervising IONM attending, fellows will design the most appropriate IONM procedure and discuss the monitoring/mapping plan with the surgery and anesthesia teams. Along these lines, the IONM fellow will be expected to facilitate planning and execution of the preoperative and intraoperative mapping procedures required for epilepsy surgery patients.

During rotations 2 and 3, fellows are expected to supervise the IONM technologists, (under the guidance of the IONM attending) give live feedback to the surgeons regarding the wellbeing of the parts of the neuroaxis that are being monitored or regarding results of the mapping procedure, guide the surgical and anesthesia team to modify the surgical procedure and/or anesthetic regimen to prevent or reverse the neurophysiologic dysfunction and thus to avoid postoperative neurologic deficit.


Core Faculty

Mirela Simon, MD
Reiner See, MD
 


Eligibility/Application Process

Candidates must be board-eligible in Neurology, have completed residency in good standing prior to the start of the fellowship, and have a solid background in clinical neurophysiology.

Applications are accepted on a rolling basis. A complete application consists of an updated CV, a letter of intent, and three letters of recommendation, including one from the applicant’s current Program Director. Application documents should be addressed to Dr. Mirela Simon, c/o Tristram Dammin and submitted via email to


Program Coordinator

Tristram “Tucker” Dammin
tdammin@mgh.harvard.edu
(617) 643-0737


Visit the Intraoperative Neuromonitoring Fellowship website for further information.