The University of California San Francisco (UCSF) Medical Center is seeking an Intraoperative Neurophysiological Monitoring (IONM) Fellow interested in obtaining training for a career in IONM. This candidate possesses a doctorate in advanced scientific or medical background and seeks didactic and clinical training in order to transition into the field of IONM. 

During the first six months, the goal of this program is for the fellow to receive supervised training, while obtaining the case volume to meet certification requirements, in all aspects of IONM provided for UCSF surgical procedures (including neurosurgery, otolaryngology, vascular and orthopedic surgery) in which neural structures are at risk. To complement the hands-on training, the fellow will learn the IONM background through participation in regular tutorials, seminars and from studying primary and secondary sources.

Continuation in the program for an additional six months is contingent on obtaining a passing score on the CNIM examination and meeting departmental standards. During the second part of the fellowship, the fellow will expand their IONM capabilities by providing IONM services with increasing complexity and independence, in preparation for a career in IONM.

The IONM fellow receive hands-on training to learn:

• Relevant anatomy, medical conditions, and surgical procedures and their bearing on IONM signals.
• How to setup, calibrate, maintain and operate IONM software and hardware (i.e. Cadwell) to record electroencephalography (EEG), evoked potentials (EP), and electromyography (EMG).
• How to establish baselines, to optimize IONM signals and monitor auditory brainstem response (ABR), EEG, free-run and triggered EMG, transcranial and direct cortical motor evoked potentials (MEP), somatosensory evoked potentials (SEP) and advanced IONM techniques, such as radiofrequency lesioning, phase reversal, dorsal column mapping, trigeminal nerve sensory mapping, lateral-spread response, brachial and lumbar plexus mapping compound nerve action potentials, brainstem mapping and other techniques.
• How to display, label and analyze IONM waveforms.
• How to recognize real-time IONM changes and to provide an immediate and clear report of them to the neurophysiologists, surgeons &/or anesthesiologists.
• How to identify and rectify technical problems, which may contaminate the real data and/or give false indications, such as signal artifacts, software and hardware anomalies, stimulation and setup errors.
• The effects of anesthesia on IONM signals and how to effectively collaborate with anesthesia personnel to achieve anesthetic conditions that promote optimal IONM recordings.
• How to document and report, clearly and expediently, the results of IONM activities, protected patient information, anesthesia and surgical events and communications for medical records and billing purposes.

The fellow will be expected to

• Adapt to changes in the work environment, such as, but not limited to, changes in procedures, modalities, providers, patients and work location.
• Monitor cases during daytimes and evenings at all UCSF sites (Parnassus, Mission Bay and Mount Zion).
• Provide IONM service under supervision at UCSF Medical Center.
• Review primary and secondary literature to advance one's knowledge in the field.

​The fellow is highly encouraged to

• Pursue an independent research project for presentation or publication.