Trainee Talk: Starting Points for the Rising Neuromuscular Fellow
Published March 20, 2025
Trainee Talk
Submitted by: Abigail Bose, MD
The turn of winter into spring is a notable time for every trainee as the weather warms, and you take on the final quarter of your training year. It鈥檚 a special time when you are able to reflect on your growth and look forward to the next challenge ahead.
As a neurology PGY-4 looking ahead to a neuromuscular (NM) fellowship, I tried to heed the advice of my mentors to use this year to round out my knowledge in other subspecialties instead of spending all my elective time in the EMG lab. However, I am excited to turn my attention back to the peripheral nervous system during my final few months and refresh my knowledge for my NM fellowship ahead. I ask the same question to every mentor and fellow; 鈥淗ow should I use this time to best prepare for the start of fellowship?鈥� Reassuringly, most give the same responses! I鈥檝e highlighted the salient themes, along with some high-yield resources that can be incorporated into an ever-busy resident schedule.
1. Master the peripheral anatomy.
This will leave you with a solid foundation of localization so you can focus your attention later on EMG/NCS technique and less on anatomy. My favorite collection of resources comes straight from the 缅北禁地 Training Program Partnership (TPP) resources.
This will leave you with a solid foundation of localization so you can focus your attention later on EMG/NCS technique and less on anatomy. My favorite collection of resources comes straight from the 缅北禁地 Training Program Partnership (TPP) resources.
- Myotome master list: I wish I knew about this reference for my first EMG rotation! This Excel spreadsheet is a comprehensive legend of muscle action and innervation at every level. It even includes variations in myotomes as they are listed in different NM textbooks.
- Videos: Dr. Setter from the Mayo Clinic introduces the neuroanatomy of the upper and lower limb with visual examples, provides a mental framework, and discusses the correlation to the exam, gradually increasing from foundational to advanced levels of detail.
- PowerPoint slides: For those who need to walk through materials slowly at your own pace and for those who like to draw out anatomical structures!
These 3 can be found in the 缅北禁地 TPP Resident and Fellow Materials under Peripheral Neuroanatomy.
2. Make sure you understand the science behind EMG and NCS.
2. Make sure you understand the science behind EMG and NCS.
It is important to grasp the mechanisms responsible for this neurodiagnostic modality. Learn what you are testing and what your results really indicate in order to troubleshoot and improve your technique!
- Intro to EMG/NCS PowerPoint: A step-by-step introduction to EMG/NCS which includes clips of commonly seen waveforms. You can find this in the 缅北禁地 TPP Resident and Fellow Materials under Study Curriculum.
- Videos: Introduction to EMG/NCS Part 1 by Dr. Salajegheh and Part 2 by Dr. Izenberg will help to reinforce these ideas. This is located in the 缅北禁地 TPP Resident and Fellow Materials under Lectures.
- The Electromyography and Neuromuscular Disorders textbook by Dr. Preston and Dr. Shapiro: One of the most referenced instructional texts for fellows. Section 1 provides a great overview of the fundamentals. Once you have mastered the basics, continue into Section 2 and beyond!
3. Have fun with it.
You chose this specialty because you love it! Use this time to follow your particular curiosities and passions, in addition to soaking up the end of residency with your friends, family, and co-residents. Here are just a few enjoyable ways to incorporate NM learning along the way.
- EMG Whiz (emgwhiz.com): Designed by Zachary London, MD, and colleagues, this program is highly recommended and fun to use! It is one of my favorite ways to practice using my neuroanatomy to make diagnostic choices and interpret EMG/NCS.
- Continuum Audio and TPP Podcast Section: Easy to cue up and listen while driving, exercising, or doing errands.
Congratulations, and best of luck to those beginning the next stage of training this summer!