Clinical Neurophysiology

Dr Sarah Finlayson

Specialty Registrar in Clinical Neurophysiology, West Midlands Deanery (currently OOPR at John Radcliffe Hospital, Oxford) 

Originally my intention was to become a psychiatrist.  After house jobs a sixth month SHO post in psychiatry, although enjoyable, made me realise it was the wrong career for me.  Early on in training I had seen a patient with myasthenia gravis and was fascinated by the condition and particularly by how the underlying pathophysiology was so well characterised.    Following medical jobs and MRCP I was only vaguely aware of clinical neurophysiology as a specialty in its own right. Then whilst working in a LAT post in neurology I met someone already training in the specialty who recommended it.  To find out what the job involved I started accompanying my patients to the neurophysiology department.


Why Clinical Neurophysiology? 
My work involves performing and/or interpreting electrodiagnostic tests on the nervous system. The majority of this is split between neuromuscular work (nerve conduction studies and electromyography), EEG and evoked potentials.  It’s important to stress that I do see patients on a day to day basis.  Nerve conduction studies and EMG are performed as a targeted extension to clinical history and examination.  EEG reporting, in general, is performed without the patient present.  However, the scope of epilepsy work is wider than just routine EEG reporting with the opportunity to develop specialist techniques including monitoring of intracranial recordings during epilepsy surgery. Some neurophysiologists run specialist epilepsy or neuromuscular disease outpatient clinics. We work as part of the neurosciences team and also interact with referring teams from other specialties. The workload is predominantly planned and therefore lends itself to little or no out of hours work.  It lacks the thrill of acute medicine (if you like that sort of thing) and you meet most patients only once.   But if you are interested in underlying physiology, neurosciences or computer technology then it is worth considering.

Training
Entry to ST3 is via CMT, ACCS or Paediatrics and requires either full MRCP or MRCHPH. Experience in the neurosciences, particularly neurology, while valuable, is not essential.  Background in paediatrics is also considered helpful. The standard ST training program lasts four years one of which is neurology.  Research during training is encouraged.  In my second year I began an out of program period of research into congenital myasthenic syndromes working towards a D.Phil.


For further information about the specialty visit The British Society for Clinical Neurophysiology’s website: www.bscn.org.uk or another site: www.clinicalneurophysiology.org.uk

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