Career pathways

• In the United States, the pathway to becoming a clinical neurophysiologist includes completing an undergraduate degree, medical school, and postgraduate medical education, usually in neurology. Following the completion of an accredited residency program, clinicians may choose to enter a fellowship in Clinical Neurophysiology. Programs may expose their fellows to the broad spectrum of electrodiagnostic neurophysiologic studies, or may focus on a single area such as EEG, Electrodiagnostic Medicine (EMG) or Intra-Operative Neuro-Monitoring (IONM). Clinical Neurophysiology fellowships are generally 1–2 years in duration and may lead to board certification in one or more subspecialty areas.

• In the United Kingdom, In the United Kingdom, there are two healthcare professionals who typically perform
neurophysiological investigations in the UK. These are medical staff trained in Clinical Neurophysiology, after completing 2 years Foundation Years training (FY1-2), 2 years of Core Medical training (ST 1-2), enter a 4-year Clinical Neurophysiology Specialist Training (ST4) program and are qualified as having obtained “Completion of Certificate Training (CCT) in Clinical Neurophysiology”.

The other is non-physician route, “Clinical Physiologists” (also known as Neurophysiology Technologists in the USA) who undertake four years of practical training whilst undertaking an honours degree. Physiologists perform the majority of EEGs, evoked potentials and nerve conduction studies, which are reported by or under supervision of Clinical Neurophysiologists (consultants).

• Relationship to Electrodiagnostic Medicine, Electrodiagnostic medicine is a subset of Clinical Neurophysiology. Electrodiagnostic medicine focuses only on the peripheral nervous system and not the central nervous system. Whereas a Clinical Neurophysiologist is trained to perform, interpret and report on all the following studies: EEG, intraoperative monitoring, nerve conduction studies, EMG and evoked potentials, an electrodiagnostic physician focuses mainly on nerve conduction studies, needle EMG examination and neuromuscular ultrasound as part of neuromuscular workup.