Clinical neurophysiology

This page provides useful information on the nature of the work, the common procedures/interventions, sub-specialties and other roles that may interest you.

Nature of the work

Clinical neurophysiologists are doctors whose role is closely linked to neurology. Clinical neurophysiologists use computer, electrical, magnetic and electronic means of investigating and recording the function of the brain, spinal cord, spinal roots, peripheral nerves and muscle to diagnose disorders of the nervous system.

Clinical neurophysiologists treat conditions such as:

• epilepsy
• motor neurone disease
• Parkinson’s disease
• amyotrophic lateral sclerosis (ALS) also known as Lou Gehrig's Disease

Common procedures/interventions

These include:

• electromyography (EMG), eg to diagnose muscle and nerve disorders
• electroencephalography (EEG) ,eg for the diagnosis and treatment of epilepsy
• nerve conduction studies (NCS)
• evoked potential tests (EP), eg for the diagnosis of MS

More specialist work includes:

• intra-operative monitoring of the integrity of the spinal cord during scoliosis surgery
• mapping of the cerebral cortex in epilepsy surgery
• localisation of the subthalamic nuclei for ablative surgery in Parkinson’s disease and tremor

Sub-specialties

Many clinical neurophysiologists develop sub-specialty interests such as:

• evaluation of patients for epilepsy surgery and Parkinson’s Disease
• intra-operative neurophysiological monitoring for spinal and neurosurgery
• uro-electromyography

Want to learn more?

Find out more about:

•  the working life [1] of a doctor in this area of medicine
• about entry requirements [2] and the training and development [3]

• Pay and conditions

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  This section provides useful information about the pay for junior doctors (doctors in training), SAS doctors (specialty doctors and associate specialists) and consultants.

  Find out more about the current pay scales for doctors [4], and there's more information on the BMA website [5].

  NHS employers [6]  provides useful advice and guidance on all NHS pay, contracts terms and conditions.

  Medical staff working in private sector hospitals, the armed services or abroad will be paid on different scales.

• Where the role can lead

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  Read about consultant and non-consultant roles in clinical neurophysiology, flexible working and about wider opportunities.

  Consultant roles

  You can apply for consultant roles six months prior to achieving your Certificate of Completion of Training [7] (CCT [8]). You will receive your CCT [8] at the end of your clinical neurophysiology training.

  Managerial opportunities for consultants include:

  • clinical lead - lead NHS consultant for the team
  • clinical director - lead NHS consultant for the department
  • medical director - lead NHS consultant for the trust

  Most NHS consultants will be involved with clinical and educational supervision of junior doctors.

  Here are some examples of education and training opportunities:

  • director of medical education - the NHS consultant appointed to the hospital board who is responsible for the postgraduate medical training in a hospital. They work with the postgraduate dean to make sure training meets GMC standards
  • training programme director - the NHS consultant overseeing the education of the local cohort of trainee doctors eg foundation training [9] programme director. This role will be working within the LETB/deanery
  • associate dean - the NHS consultant responsible for management of the entirety of a training programme. This role will be also be working within the LETB/deanery

  SAS doctor roles

  SAS doctors (Staff, Associate Specialists and Specialty Doctors) work as career grade specialty doctors who are not in training or in consultant posts. You will need at least four postgraduate years training (two of those being in a relevant specialty) before you can apply for SAS roles.

  Further information on the SAS doctor role [10]is on this site.

  Other non-training grade roles

  These roles include:

  • trust grade
  • clinical fellows

  Academic pathways

  If you have trained on an academic clinical neurophysiology pathway or are interested in research there are opportunities in academic medicine.

  For those with a particular interest in research, you may wish to consider an academic career in clinical neurophysiology. Whilst not essential, some doctors start their career with an Academic Foundation post. This enables them to develop skills in research and teaching alongside the basic competences in the foundation curriculum.

  Entry into an academic career would usually start with an Academic Clinical Fellowship (ACF) and may progress to a Clinical Lectureship (CL). Alternatively some trainees that begin with an ACF post then continue as an ST trainee on the clinical programme post-ST4.

   Applications for entry into Academic Clinical Fellow posts are coordinated by the National Institute for Health Research Trainees Coordinating Centre (NIHRTCC). [11]

  There are also numerous opportunities for trainees to undertake research outside of the ACF/CL route, as part of planned time out of their training programme. Find out more about academic medicine. [12]

  The Clinical Research Network [13](CRN) actively encourages all doctors to take part in clinical research.

  Other opportunities

  There are opportunities to be employed by the NHS, academic institutions, private sector, universities, the armed forces, organisations and national governing bodies.

• Job market and vacancies

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  This section provides useful information about the availability of jobs, finding vacancies and where to find out more.

  Job market information

  Clinical neurophysiology had 108 consultants and 21 medical registrars in England (NHS Digital, 2016 [14]).

  Women make up 25% of the consultant workforce, 39% of higher specialty trainees in the UK (2014/15 RCP census, 2016 [15]).

  In 2016, the competition ratio for Core Medical Training was 1.53, and for ST3 Clinical Neurophysiology it was 3.14 (NHS specialty training 2016). [16]

  On this section we have information for England only. For information regarding Scotland, Wales and Northern Ireland please click on the links below.

  NHS Scotland medical and dental workforce data [17]

  NHS Wales medical and dental workforce data [18]

  Department of Health, Social Services and Public Safety workforce information for Northern Ireland [19]

  Where to look for vacancies

  All trainees apply through the online application system Oriel [20]. You will be able to register for training, view all vacancies, apply, book interviews and assessment centres, and manage offers made to you.

  All jobs will be advertised on NHS Jobs [21]

  The BMJ Careers [22] website also advertises vacancies.

• Further information

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  Organisations

  Royal College of Physicians [23]

  Royal College of Physicians of Edinburgh [24]

  Royal College of Physicians and Surgeons of Glasgow [25]

  British Society for Clinical Neurophysiology [26]

  International Federation of Clinical Neurophysiology – European Chapter [27]

  Real-life stories

  Dr Sarah Finlayson, specialty registrar in clinical neurophysiology [28]