The clinic
Sleep technologist, EEG technologist, intraoperative neuromonitoring. Shadowing the epilepsy unit, an awake DBS implantation, a cochlear implant activation, a stroke rehab gym. The wings only count if you have stood in a hospital.
On this pageOngoing from year one
Biomedical engineers are supposed to be the engineers who understand the clinic. Most never enter one until their capstone. The difference between a BME who has spent a hundred hours in a hospital and one who has not is visible in the first five minutes of any device conversation. Here are the ways in, ranked by how much neuro you see per hour.
Get a job in it
Sleep technologistSleep technologist The person who runs overnight sleep studies and scores them; a certification path an undergraduate can complete and work nights. Related: Polysomnography (PSG)Polysomnography (PSG) The overnight sleep study: EEG, EOG, chin EMG, breathing, oxygen, and heart rate recorded together and scored in 30-second epochs. . Glossary entry. Overnight polysomnographyPolysomnography (PSG) The overnight sleep study: EEG, EOG, chin EMG, breathing, oxygen, and heart rate recorded together and scored in 30-second epochs. Related: HypnogramHypnogram The staircase plot of sleep stage against time across a night, scored in 30-second epochs from EEG, EOG, and EMG., Sleep technologistSleep technologist The person who runs overnight sleep studies and scores them; a certification path an undergraduate can complete and work nights.. Glossary entry in a sleep lab. Training is a few months (a course plus supervised shifts; the certification, RPSGT, comes after a year of experience), the shifts are nights, which students can do, and you will spend hundreds of hours applying electrodesElectrode The conductor that turns ion currents in tissue into electron currents in a wire; its chemistry and contact quality set the noise you live with. Related: Silver/silver-chloride (Ag/AgCl)Silver/silver-chloride (Ag/AgCl) The standard electrode material for biopotentials, because its chemistry produces a stable, low-noise, low-drift interface with salty gel. , Electrode impedanceElectrode impedance How hard it is to push current through the skin-electrode contact, typically 5 to 50 kilohms with gel and megohms dry, higher at low frequencies. , Half-cell potentialHalf-cell potential The DC voltage that appears wherever a metal meets an electrolyte; two electrodes with different half-cell potentials produce an offset that can swamp the signal. . Glossary entry and watching EEGElectroencephalography (EEG) Recording the brain's electrical activity from electrodes on the scalp, a few tens of microvolts of blurred, summed cortical activity. Related: Electrocorticography (ECoG)Electrocorticography (ECoG) Recording from electrodes placed on the surface of the brain under the skull, usually during epilepsy surgery evaluation; cleaner and sharper than EEG. , Magnetoencephalography (MEG)Magnetoencephalography (MEG) Recording the tiny magnetic fields produced by cortical currents with superconducting sensors in a shielded room; less blurred by the skull than EEG, and far more expensive. , Volume conductionVolume conduction The spreading of currents from a source through the conductive tissues of the head, which is why one source shows up on many electrodes and why scalp EEG is blurry. , Microvolt (µV)Microvolt (µV) One millionth of a volt. Scalp EEG is tens of microvolts; a AA battery is 1.5 million of them. . Glossary entry, EOGElectrooculography (EOG) Recording eye position from the standing voltage across the eyeball, which moves with the eyes; also the main source of blink artifacts in EEG. Related: Blink artifactBlink artifact The large, slow deflection an eye blink produces in frontal channels, often ten times the size of the brain signal. , Electroencephalography (EEG)Electroencephalography (EEG) Recording the brain's electrical activity from electrodes on the scalp, a few tens of microvolts of blurred, summed cortical activity. . Glossary entry, and EMGElectromyography (EMG) Recording the electrical activity of muscles, hundreds of microvolts to millivolts, much larger than EEG. Related: Myoelectric prosthesisMyoelectric prosthesis An artificial limb controlled by EMG from the remaining muscles. , Electroencephalography (EEG)Electroencephalography (EEG) Recording the brain's electrical activity from electrodes on the scalp, a few tens of microvolts of blurred, summed cortical activity. . Glossary entry scroll past on a real patient. You will learn artifactsArtifact Anything in the recording that did not come from the brain: blinks, muscle, heartbeat, movement, sweat, mains hum, electrode pops. Related: Blink artifactBlink artifact The large, slow deflection an eye blink produces in frontal channels, often ten times the size of the brain signal. , Independent component analysis (ICA)Independent component analysis (ICA) A method that unmixes multichannel data into statistically independent sources, so blinks and heartbeat can be identified and removed. , Artifact subspace reconstruction (ASR)Artifact subspace reconstruction (ASR) An automatic method that detects short high-variance bursts and reconstructs them from clean data; common in real-time pipelines. . Glossary entry, staging, and the clinical realities of sleep apnea by hand. The University of Utah’s Sleep-Wake Center and the private sleep labs around Salt Lake hire trainees.
EEG technologistEEG technologist The person who applies electrodes and runs clinical EEGs, with a certification path of its own. Glossary entry. Applying the full ten-twenty montageMontage The particular arrangement of which electrodes are subtracted from which, such as referential, bipolar, or average reference. Related: Reference electrodeReference electrode The electrode every other channel is measured against; there is no neutral spot on the head, so the choice shapes every trace. , Common average referenceCommon average reference Re-referencing every channel to the mean of all channels, which approximates a neutral reference when electrodes cover the head well. , Surface LaplacianSurface Laplacian Subtracting the average of neighbouring electrodes from each electrode, which sharpens spatial detail and suppresses distant sources. . Glossary entry and running routine and long-term EEGsElectroencephalography (EEG) Recording the brain's electrical activity from electrodes on the scalp, a few tens of microvolts of blurred, summed cortical activity. Related: Electrocorticography (ECoG)Electrocorticography (ECoG) Recording from electrodes placed on the surface of the brain under the skull, usually during epilepsy surgery evaluation; cleaner and sharper than EEG. , Magnetoencephalography (MEG)Magnetoencephalography (MEG) Recording the tiny magnetic fields produced by cortical currents with superconducting sensors in a shielded room; less blurred by the skull than EEG, and far more expensive. , Volume conductionVolume conduction The spreading of currents from a source through the conductive tissues of the head, which is why one source shows up on many electrodes and why scalp EEG is blurry. , Microvolt (µV)Microvolt (µV) One millionth of a volt. Scalp EEG is tens of microvolts; a AA battery is 1.5 million of them. . Glossary entry in the hospital’s neurodiagnostics lab. Certification (R. EEGElectroencephalography (EEG) Recording the brain's electrical activity from electrodes on the scalp, a few tens of microvolts of blurred, summed cortical activity. Related: Electrocorticography (ECoG)Electrocorticography (ECoG) Recording from electrodes placed on the surface of the brain under the skull, usually during epilepsy surgery evaluation; cleaner and sharper than EEG. , Magnetoencephalography (MEG)Magnetoencephalography (MEG) Recording the tiny magnetic fields produced by cortical currents with superconducting sensors in a shielded room; less blurred by the skull than EEG, and far more expensive. , Volume conductionVolume conduction The spreading of currents from a source through the conductive tissues of the head, which is why one source shows up on many electrodes and why scalp EEG is blurry. , Microvolt (µV)Microvolt (µV) One millionth of a volt. Scalp EEG is tens of microvolts; a AA battery is 1.5 million of them. . Glossary entry T.) takes longer, but labs hire and train. You will see seizures on the screen and learn what a neurologist looks for.
Intraoperative neuromonitoring technologist. In the operating room, running evoked potentials and EMGElectromyography (EMG) Recording the electrical activity of muscles, hundreds of microvolts to millivolts, much larger than EEG. Related: Myoelectric prosthesisMyoelectric prosthesis An artificial limb controlled by EMG from the remaining muscles. , Electroencephalography (EEG)Electroencephalography (EEG) Recording the brain's electrical activity from electrodes on the scalp, a few tens of microvolts of blurred, summed cortical activity. . Glossary entry during spine and brain surgery to warn the surgeon before damage. The most demanding of the three and the closest to the neurosurgery world; usually reached after EEGElectroencephalography (EEG) Recording the brain's electrical activity from electrodes on the scalp, a few tens of microvolts of blurred, summed cortical activity. Related: Electrocorticography (ECoG)Electrocorticography (ECoG) Recording from electrodes placed on the surface of the brain under the skull, usually during epilepsy surgery evaluation; cleaner and sharper than EEG. , Magnetoencephalography (MEG)Magnetoencephalography (MEG) Recording the tiny magnetic fields produced by cortical currents with superconducting sensors in a shielded room; less blurred by the skull than EEG, and far more expensive. , Volume conductionVolume conduction The spreading of currents from a source through the conductive tissues of the head, which is why one source shows up on many electrodes and why scalp EEG is blurry. , Microvolt (µV)Microvolt (µV) One millionth of a volt. Scalp EEG is tens of microvolts; a AA battery is 1.5 million of them. . Glossary entry tech experience or via specific training companies.
Medical scribe, CNA, or EMT. Less neuro, more patient contact, and widely available. EMT certification is one semester and puts you in the field seeing what actually breaks.
Shadow
Shadowing goes through a department coordinator and requires HIPAAHIPAA The US law governing health information privacy; it shapes how clinical data can be stored and shared. Glossary entry training, immunization records, and paperwork. A research lab you belong to can make the introduction, which is the fastest route. Ask for:
The epilepsyEpilepsy A tendency to recurrent seizures; its monitoring units are where seizure-detection algorithms get validated and where ECoG data comes from. Related: Epilepsy monitoring unit (EMU)Epilepsy monitoring unit (EMU) The hospital ward where patients are recorded on video-EEG for days to capture seizures before surgery. , Seizure detectionSeizure detection Automatically flagging seizures in EEG, a real clinical need and a good first machine-learning project on the TUH corpus. . Glossary entry monitoring unit. Patients on video-EEGElectroencephalography (EEG) Recording the brain's electrical activity from electrodes on the scalp, a few tens of microvolts of blurred, summed cortical activity. Related: Electrocorticography (ECoG)Electrocorticography (ECoG) Recording from electrodes placed on the surface of the brain under the skull, usually during epilepsy surgery evaluation; cleaner and sharper than EEG. , Magnetoencephalography (MEG)Magnetoencephalography (MEG) Recording the tiny magnetic fields produced by cortical currents with superconducting sensors in a shielded room; less blurred by the skull than EEG, and far more expensive. , Volume conductionVolume conduction The spreading of currents from a source through the conductive tissues of the head, which is why one source shows up on many electrodes and why scalp EEG is blurry. , Microvolt (µV)Microvolt (µV) One millionth of a volt. Scalp EEG is tens of microvolts; a AA battery is 1.5 million of them. . Glossary entry for days; the technologists and neurologists reviewing hours of recording; seizures caught live. The place seizure detectors are validated.
An awake deep brain stimulation implantation. Microelectrode recording as the electrodeElectrode The conductor that turns ion currents in tissue into electron currents in a wire; its chemistry and contact quality set the noise you live with. Related: Silver/silver-chloride (Ag/AgCl)Silver/silver-chloride (Ag/AgCl) The standard electrode material for biopotentials, because its chemistry produces a stable, low-noise, low-drift interface with salty gel. , Electrode impedanceElectrode impedance How hard it is to push current through the skin-electrode contact, typically 5 to 50 kilohms with gel and megohms dry, higher at low frequencies. , Half-cell potentialHalf-cell potential The DC voltage that appears wherever a metal meets an electrolyte; two electrodes with different half-cell potentials produce an offset that can swamp the signal. . Glossary entry descends, the neurophysiologist listening for the target nucleus’s firing pattern, the patient awake and tested. The most interesting hour you can spend in a hospital, and neurosurgery departments do let students observe with arrangement.
A cochlear implantCochlear implant The most successful neural prosthesis: an electrode array in the inner ear that stimulates the auditory nerve in up to 22 bands. Related: Vocoder (noise vocoder)Vocoder (noise vocoder) A simulation of what a cochlear implant delivers: the loudness envelope of each frequency band, applied to noise in that band. . Glossary entry activation. At the audiology clinic, the day the implant is switched on and a person hears through electrodesElectrode The conductor that turns ion currents in tissue into electron currents in a wire; its chemistry and contact quality set the noise you live with. Related: Silver/silver-chloride (Ag/AgCl)Silver/silver-chloride (Ag/AgCl) The standard electrode material for biopotentials, because its chemistry produces a stable, low-noise, low-drift interface with salty gel. , Electrode impedanceElectrode impedance How hard it is to push current through the skin-electrode contact, typically 5 to 50 kilohms with gel and megohms dry, higher at low frequencies. , Half-cell potentialHalf-cell potential The DC voltage that appears wherever a metal meets an electrolyte; two electrodes with different half-cell potentials produce an offset that can swamp the signal. . Glossary entry for the first time. Then the mapping sessions where each electrodeElectrode The conductor that turns ion currents in tissue into electron currents in a wire; its chemistry and contact quality set the noise you live with. Related: Silver/silver-chloride (Ag/AgCl)Silver/silver-chloride (Ag/AgCl) The standard electrode material for biopotentials, because its chemistry produces a stable, low-noise, low-drift interface with salty gel. , Electrode impedanceElectrode impedance How hard it is to push current through the skin-electrode contact, typically 5 to 50 kilohms with gel and megohms dry, higher at low frequencies. , Half-cell potentialHalf-cell potential The DC voltage that appears wherever a metal meets an electrolyte; two electrodes with different half-cell potentials produce an offset that can swamp the signal. . Glossary entry’s levels are set.
The rehabilitation gym. At the Neilsen Rehabilitation Hospital: people with spinal cord injury and strokeStroke Loss of blood supply to part of the brain; rehabilitation after it is the largest clinical use of neurotechnology today. Glossary entry working with therapists and technology. Where Phase 5 lives.
The biomedical equipment shop. The BMETsBiomedical equipment technician (BMET) The hospital staff who maintain and repair medical devices and know every way they fail in real use. Glossary entry who maintain every device in the building and know exactly how each one fails. An afternoon there is a course in real-world device reliability.
Volunteer
The EpilepsyEpilepsy A tendency to recurrent seizures; its monitoring units are where seizure-detection algorithms get validated and where ECoG data comes from. Related: Epilepsy monitoring unit (EMU)Epilepsy monitoring unit (EMU) The hospital ward where patients are recorded on video-EEG for days to capture seizures before surgery. , Seizure detectionSeizure detection Automatically flagging seizures in EEG, a real clinical need and a good first machine-learning project on the TUH corpus. . Glossary entry Foundation, the ALSAmyotrophic lateral sclerosis (ALS) A progressive disease of motor neurons that removes movement and eventually speech while leaving thought intact; the population many BCIs are built for. Related: Locked-in syndromeLocked-in syndrome Full awareness with almost no voluntary movement, sometimes only the eyes; communication depends entirely on assistive technology. , Augmentative and alternative communication (AAC)Augmentative and alternative communication (AAC) Any tool that helps someone who cannot speak communicate, from picture boards to eye-gaze spellers to BCIs. . Glossary entry Association, spinal cord injury and strokeStroke Loss of blood supply to part of the brain; rehabilitation after it is the largest clinical use of neurotechnology today. Glossary entry support groups, the independent living centre. Not for the resume line; because the people BCIsBrain-computer interface (BCI) A system that turns measured brain activity into control of something outside the body, from a cursor to a wheelchair to a speech synthesizer. Related: DecoderDecoder The algorithm that maps neural signals to intended actions, such as a classifier or a Kalman filter. , Closed loopClosed loop A system in which the output feeds back to influence the input, such as a user adjusting their brain activity while watching the cursor it controls. . Glossary entry are for should be people you know, and because they will tell you what they need if you are there long enough to be trusted.
The needs journal
In every clinical setting, carry the notebook. Every “that was slow,” “that was awkward,” “that was unsafe” is a line. After a hundred hours you will have a list of needs no textbook contains. That list is the raw material of Phase 5 and of any company you might start. The needs-finding explainer is the method.
- First year: HIPAAHIPAA The US law governing health information privacy; it shapes how clinical data can be stored and shared. Glossary entry training (often required for shadowing; free online). Volunteer with one organization.
- First or second year: sleep tech training and night shifts, if your schedule allows. Otherwise EMT.
- Second year: shadow the EMUEpilepsy monitoring unit (EMU) The hospital ward where patients are recorded on video-EEG for days to capture seizures before surgery. Related: EpilepsyEpilepsy A tendency to recurrent seizures; its monitoring units are where seizure-detection algorithms get validated and where ECoG data comes from. . Glossary entry and the rehab gym through your lab’s introductions.
- Third year: an awake DBSDeep brain stimulation (DBS) Electrodes implanted deep in the brain and pulsed continuously, the standard treatment for advanced Parkinson's disease and essential tremor. Related: Charge densityCharge density The charge injected per pulse divided by electrode area; keeping it below safe limits prevents electrode damage and tissue injury. . Glossary entry case and a cochlear implantCochlear implant The most successful neural prosthesis: an electrode array in the inner ear that stimulates the auditory nerve in up to 22 bands. Related: Vocoder (noise vocoder)Vocoder (noise vocoder) A simulation of what a cochlear implant delivers: the loudness envelope of each frequency band, applied to noise in that band. . Glossary entry activation. The BMETBiomedical equipment technician (BMET) The hospital staff who maintain and repair medical devices and know every way they fail in real use. Glossary entry shop.
- Throughout: the needs journal.