The neurocritical care fellowship is organized in a way to assure fellow eligibility for specialty certification in Neurocritical Care through the United Council for Neurological Subspecialties (UCNS).

The first year is dedicated to the establishment of a sound foundation of knowledge and skills relevant to the clinical practice of neurocritical care. There will be a particular focus on the following acute neurological problems:

  • Intracerebral hemorrhage
  • Subarachnoid hemorrhage
  • Acute ischemic stroke interventions and thrombolytic therapy
  • Stroke related cerebral edema (hemispheric and cerebellar)
  • Cerebral edema
  • Intracranial hypertension
  • Brain death
  • Cerebral aneurysms
  • Arteriovenous malformations
  • Status epilepticus
  • Coma
  • Metabolic encephalopathies
  • Guillain-Barre syndrome
  • Myasthenia gravis crisis
  • Neurological prognostication

The fellow will also develop high quality consultative skills when interfacing with patients with neurological complications in the medical, cardiac, cardiac surgical, general surgical critical care units and the emergency department. In addition, fellows will enhance their confidence with the management of airway compromise, mechanical ventilators, hemodynamic compromise, and the multi-disciplinary management of critically ill patients as well as become skilled in the performance of:

  • Brain parenchymal intracranial pressure monitor insertion and use
  • Ventricular drain insertion and use
  • Central venous catheter insertion
  • Endotracheal intubation
  • Swan-Ganz catheter placement and use

The fellows are closely supervised by the neurocritical care attendings. Learning will occur through discussions on daily rounds, independent case-related reviews, daily educational conferences, weekly literature reviews, and, of course, independent self-directed learning. An emphasis on the development of a compassionate approach to patients and families is a theme throughout the fellowship, and core neuro-ethical issues are covered through formal and bedside discussions.

Each fellow’s training experience is tailored to his/her background and fulfilling the criteria necessary for UCNS Certification. For those coming from a Neurology background this will include required rotations outside of the Neurosciences ICU including the Medical ICU, Coronary Care Unit, anesthesia (for airway management experience), and neurovascular ultrasound.

As each fellow becomes comfortable with his/her clinical role, research will become an increasing priority. Fellows will be encouraged to develop independent research projects and will be mentored in this area. We expect our fellows to participate in the writing of several publications during their fellowship as well as presenting at national/international conferences. The fellows will also be exposed to the general administrative management skills necessary to successfully “run” a Neurocritical Care Unit.

We are invested in the long-term success of each of our fellows, and we will do whatever we can to help our fellows achieve their goals.