Neurocritical Care Fellowship

The small and selective nature of the programs guarantees ample clinical and academic mentoring is available to trainees. Over the course of the program, fellows receive graded autonomy and are well-prepared to transition into independent neurocritical care practice. Fellows receive structured didactic critical care training as well as clinical- simulator based instruction.

Neurocritical care fellows will acquire broad experience in the management of a variety of neurosurgical and neurological conditions, including:

Expertise is acquired in intracranial pressure monitoring and management, hemodynamic support and augmentation, mechanical ventilation, airway management and the use of continuous EEG in the ICU. Participation in a neurocritical care consult service provides exposure to neuroprognostication after cardiac arrest, neurological complications of medical illness, complications of cardiothoracic surgery and transplant, among others.

Procedural skills acquired include: percutaneous tracheostomy, endotracheal intubation, bronchoscopy, central venous catheterization, arterial catheterization, and use of point-of-care ultrasound for a variety of conditions in the neuro-ICU, including transcranial doppler ultrasonography (TCD).

Rotations

In addition to time in the neuro-ICU, mandatory rotations include:

• Neuroanesthesiology: Fellows receive advanced airway training and gain experience with perioperative neurosurgical management.
• Emergency Critical Care: Fellows rotate through the novel Emergency Department Critical Care Center (EC3), where they participate in the initial resuscitation and critical care of patients with a wide variety of conditions including sepsis, CHF and COPD exacerbations, DKA, cardiac arrest as well as stroke and status epilepticus.
• Surgical ICU: In additional to the management of critically ill general surgery patients, fellows receive exposure to ECMO, which was pioneered at the University of Michigan, and a large population of patients with severe ARDS in this 20-bed unit.
• Medical ICU: Known as the Critical Care Medical Unit (CCMU), this 20-bed ICU cares for a large volume of patients with sepsis, ARDS, pulmonary disease, hepatic failure and other medical conditions.
• Trauma/Burn ICU: Fellows receive exposure to patients with polytrauma, many of whom have varying degrees of neurological injury.
• Cardiothoracic/Cardiac ICU: In the 10-bed CCU and 24-bed Cardiovascular ICU, fellows gain experience with advanced CHF, STEMIs, and a large population of patients with cardiac-assist devices, as well as the postoperative care of patients undergoing cardiac and thoracic procedures.

Elective rotations are also available in a wide range of subspecialties including stroke, EEG and interventional neuroradiology. Many opportunities for clinical research in neurointensive care, neurosurgery and acute ischemic stroke are available and presentation of original research by fellows at national meetings is expected.