Eric S. Rosenthal, MD
Message from the Director
Welcome to the Massachusetts General Hospital, Brigham and Women's Hospital, and Harvard Medical School Fellowship Training Program in Neurocritical Care.
We are proud to be not only the country’s oldest neurocritical care training program, but also one of its most innovative. The outstanding care, clinical and research innovations, and clinical and research leadership provided and generated by our graduates have played a significant role in the transformation of acute and preventative care for patients across the world. To support this educational mission, we have built a program that stretches beyond the walls of the ICU, encompassing training in telemedicine, airway management, bedside emergency ultrasound, transcranial ultrasonography, general critical care, EEG and electrophysiology, bronchoscopy, formal simulation training, international health, guideline and protocol development for clinical practice innovation, and a major component of independent elective time for reinforcing these diverse clinical skills or for mentored academic research in a wide variety of settings.
A unique aspect of our program is the strong individualized mentorship provided to each trainee. I devote substantial effort to the career development of our fellows, recognizing that each of you comes to us with different backgrounds, different strengths and different goals. I work with fellows individually, getting to know them and helping each one of them to identify a uniquely tailored career direction that will lead to substantial professional contributions as well as personal satisfaction. We welcome applicants with a variety of long-term goals, including future clinicians who may be a clinical leader of an intensive care unit, a champion of clinical innovation, an independent federally-funded investigator, or a leader spreading the international mission of neurocritical care federally-funded research. We nonetheless believe that learning and applying a scientifically-based rigorous approach to data analysis, at the bedside and in research, is the foundation for providing outstanding care to the patients of today and improving the care of patients of tomorrow.
Our clinical fellows interact with a variety of faculty, fellows from colleague training programs, as well as a large group of research fellows who join our community to pursue and support cutting-edge clinical research.
We invite you to visit us and help us innovate by joining our team.
What Our Fellowship Offers Prospective Trainees
- Broad and Deep Clinical Training through a core clinical experience in neurocritical care in the Neuro-ICU and additional clinical training in general critical care within the Surgical, Medical, and Cardiac Intensive Care Units.
- Leadership Training via fellow-driven design of Patient Management Guidelines and Protocols.
- Formal Didactic Procedural Training with an established didactic training series encompassing general ultrasound, bronchoscopy, airway management, Transcranial Doppler ultrasound, EEG, and opportunity to build these skills in a dedicated clinical environment.
- Formal clinical experiences for airway management training in an operative environment.
Simulation training for code management, airway skills.
- Diverse research experiences in clinical, patient-oriented, informatics, computational, and laboratory-based research, with a broad and deep list of available mentors.
- Dedicated Flexible Elective Time.
- Multiple Didactic Lecture Series including Neuro-ICU Leadership (Monday), Acute Stroke and Vascular Neurology (Wednesday), General Criticial Care (bimonthly on Thursday), and Neurocritical Care Practice (Friday).
Hospitals & Leadership
Fellows in this program will train at the Massachusetts General Hospital and Brigham and Women’s Hospital and will have access to additional training at Spaulding Rehabilitation Hospitals. Fellows will have significant interaction and collaboration with physicians, nurse practicioners, clinical nurse specialist, therapists, nutritionists, specializing in neurology, epilepsy and neurophysiology, neurosurgery, other critical care disciplines, radiology, neuro-interventionalists, and rehabilitation medicine.
|Neurosciences Critical Care,
Massachusetts General Hospital
|Spaulding Rehabilitation Hospital||Brigham and Women's Hospital|
Faculty, Massachusetts General Hospital
|Neurocritical Care, Acute Stroke, and Emergency Neurology|
|Neurocritical Care and Neuroanesthesia|
|Vascular Neurology and Acute Stroke|
|Faculty, Brigham and Women’s Hospital|
|Neurocritical Care and Acute Stroke|
|Neurosurgery and Neurocritical Care|
|July 2013 – June 2015|
|July 2014 – June 2016|
|July 2015 – June 2017|
|Alumni – A quick look at where some of our recent alumni are now...|
|From left to right, Mary Guanci, RN, nurse clinical specialist; Jonathan Rosand, MD, Director, Neurocritical Care & Emergency Neurology, and Terrance Kummer, MD, Neurocritical Care Fellowship alumni.|
Per United Council for Neurologic Subspecialties (UCNS) eligibility requirements, applicants must be a graduate of a residency program in neurology, neurological surgery, internal medicine, anesthesiology, surgery, or emergency medicine accredited by the Accreditation Council for Graduate Medical Education (ACGME) or the Royal College of Physicians and Surgeons of Canada (RCPSC).
Applicants from a non-neurology background/residency are advised to include a detailed description of their relevant neurology training and experiences in the letter of intent submitted with their CV. Non-neurologist applicants should also include letter of reference authored by a neurologist with whom they have worked and who can speak to their clinical knowledge and skills.
Applicants are also required to successfully complete USMLE Step II CK, CS, and Step III. Canadian physicians and Doctors of Osteopathy who are eligible for licensure may substitute successful completion of LMCC/MCCQE and COMLEX examinations, respectively, in lieu of USMLE examinations.
Our program does accept ECFMG certified physicians and sponsors both J1 and H-1B visas for trainees.
Neurocritical Care Fellowship Training Program Curriculum
Neurosciences ICU Staff
A patient's room in the Neurocritical
Care Facility in Mass General
Mission and Goals
- Broad and deep clinical training inside and outside the neurocritical care environment
- Increasing independence with advancement in training
- Diverse research experiences
- Leadership training via fellow-driven design of patient management guidelines and protocols
- Comprehensive didactic and hands-on procedural training
- MGH Neuro ICU, Red Team (~9 wk)
The Red Team focuses on critical care neurology and neurotrauma patients. It is composed of a Neuro ICU attending, a junior and a senior fellow, a Neuro ICU nurse practitioner, and a neurology resident.
- MGH Neuro ICU, Blue Team (2-6 wk)
The Blue Team focuses on vascular neurosurgery patients and perioperative patient. It is composed of a Neuro ICU attendiing, a fellow, and a Neuro ICU nurse practitioner.
- MGH Neuro ICU, Night Float coverage (3-6 wk)
At night, the MGH Neuro ICU team consists of a fellow (responding clinician for neurosurgical patients and Acute Stroke Team Leader) and a neurology resident (responding clinician for neurology patients)
- BWH Neuro ICU, Critical Care Neurology and Acute Stroke Service (3-5 wk)
The BWH Neuromedicine Team focuses on critical care neurology and acute stroke patients. It is composed of a Neuro ICU attending, a fellow, and a senior neurology resident.
- BWH Neuro ICU, Critical Care Neurosurgery (2-6 wk)
The BWH Neurosurgery Fellow works with the BWH Neurosurgery team, learn indications for neurosurgical procedures, such as EVD and ICP bolts, and performs neurology consults.
Acute Stroke Neurology
- MGH Acute Stroke and TeleStroke Team Leader (2-3 wk)
During this rotation, the fellow will work most closely with the acute stroke attending and residents for acute and non-acute cases that need to be staffed or further evaluated. Patients evaluated for acute intervention are reviewed first with the acute stroke attending of the day, but may ultimately be staffed by the Inpatient Stroke/ICU Consult Neurology Service attending.
- Neuroanesthesia and Airway Management (~4 wk)
During these rotations, fellows are assigned to either the BWH Anesthesia Department or the MGH Anesthesia Department. Skills may begin with bag-mask ventilation and progress to airway assessment for intubation as well as observed endotracheal intubation or laryngeal mask airway placement.
- Surgical Intensive Care Unit (2-4 wk)
This rotation begins with a week of observation in the Ellison 4 SICU, followed by 2-3 weeks in the Blake 12 ICU during which time the fellow is the SICU team leader, supervised by the Surgical Critical Care attending.
Independent Elective/Selective Time (10-18 wk)
- Independent Research with Faculty Mentorship
- Additional Selective Experience Rotations
- International Neurology Elective
- EEG and Neurophysiology
- Intervtional Pulmonary Training
- Affiliated Intensive Care Unit Training
- Surgical Intensive Care Unit (SICU)
- Medical Intensive Care Unit (MICU)
- Cardiac Care Unit (CCU)
- Transcranial Doppler Ultrasound
Weekly Conference with teleconferencing available as needed.
- MGH NeuroICU Conference (Monday 4pm)
- MGH Stroke Service Conference (Wednesday 12pm)
- Fellow Didactic Conference (Thursday 2 pm)
- Brigham & Women’s Stroke/ICU Conference (Friday 1:30pm)
Formal Procedural Training
- Longitudinal general ultrasound training hands-on workshops and didactics
- Formal arterial and venous access training
- Simulation training for code management, airway skills
- Hands-on workshops and didactics in emergency airway management
A patient's room in the Neurocritical
Care Facility in Mass General
Quantitative EEG and
The MGH Lunder Neuro-ICU (www.mghneuroicu.org) opened for patient care in September 2011. The Neurosciences ICU occupies the entire 6th floor of the Lunder Building. Stepping off the elevator, into the Neuro ICU Atrium, the building’s centerpiece is calming and inspiring. The building was designed and constructed using green features and strategies for energy conservation, water efficiency, carbon dioxide emission reductions and sustainable resources to provide the utmost care for our patients and provide a natural environment that can help promote healing. The Atrium has floor-to-ceiling glass walls, and a dozen hanging plants that filter in natural light. Allowing city and river views, bamboo-rimmed patient room line the perimeter of the sixth floor. Clinically, the expansion allowed for a neuromonitoring suite, intended for EEG readings, MRI’s, and CT scans in-house to ensure timely diagnosis and treatment, and less travel for the ICU patients. Along with the expansion of space, all of our inpatient rooms offer specialized features such as ceiling mounted equipment and incorporate imaging stations within the same patient room. These features will allow maximum flexibility within the patient care space and gives the staff the ability to adjust the room according to patient needs
The Brigham and Women’s Hospital Neurological Intensive Care Unit is a 20-bed unit, where patients are managed by the Allan H. Ropper Neuro-ICU Service. The Brigham and Women’s Hospital (BWH) Department of Neurology provides comprehensive neurological care for patient communities locally, nationally and all over the world. The Department’s multidisciplinary staff encompasses65 clinical faculty and over 350 department members strives to provide patient-focused, world-class medical care for the entire spectrum of neurological diseases. The unit enjoys close collaboration between neurology and neurosurgical team members, and state-of the art technology including on-premisis EEG and neuroimaging facilities.
- Advanced Intracranial Monitoring (Microdialysis, Brain Tissue Oxygenation, Cerebral Perfusion Probe Monitoring)
- Arterial Pressure Monitoring
- Central Venous Pressure Monitoring
- Comprehensive Ultrasonography for Volume Status and Cardiopulmonary
- Assessment, and Vascular Access
- Continuous and Quantitative Video EEG
- Direct and Video Laryngoscopy and Adjunctive Airway Management Tools
- Evoked Potential Assessement
- Intracranial Pressure Monitoring
- Noninvasive Cardiac Output Monitoring
- Surface Cooling
- Transcranial Doppler Ultrasound
Partner Training Programs
- Vascular Neurology Fellowship
- Massachusetts General Hospital Epilepsy and Neurobiology Fellowship
- Brigham and Women’s Clinical Neurophysiology Fellowship
- Vascular Diagnostic and Intervention Fellowship Program
- Acute Stroke Research Fellowship
- Stroke and Neuro-ICU Observership
Research opportunities are available throughout our hospital and university network. Prospective applicants are encouraged to form mentored relationships with individual investigators with oversight by program leadership.
Neurocritical Care Studies
Determine whether occurrence of CSD is associated with development of new infarcts and neurological deterioration after aSAH/TBI/MHS
Co-PIs: Eric Rosenthal, MD; Brandon Westover, MD
Investigate the prognostic value of advanced serial assessments (eg EEG, MRI) for predicting long-term outcome in comatose cardiac arrest patients treated with therapeutic hypothermia
Co-PIs: Eric Rosenthal, MD; Ona Wu, PhD
Determine if early advanced MRI and EEG predict recovery in patients with acute traumatic coma
PI: Brian Edlow, MD
Safety of SAGE-547 (allopregnanolone) in subjects in super-refractory status
PI: Eric Rosenthal, MD
ATACH-II (Phase III)
Efficacy of intensive blood pressure control
PI: Josh Goldstein, MD PhD
iDEF (Phase II)
Safety and futility of DFO infusion
PI: Josh Goldstein, MD PhD
GAMES-RP (Phase II)
Safety and efficacy of IV glyburide in patients at risk of developing malignant cerebral edema
PI: Taylor Kimberly, MD PhD
MR WITNESS (Phase II)
Safety of IV-tPA using an MRI algorithm to estimate time of stroke onset for patients with unknown stroke onset
PI: Lee Schwamm, MD
POINT (Phase IV)
Efficacy of aspirin plus clopidogrel versus aspirin alone in preventing major ischemic vascular events following TIA or minor ischemic stroke
PI: Scott Silverman, MD
RHAPSODY (Phase II)
Safety of ascending doses of 3K3A-APC (activated protein C) in patients with moderate to severe acute ischemic stroke who received IV tPA
PI: Natalia Rost, MD
SHINE (Phase III)
Efficacy of intensive insulin treatment in hyperglycemic patients
PI: Chris Anderson, MD
Role of pre-stroke statin use on ischemic tissue fate and clinical outcomes
PI: Natalia Rost, MD
Update: August 2015
The MGH/BWH/HMS Neurocritical Care Fellowship uses the SF Match Central Application Service (CAS) for document collection. Applicants for our July 2017 start should submit all materials via CAS – application documents no longer need to be sent individually to our program address.
The following materials will be requested of you, by CAS:
- CAS Distribution List (On-line Submission)
- Completed CAS application form (On-line Submission)
- USMLE Scores or equivalent score reports
- ECFMG Certificate (applicable to International Graduates)
- Three (3) letters of reference
- Curriculum Vitae (C.V.)
The SF Match CAS instruction manual, available through your SF Match online profile will provide additional information regarding application requirements and the submission of application documents.
If you have any questions regarding the application process, or encounter any problems/concerns related to submitting your application through CAS, please contact:
Mia Falco, Program Coordinator
The application deadline for our 2017-2019 program is February 1st.
Neurocritical Care Fellowship
Lunder 6, Neurosciences Intensive Care Unit
MGH/BWH/HMS Neurocritical Care Fellowship
Program Director: Eric S. Rosenthal, MD
Program Coordinator: Mia Falco
For questions regarding our fellowship program or application process, including the use of CAS for application submission, please contact Mia Falco (firstname.lastname@example.org).