Neurocritical Care Fellowship Curriculum

Clinical Rotations

Neurocritical Care

Core rotations in neurocritical care:

• The Massachusetts General Hospital NeuroICU is a 22-bed ICU
• The Brigham and Women’s Hospital NeuroICU is a 20-bed ICU

At MGH there are two rounding teams: Red team (caps at 14 patients) and Blue team (caps at 8 patients). Both teams cover neurology medical, neurosurgical and trauma patients. At BWH there are two teams: Neurology (primarily covers neurology medical patients) and Neurosurgery (primarily covers neurosurgical and trauma patients).  The fellows rotate through all teams, working closely with a team of APPs, residents, and neurocritical care attendings to provide collaborative and multidisciplinary care to a spectrum of neurology and neurosurgical patients.

Acute Stroke Neurology (2 weeks/year)

During this rotation, the fellow works closely with the acute stroke attending physician and residents for acute stroke cases that need to be evaluated for acute intervention. Fellows also receive training in telestroke and telemedicine.

Neuroanesthesia and Airway Management (4 weeks/year)

Fellows rotate through the Newton-Wellesley Hospital Anesthesia Department. Skills include bag-mask ventilation, endotracheal intubation, laryngeal mask airway placement and anesthesia management.

Surgical Intensive Care Unit (2-4 weeks)

Fellows rotate through the Ellison 4 Surgical ICU and the Blake 12 ICU, supervised by the Surgical Critical Care attending physician.

Independent Elective/Selective Time (10-18 weeks)

• Independent research with faculty mentorship
• Additional selective experience rotations
• International neurology elective
• EEG and neurophysiology
• Interventional 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 Conferences

Weekly Conference with teleconferencing available as needed.

• Mass General Neuro ICU conference (Mondays 4:00 pm)
• Mass General Stroke Service conference (Wednesdays 12:00 pm)
• Brigham & Women’s Neurovascular Case Conference (Thursdays 7:00am)
• Fellow Didactic conference (Thursdays 2:00 pm)
• Brigham & Women’s Stroke/ICU Journal Club (Fridays 2:30 pm)

Formal Procedural Training

• Simulation training at the BWH STRATUS Center: arterial, venous and intraosseous access training; bronchoscopy training
• Annual general ultrasound training hands-on workshops at MGH
• Hands-on workshops and didactics in emergency airway management
• Formal training in bronchoscopy

Training in Multimodal Monitoring

• Advanced intracranial monitoring (brain tissue oxygenation, cerebral perfusion probe monitoring)
• Intracranial pressure monitoring
• Continuous and quantitative video EEG
• Evoked potential assessment
• Noninvasive cardiac output monitoring
• Surface cooling
• Transcranial doppler ultrasound