School of Medicine

Wayne State University School of Medicine

Neurocritical Care Fellowship Program

Like other intensivists, the neurointensivist assumes the primary care role for his or her patients in the ICU, coordinating both the neurological and medical management of the patient. Hence, the Neurocritical Care Core Curriculum is evenly split between neurological and medical diseases and conditions, and fellowship training may include rotations through non-neurological ICUs. Most uniquely, Neurocritical care is concerned with the interface between the brain and other organ systems in the setting of critical illness.

 

Fellowship training in Neurotrauma and Critical Care Neurology at Detroit Medical Center/ Wayne State University has been in place for more than 15 years.  Education and research are an integral part of providing a continuing service to acutely ill neuroscience patients. Currently, our fellows train at two neuroscience units, the primary unit functioning as a  ‘closed ICU’ model where the ICU team directs all medical management.  The unit is completely staffed and equipped as a critical care area, having routinely a 1:2 nurse-to-patient ratio with resident and fellow coverage and an attending faculty member. The population in the unit consists of patients that are medically or neurologically unstable from the specialty areas of neurology and neurosurgery. 

 

Goals and Objectives

The purpose of the training program is to prepare the physician for the independent practice of

Neurocritical Care. This training is based on supervised clinical work, with increasing patient care responsibility over the course of the training program.

 

Duration of Training and Trainee Appointment

Number of positions: 1-2/year

Duration of Training: 24 months. This period is split into mandatory requirements (15 months) and electives (9 months)

 

Mandatory requirements (15 months):

- Neurointensive care rotations: 11 months
- Medical ICU: 1 month
- Surgical/Trauma ICU: 1 month
- Cardiothoracic ICU: 1 month
- Anesthesiologty: 1 month

 

Elective rotations (9 months):

- Electroencephalography
- Endovascular neurology
- Critical Care Ultrasonography
- Neurosurgery
- Vascular Lab (Transcranial Dopplers, Carotid Dopplers)
- Research
- Pediatric Inteseive Care Unit
- Stroke
- Physical Medicine and Rehabilitation

 

Vacation: 3 weeks of vacation every 12 months. Vacation can only be requested during elective rotations. The fellow is free to add more intensive care months during their elective time.

Eligibility

The trainee must:
- Have a current valid and unrestricted license to practice medicine in the US or Canada.
- 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).

 

Competencies

Fellows are provided with training that provides progressively increasing responsibility for patient management. In addition to the specific cognitive and procedural competencies listed in the Neurocritical Care Core Curriculum the program requires its trainees to obtain competence in the six areas listed below (ACGME core competencies) to the level expected of a new practitioner of

Neurocritical care.

1. Patient care that is compassionate, appropriate, and effective for the treatment of critically ill neurological patients.
2. Medical Knowledge about established and evolving biomedical, clinical, and basic sciences, as well as the application of this knowledge to patient care.
3. Practice-based learning and improvement that involves the investigation and evaluation of care for their patients, the appraisal and assimilation of scientific evidence, and improvements in patient care.
4. Interpersonal and communication skills that result in the effective exchange of information and collaboration with patients, their families, and other health professionals.
5. Professionalism, as manifested through a commitment to carrying out professional responsibilities, adherence to ethical principles, and sensitivity to patients of diverse backgrounds.
6. Systems-based practice, as manifested by actions that demonstrate an awareness of and responsiveness to the larger context and system of health care, as well as the ability to call effectively on other resources in the system to provide optimal health care.
 

Didactic Components

Didactic sessions are held once a week. These are considered mandatory and topics will be distributed among the fellows and faculty. Trainees must also try to attend seminars and conferences in neurology, neurosurgery, critical care, and neuroradiology. Trainees must learn about major developments in both the basic and clinical sciences relating to critical care, neurology, neurosurgery, and neuroradiology.

 

Scholarly Activities

The program provides ample opportunities for the fellows to participate in research and other scholarly activities.